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Nunavut infant deaths, flu outbreak revive drug debate

The Canadian Press
Published Friday, March 11, 2011 6:56AM EST

IQALUIT, Nunavut - A flu-like illness that has swept through half of Nunavut's communities and which is suspected in at least two infant deaths is renewing a debate on whether the territory should distribute a drug to all its newborns. 

More than half of Nunavut's 26 communities have experienced outbreaks over the last couple of months, says Isaac Sobol, the territory's chief medical health officer. 

Some communities have been hit especially hard. 

Sanikiluaq, on the Belcher Islands in southern Hudson Bay, has had more than 50 of its 750 residents flown out for medical reasons. 

"In a few of our communities in the past couple of weeks they've been very busy with seeing patients who have flu-like symptoms," Sobol said. " It seems to be a bit better now." 

But the member of the legislature for Igloolik, where two infants died within days of each other, says it's time for a public inquiry into the cause of the outbreak.  The territory is still waiting for autopsy results. 

"I am asking whether or not they will try to get to the bottom of this so that everybody will know exactly what happens," Louis Tapardjuk told the territorial legislature. 

Nunavut Health Minister Tagak Curley received a similar request from Igloolik's hamlet council. 

Tapardjuk also told the legislature that a third infant had died in Arviat, although Sobol couldn't confirm that. 

He said most of the infections seem to be various strains of influenza.  He did acknowledge the presence of respiratory syncytial virus, a serious infection that can be fatal and puts one in four infant sufferers on life support. 

"We have had some cases of RSV that have been documented this year," he said. " I wouldn't say they're unusual." 

Medical researcher Anna Banerji, who has extensively studied respiratory disease in the Arctic, said RSV is the probable culprit for most of the sickest children. 

"It's atypical for influenza alone to put kids in the hospital," she said. 

"It sounds like at least some of it is RSV.  Even (in the case of) H1N1 -- and we've been tracking this for the past year -- the sickest kids were not the ones with H1N1.  The sickest kids were the ones with RSV." 

Banerji repeated a call she made last year for the territory to provide a preventative antibody called palivizumab to all newborns, as recommended by the Canadian Pediatric Society. 

"Every two to four kids you treat, you can keep a kid out of hospital." 

Last year, the pediatric society recommended that "consideration should be given" to administering the antibody to all full-term Inuit infants younger than six months of age at the onset of the RSV season in the North. 

Even though the treatment costs about $6,500 per infant, that's still cheaper -- and less traumatic -- than flying babies to Iqaluit, Ottawa, Yellowknife or Edmonton when they get sick, said Banerji. 

Sobol said the territory's current policy of providing the flu vaccine to anyone who asks is enough.  It also gives palivizumab to infants who are premature or suffer from chronic heart or lung conditions. 

"We continue to review our program," he said. " If we find evidence of any need for a change, that's when we might make that change." 

Banerji warns that the RSV season in the North is just beginning.  After two quiet years, she said, this year is expected to be worse. 

"We were expecting this year to be a bad year ... The rates of RSV are many, many, many times higher than in the south."