H1N1 vaccine key for future outbreaks, Montreal officials say

Health officials in Montreal are urging people to get vaccinated against the H1N1 virus because they expect the next outbreak – either this fall or winter – to be as widespread as the wave of infections that spread across the island last spring.

At least 1,280 Montrealers contracted  H1N1 (type A) this year when the virus hit North America, according to figures released by the city's public health agency Tuesday.

The Montreal cases represented nearly half of all reported infections in Quebec, and 18 per cent of all known Canadian cases.

Twelve people among infected Montrealers died from the virus. The majority of patients hospitalized were under five years old, or older than 60, or women.

Widespread vaccination is important because of the range of reported infections earlier this year, the public agency said.

The vaccine will be offered free of charge to all Quebecers later this fall.

Agency mapped the spread of H1N1

Epidemiologists spent the summer reviewing data collected from reported cases and found the outbreak peaked in late spring before subsiding at the end of June. 

They used patients' postal codes to map the breakout, and traced its trajectory from Montreal's West Island to the east end.

There was a higher incidence rate in lower-income neighbourhoods, said Dr. Richard Lessard, head of the public health agency.

That can be explained in part by more crowded housing conditions, he said.

Epidemiological information will help health officials better track any outbreak this fall or winter, Lessard said.

He said there could be as many as 10 to 15 per cent more cases of H1N1 virus infections in coming months.

"As we [move] toward the winter, the only stop that we can imagine is the Christmas vacation," he said at a news conference in Montreal. "So we will probably get, as we go along, more cases, I expect.

"But it's only a guess."

The outbreak ebbed at the end of the school year, but health officials are not drawing a direct link between the two.

The agency is still reviewing the idea of closing schools if needed in case of a massive outbreak of the H1N1 virus.

Quebec First Nations brace for H1N1 outbreak

Health directors in First Nations communities say they're better prepared for an expected wave of the H1N1 this fall.

Chronic overcrowding, language barriers and isolation contributed to higher than average infection rates among Quebec's First Nations communities.

But efforts to educate the public have paid off, said Jason Coonishish, co-ordinator of prehospital and emergency measures for the Cree Regional Health Board.

"People are more educated now with the washing hands and coughing," Coonishish told CBC News. "They're educated and they even stay away from somebody who is coughing."

Special provisions are being made to address overcrowding, he added. Anyone who is diagnosed with the H1N1 flu will be kept in special isolated rooms.

Language was an issue in the spring, when regional health officials had trouble communicating with their provincial counterparts.

"English managers [in the communities] didn't get information on a timely basis" because updates were being sent from the main provincial health agency, where French is the working language, said Marjolaine Sioui, a worker at the Assembly of First Nations' Health Commission.

"They do get communiqués and regular updates from the Quebec system network, they work with the agencies, but when they get it, it's in French."

That barrier should be less of a problem this fall and winter after Health Canada agreed to pay for translation needed in Quebec's First Nations communities, Sioui said.