Meningitis risk low, Treaty 8 told

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Alberta Treaty 8 Health Authority has delivered a strongly worded request for meningitis vaccinations in the region to Dr. Harry Hodes, assistant regional director of the Medical Services Branch of Health Canada, but is unsatisfied with Hodes' answer.

The March 15 letter said in part that Treaty 8 leaders expect Hodes to honor his "responsibilities under the Public Health Act and on behalf of the Crown for the health of the descendants of the signatories to Treaty 8, by ordering an immediate meningitis vaccination program." But the government's position is there is "no indication in the Treaty 8 area for the use of meningococcal vaccine," according the Marion Perrin, regional nurse epidemiologist with MSB.

According to Clifford Freeman, Treaty 8 Health Authority vice-chairman, "they're taking an attitude that really there was no real emergency, and they also outlined some precautions to take. . . . In some ways (it's) a relief, but in some ways it's not really clear to us, because it was a major concern in Alberta in terms of them having a major immunization program." He added "The reason why we sent the letter mainly was in the event something does happen (MSB would) be held accountable."

In fact, 16 cases of meningitis were reported in the Capital Health Authority region since December and two teenagers have died. That prompted authorities to set up a vaccination program Feb. 15 for 15 to 19 year olds, which was expanded a couple of days later to include children two to 14. Crossroads Regional Health Authority was added to the program Feb. 17, and a second round of inoculations was done Feb. 23 to 28 in the Capital Health region. Medical Services Branch then inoculated children in the Treaty 6 communities of Hobbema, Enoch, Paul, Alexis and Alexander.

Freeman said although his health authority "did push (MSB) a little bit," they didn't get much political support from the chiefs. He added that unless MSB is subjected to "a real outcry from leadership, well then they tend to just ignore it."

Hodes acknowledged Treaty 8 Health Authority's letter in writing, Freeman said. "Personally I wasn't very satisfied . . . . I still feel they're responsible to make sure the health and safety of First Nations are intact."

He says that prevention and the possibility of saving even one life are reasons enough to vaccinate, and didn't think rural communities should be overlooked just because the population is low.

Verna Hatfield, executive director at Treaty 8 Health Authority, reiterated Freeman's concern for youth from rural northern communities who come south for hockey tournaments or school, so are in close contact with youth in the area of the outbreak. She said Health Canada assures them the scare is over, but "there's different strains (of meningitis) up North."

Marion Perrin explained the reason MSB only vaccinated some Treaty 6 First Nations was "because they were in the geographic location for where there was an indication for vaccine." She said "just because you travel into the city and might play hockey or be involved in sports activities is not an indication for meningococcal vaccine. The Alberta Winter Games happened during the time of the vaccine delivery, and there was no vaccine delivered to the young people or travellers to Sherwood Park, which was very much a part of the geographic area where vaccine was delivered.

"The message for hockey teams and sports teams," Perrin continued, "is a prevention message, around not sharing water bottles and good hand washing. So those are the messages that are given to sports teams, not just for meningococcal meningitis, but as a way of preventing many diseases which tend to be spread by saliva or respiratory contact."

Perrin says what they know about meningococcal meningitis is that "it is transmitted through saliva . . . and through sharing cigarettes, drinking utensils, and those are significant ways of potentially acquiring the disease." Sharing lipsticks too, she said.

nother thing,,"Meningitis is one of the diseases that's reportable within the province, and I'm not aware of a whole bunch of meningitis," she said. "There are a number of viruses that may cause meningitis, and that may be what individuals are talking to, but that's a different process than bacterial meningitis, which is what meningococcal mengitis is.

"If you have a viral meningitis, you certainly can't use antibiotics, and it's not as severe and doesn't have the same potential sequelae, or post-meningitis problems. Most people with viral meningitis will recover completely," said Perrin.

She said the recent vaccination program only went where an actual risk was identified "and it's based on . . . a good scientific and public health indication for the use of the specific vaccine that we were using." In this case the 15-to-19-year-olds were targeted.

Perrin added that the type of vaccine they used in February is not routinely recommended, it's only for outbreaks. Misuse, she explained, could contribute to the development of a more severe form of meningitis that they wouldn't be able to treat.

"The two-to-14-year-olds in those areas were added in an attempt to allay parental concerns," Perrin said, adding that the reason the younger group was innoculated was because of "parental and political pressure." She said the reason Health Canada did not consider the younger children at risk in this outbreak was because only the older ones were getting sick. With this type of meningitis, usually the "very young ones will get it first and then it starts to show up in the older ones, and that didn't happen."