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Outbreak of Hepatitis A on Vancouver Island Hitting Aboriginals Hard

A Hepatitis A outbreak is hitting aboriginal communities hard on the west coast of Vancouver Island.

Aboriginal people on the West Coast of Vancouver Island are being hit hard by an outbreak of Hepatitis A, according to Vancouver Island Health Authority (VIHA) chief medical health officer Paul Hasselback.

“Of the last 17 cases that were diagnosed, 15 of them are from the Alberni Valley and West Coast,” Hasselback said in early December. “We've seen clusters of Hep A in various locations, but right now the cluster is there.”

Ninety-one cases of Hepatitis A have been diagnosed on Vancouver Island so far this year, Hasselback said. Although he said the aboriginal population has been hit particularly hard, he would not disclose any numbers.

Socio-cultural factors such as close family and children-to-children interaction, as well as interaction generated by cultural activities, create conditions in which Hepatitis A can spread with greater frequency, Hasselback said.

According to VIHA's website, hepatitis A is caused by a virus that affects the liver. This virus is found in the feces of infected people and is spread through close personal contact or via contaminated food that has been handled by an infected person. Symptoms include fever, tiredness, loss of appetite, nausea, vomiting and abdominal pain.

“It very uncommonly results in death or liver failure,” the site notes.

VIHA officials are working closely with Nuu-chah-nulth Tribal Council health staff in a public education and immunization initiative. The tribal council is the political and public service arm for 14 tribes on the west coast of Vancouver Island.

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Vigorous tracing is being done by VIHA staff to find patients’ closest contacts and vaccinate them against the disease. Aboriginal communities on the island were already undergoing hepatitis A vaccinations as part of a province-wide program. More than 8,000 people on Vancouver Island have been given Hepatitis A immunizations so far this year.

But now the disease is infiltrating a younger demographic.

“Of those 15 [diagnosed], nine of them are under age 19,” Hasselback said, adding that few cases are commonly diagnosed among people over 30. “Older people usually have developed an immunity to it already.”

The outbreak started in early August, Hasselback said. It originated in Cowichan, VIHA spokesperson Shannon Marshall said. VIHA officials have declared it an outbreak because of the rapid spread of the disease.

“It's spreading beyond patients' immediate circle of contacts,” Hasselback said. “We don't have full control of it yet.”

The Hepatitis A outbreak is different than the tuberculosis eruption three years ago in which more than 45 people were infected, Hasselback said.

“This [Hepatitis A] is not about hygiene of overcrowded conditions,” he said. “This is about socialization.”

But VIHA’s experience with the TB outbreak created tools and a logistical framework that it is drawing on in response to the Hepatitis A outbreak, Hasselback said.