Hepatitis A is highly contagious and on the rise in rural Manitoba

A needle and syringe used to administer vaccines is shown. THE CANADIAN PRESS/Tara Walton

WINNIPEG – Hepatitis A is highly contagious and on the rise in Manitoba.

According to the province’s latest bulletin, there have been 658 cases of the virus since an outbreak began in northern Manitoba last year, and 143 of those cases are in Winnipeg.

One-hundred forty-two people have been hospitalized, five people have been admitted to the intensive care unit (ICU) and four people have died.

Denise Bear says some residents in Peguis First Nation, about 160 kilometres north of Winnipeg, have recently seen a rise in symptomatic cases.

“More cases have risen since July,” said Bear, who is the nurse in charge at the health centre in Peguis First Nation. “We’re ordering vaccines, and we’re asking people to come in and get immunized for hepatitis A.”

Hepatitis A is an acute liver disease caused by the hepatitis A virus.

The province says hepatitis A can spread through contaminated water, food, and close contact with someone who has the infection.

While some people, including young children, may show no symptoms, others can experience illness ranging from mild to severe.

The province says some symptoms include:

• Fever
• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark urine

People infected with hepatitis A can spread the virus for up to two weeks before symptoms appear, and for roughly one week after jaundice or other symptoms develop.

Epidemiologist Dr. Christopher Labos says hepatitis A differs from hepatitis B and C, because it rarely causes chronic liver damage.

He says the infection is primarily short-lived and people do recover.

“It’s very common and most people of a certain age probably got hepatitis A infection and may not have ever even realized it,” he said.

Labos explained that hepatitis A is most commonly transmitted through the fecal-oral route, often due to poor hand hygiene.

“They go to the bathroom, they don’t wash their hands, and they then touch food or handle somebody else’s food or touch their face, and then introduce the virus into that person,” he said.

Bear says those conditions are contributing to the spread in Peguis First Nation.

“It can be improper handwashing, water can be contaminated, and there can be improper sanitizing of the bathroom,” she said.

She also stressed that hand sanitizer alone is not effective against hepatitis A and recommends thorough handwashing with soap and water.

“It’s easily preventable,” she said. “Get vaccinated, do proper handwashing and sanitizing of the bathrooms, wash your fruits and vegetables and make sure your water is tested.”

Cases primarily in rural, northern communities

Back in November, Garden Hill First Nation declared a state of emergency due to the rise in cases in that community.

Since then, the province has expanded free vaccine eligibility for anyone aged six months and older in several First Nations communities. They are also offering free vaccines to staff and volunteers of non-health care, community based organizations in Winnipeg who serve people experiencing homelessness.

Caroline Chartrand says there are a number of factors that lead to higher case counts in First Nations communities, but says a lack of proper infrastructure plays a key role.

“What we’re seeing is crowded housing conditions, the lack of access to clean drinking water, there are some issues with sewage disposal,” said Chartrand, who is the senior nurse advisor at Keewatinohk Inniniw Minoayawin Inc. (KIM), which supports health and wellness services for 23 First Nations in northern Manitoba.

“Because of the contagious nature of the virus, what you see is the population living in close quarters, and you’ll have like 10-to-15 people living in the same household, so there’s more chance the virus spreads.”

Chartrand says she would like to see a more proactive approach from both the provincial and federal governments to help prevent the spread from worsening.

A spokesperson from Indigenous Services Canada (ISC) told CTV News, they are working closely with Manitoba health and local leadership to respond to the outbreak.

“We have been supporting community-wide vaccination clinics,” a statement reads. “We are also reinforcing safe water and sanitation measures and sharing culturally relevant health information on prevention.”

“We remain committed to working with First Nations leadership and health partners to contain this outbreak and protect community wellness.”

Chartrand worries case numbers could climb higher during the summer months if stronger preventative measures are not implemented soon.

“To keep our most vulnerable population safe, we need to get them vaccinated,” she said. “We need to protect our elders, our children, our pregnant moms, and all First Nations people.”