NORTHEAST – British Columbia is past the peak of H1N1 flu activity, said the provincial health officer, but the Province’s reaction was not overblown and there is still the possibility of another outbreak.

 Dr. Perry Kendall joined Ida Chong, Minister of Healthy Living and Sport, for an update on Jan. 28. There have been no new severe cases or deaths reported in the province since Jan. 19, and Kendall said the peak of flu activity took place between October and November last year. However, he said seasonal flu is usually experienced up until the end of March, and there is a possibility there could be another outbreak of either strain.

 “Influenza is unpredictable, and we probably won’t be able to say with confidence there won’t be any resurgence of either seasonal influenza or H1N1 until the end of March or April,” said Kendall. “The BC Centre for Disease Control is still vigilantly monitoring for a possible resurgence.”

 He added while it’s not expected there would be a significant resurgence, people who have not already been vaccinated should do so as a precaution. He said H1N1 is likely to be the dominant strain of flu circulated in the foreseeable future.

 He said it was the first influenza pandemic in 40 years, and although some might assume a pandemic means a “killer flu,” that’s not the case. He said a flu pandemic means a novel strain of the virus to which all or a large proportion of the global population is susceptible, but one that can vary in severity of illness and death that it may cause. Kendall said the World Health Organization was not wrong in declaring a flu pandemic, and governments were not overreacting to take the steps they did to prepare.

 “The declaration of H1N1 as a pandemic gave us the opportunity to be proactive and manage this virus across Canada before it had a chance to have a greater impact in regards to illness and death,” he said.

 He added he believes more lives were saved and serious illness averted because the Province had a strategy in place, including providing the vaccine and antiviral drugs at no cost to the public, and facilitating early access to treatment, especially for those with underlying medical conditions or who were pregnant.

 “We might have had double the rate of illness and death without that strategy in place.”

 Kendall said while the majority of cases in the province, and globally, were mild to moderate in severity, the BCCDC has confirmed 1,032 severe H1N1 cases since April 2009, with about 20 per cent of those cases requiring intensive care, and 51 deaths related to the virus. Of the deceased, 53 per cent were ages 45 to 64, 18 per cent were between the ages of 20 and 24, and 20 per cent were over 64 years old. Of those fatalities, 47 cases had underlying medical conditions, five had none, and three are still being investigated.

 The BCCDC compared those numbers to data from new Zealand, which has a population similar in size and make-up to British Columbia, and despite a rate of exposure more than twice that experienced in that country, both jurisdictions had nearly the same mortality and morbidity rates.

 Kendall said they realized early on that H1N1 was not like seasonal flu in that it wasn’t targeting the elderly, but instead younger people were being hospitalized, and in about a third of those cases the patients had no underlying risk conditions. However, he said although the highest rates of laboratory-confirmed cases occurred in people under 20, young people aged five to 19 had low rates of complications leading to hospitalization. He said that is why they didn’t target children for access to the first shipments of vaccine.

 Kendall said in an ideal world, they would have had the vaccine available for everybody sooner, but added this was the only time in history a vaccine was available while a pandemic was still underway.

 He said they were aiming to have about two-thirds of British Columbians immunized, but they estimate only about 40 per cent of the population received the vaccine. He said perhaps many British Columbians were skeptical, or when the vaccine was made available in November many might have assumed the danger had already passed, but he said he didn’t know why so many people chose not to get vaccinated.

 Kendall said in the future, they will work with the federal government to secure larger supplies of vaccine. He said information provided to the public and the media could have been clearer, but some of the confusion was due to changing circumstances. He added one of the positives was the co-operation with First Nations communities and health officials, which he said resulted in less anxiety and less illness and death as seen in some remote communities in other parts of the country.

 The provincial government budgeted $80 million to deal with the pandemic, and Kendall said $13 million was spent on vaccine, through a cost-shared agreement with the federal government. He said the remaining $66 million was and continues to be used to pay for antiviral medications, doctor’s visits, and to cover the cost burdens incurred by the regional health authorities. He said about 750,000 doses of vaccine have been loaned to Mexico for their immunization program, but those doses could be replaced if needed. He said the BCCDC still has about half a million doses, and the vaccine is still available through local hospitals, health clinics and qualified pharmacists.