Meningitis outbreak threatens reserves

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An outbreak of meningitis in Manitoba and Saskatchewan resulting in the death of five children has prompted a massive immunization program in the two provinces.

A total of 77,000 children, on all reserves in Manitoba, in Saskatoon, and seven northern communities in Saskatchewan, will be vaccinated against meningococcal meningitis during the intense three-week campaign.

Eleven cases of the disease have been recorded on Manitoba reserves since January, compared to an annual average of one to four cases. In Saskatchewan, 24 cases have surfaced in the general population, compared to an average of six to 12.

Meningitis is an infectious disease that causes swelling around the brain. Symptoms include a sudden fever, headache, stiff neck and nausea. Immediate medical attention and antibiotic therapy are used to combat the illness.

Three children have died in Saskatoon this year as a result of meningococcal meningitis, a one-year old, a two-year old, and a 12-year-old, all from low-income districts in the city. Immunization clinics are being established at local schools and public health clinics for children aged two to 19.

Similar clinics are being managed by community nurses in Wollaston, Black Lake, Fond du Lac, Stoney Rapids, Uranium City and Camsell Portage. A total of 52,000 children will be vaccinated by mid December.

Approximately 25,000 children in Manitoba aged six months to 19 years have been targeted in an effort to stem the spread of meningococcol meningitis. Children in Nelson House and Sandy Bay reserves were immunized immediately during the summer following the deaths of a six-month-old infant and three-year-old child from the disease.

A total of six cases were recorded on the two reserves, with seven more cases appearing on Ebb and Flow, and God's Lake Narrows reserves.

Dr. John Guilfoyle, Manitoba's chief medical officer, believes the poor living conditions prevalent on reserve puts residents at higher risk of contracting meningitis.

Meningococcal meningitis is spread through close contact with saliva from an infected person. Sharing cutlery, cigarettes and toothbrushes can spread the germ from one person to another. On many reserves and isolated communities sanitation levels are

at best poor, mostly due to lack of running water.

"The lack of optimum sanitation facilitates the spread of communicable diseases," said Guilfoyle. "One would like to think that we could avoid these situations by addressing some of these conditions that exist on these communities."

Reserves and reserve-like residents that live in relative isolation are also more at risk of contracting a disease such as meningitis because they lack the immunity city populations attain, said Guilfoyle.

"The population is exposed to all the bugs that are floating around in cities," he said. "So people in remote areas don't have the same immunity profile as in the city."

And bugs like meningitis are always in the air. People develop stronger immunities as they come into contact with them, which is why children and adolescents are more at risk of contracting and suffering acute cases of meningitis, explained Guilfoyle.

But there are serious questions as to how effective the vaccine is. There is no doubt that its effectiveness is dramatically reduced in children under the age of two, who are at most risk of dying or suffering lasting complications from contracting meningitis.

And the vaccine is only effective for three to five years, as opposed to other vaccines that grant life-long immunity, such as the measles vaccine. The immunization

also does not cover for certain types of meningitis, Type B specifically, which appears

to be on the rise.

Despite the limitations, medical surveys show mass immunization against meningococcal meningitis proven to be effective in preventing the spread of the deadly disease. Phil Fontaine, Grand Chief of the Assembly of Manitoba Chiefs has appealed to

all First Nations community members to take pat and ensure a 95 per cent immunization rate.

Approximately 400 meningococcal meningitis cases are recorded annually nation-wide. Large scale immunization against the disease is usually initiated only when disease rates reach three times the average. The immunization programs are being funded through provincial and federal health agencies.