A recent surge in hepatitis A cases in Manitoba has prompted the United States Centers for Disease Control and Prevention (CDC) to issue a Level 1 travel advisory for the province. This advisory comes in light of over 100 new cases reported in just the past month, raising the total number of infections linked to the outbreak to 784 since it began in April 2025. Authorities are stressing that these developments should not deter travel to the region.
Rising Case Numbers
The CDC’s advisory was announced on June 4, coinciding with the latest figures from Manitoba’s health officials, which indicated a notable rise in cases from 658 reported in early May. Dr. Brent Roussin, the Chief Provincial Public Health Officer of Manitoba, highlighted that the advisory serves merely to inform, rather than to dissuade travel. “This response is really just echoing the communications that we’ve been sharing with our partners and through jurisdictions in Canada,” Roussin explained. “There is no reason to consider deterring travel.”
The outbreak has disproportionately affected Winnipeg, with nearly a quarter of the reported infections—186 cases—occurring in the city. Alarmingly, the health department has also reported that since the outbreak’s onset, 165 individuals have been hospitalised, including eight who required intensive care. Tragically, the outbreak has claimed four lives.
Understanding the Outbreak
The hepatitis A outbreak first emerged in several northern Manitoba communities, primarily driven by inadequate sanitation and water access. Dr. Roussin pointed out that the virus has since spread beyond these initial areas, affecting vulnerable populations, particularly those living in precarious housing and shelters. Individuals who use drugs or engage in substance abuse are also at heightened risk.
Hepatitis A is a viral infection that primarily impacts the liver, causing symptoms such as nausea, vomiting, dark urine, and jaundice in some cases. While it is not part of Manitoba’s routine vaccination programme, the province is actively increasing eligibility for the hepatitis A vaccine. This vaccine can be administered to prevent illness both prior to and shortly after exposure to the virus.
Vaccine Eligibility Expansion
In a proactive move, Manitoba has expanded the list of communities eligible for the hepatitis A vaccine. As of May 28, the Tataskweyak Cree Nation (Split Lake Cree First Nation) became part of this initiative. Earlier in May, Cross Lake First Nation (Pimicikamak Cree Nation), Ebb and Flow First Nation, and Bloodvein First Nation were also added to the list. War Lake First Nation (Ilford) became eligible in April, while Peguis First Nation was included in February.
Individuals travelling to, working in, or having visitors from these communities are strongly encouraged to get vaccinated. Moreover, inmates in correctional facilities and staff or volunteers from community-based organisations serving the homeless population in Winnipeg are also eligible for vaccination.
Dr. Roussin stated, “We’re always looking at where are we seeing transmission occur, who’s likely going to be at risk for the next transmission cycle.”
Expert Insights on Outbreak Dynamics
While experts acknowledge the gravity of the situation, Dr. Isaac Bogoch, an infectious diseases specialist, believes the outbreak is unlikely to spread significantly beyond its current demographic. He noted that data suggest the virus is not infiltrating the general population at large, indicating a containment within specific communities with limited access to resources.
“It appears this is among a community that is predominantly in shelters, in low-income and low-resource settings and settings that have poor infrastructure for sanitation and hygiene,” Bogoch remarked. He advocates for a targeted vaccination approach, asserting, “If the population is largely restricted to Manitoba, then it’s probably going to stay in Manitoba.”
Despite the rare occurrence of fatalities, Bogoch cautioned that adults infected with the virus can experience severe illness. “It’s the kind of thing where some people say, ‘it’s not going to kill you but you’ll wish you were dead,’” he added, underlining the importance of vaccinations in mitigating the outbreak’s impact.
Why it Matters
The ongoing hepatitis A outbreak in Manitoba serves as a stark reminder of the vulnerabilities faced by marginalised communities, particularly regarding access to sanitation and healthcare. The situation calls for immediate action and attention from public health officials, not only to protect those at risk but also to prevent wider dissemination of the virus. Ensuring equitable access to vaccinations and health resources is critical in safeguarding public health and addressing disparities in healthcare delivery.
