Image Credit: ADOBE STOCK

Internal memos and reports about last year’s meningitis outbreak in the Okanagan show just how uncommon such disease outbreaks are these days.

The outbreak was declared just before Christmas in 2017 and involved 11 cases in the Okanagan, with a twelfth elsewhere in the Interior Health Authority. One Oliver teen died, although it is unclear if it was from meningitis or another medical condition, according to a report from Global News. In Vernon, a teenage girl was in serious condition for weeks but survived. 

A Freedom of Information request by iNFOnews.ca into reports and memos about the outbreak shows an intense several weeks as health authority staff launched a mass immunization and public messaging campaign to limit the contagion. 

LAST OUTBREAK IN B.C. WAS 17 YEARS AGO 

An epidemiology report from Jan. 15, 2018 notes that since 2001, there were between zero and two cases of “serogroup W” in B.C. — with the exception of 2005 when there were four cases. For some reason, that specific strain burgeoned in 2017, with 16 cases in B.C., including 10 in Interior Health specifically. The other areas with reported cases were Fraser Health Authority, Vancouver Health Authority and Island Health. (For the number of invasive meningitis cases in B.C. annually, including all strain types, go here. You will see the number is on a downward trend overall.)

According to the epidemiology report, outbreaks of meningitis are not common in B.C. The last one was in 2001 in Abbotsford when seven individuals became sick and two died due to a serogroup C strain. Since an immunization program began in 2008, only one serogroup C case was reported in a person under 25.

Deborah Preston, health services administrator for communities in the Okanagan, worked closely on the meningitis file and says it was the first outbreak in her career. Despite the new territory, she says the health authority was able to implement its incident command structure — the same strategy it uses for emergencies such as wildfires — to make sure everyone knew their role and kept things on track.

“It was amazing, the nurses, medical health officers, administration — everybody just pulled up their boots and hit the ground running,” Preston says.

As further proof of the enormity of the workload, our Freedom of Information request detected some 700 emails sent between key staff regarding the outbreak specifically, and 1,500 emails regarding meningitis in general. iNFOnews.ca asked to see those emails, but was given a large fee estimate.

OUTBREAK ORIGIN WAS NEVER DETERMINED 

The 72 pages of internal memos and reports Interior Health did release show regular updates on the inventory of vaccine, where to store it, progress reports on the number of immunizations achieved, and the preparation of communications materials such as news releases, infographics and Q&A’s for the website, as well as a bulletin on musical instruments in schools and infection prevention. The bulletin advises that students should own their own instrument and mouthpiece — if possible — and must have their own individual reeds. According to the document, the Interior Health Communicable Disease Unit team will be developing a B.C. specific local guideline for schools. Preston says the bulletin was a preventative measure and there was no evidence to suggest musical instruments contributed to the outbreak.

All information about the individuals who got sick was redacted for privacy reasons and none of the documents discuss the cause or origin of the outbreak. One report from Feb. 6, 2018 references "challenging questions from the media about the individual in Oliver who passed away." 

According to Preston, the health authority did investigate the outbreak, however was not able to trace it back to “patient zero.”

“We know there were some linkages,” she says.

She was unable to comment on any further investigative findings the medical health officers may have uncovered.

According to a Dec. 28 situation report, Interior Health received some complaints about “mature minor consent forms” and confidentiality in school settings. Preston says most of the challenges around consent forms were due to logistical challenges with international students. Other students did not consent to being immunized, but Preston did not say how many.

“Overall we were quite happy with the uptake during the outbreak,” she says.

In 2017 during the regular Grade 9 immunizations, roughly 20 per cent of students did not get the vaccine, and Preston says that percentage was lower during the outbreak.

Overall, more than 11,000 individuals were vaccinated during the outbreak. Interior Health didn’t have to pay for the vaccine (it came from the B.C. Centre for Disease Control) and Preston says the cost of the outbreak on the health authority was around $200,000, primarily in staff time and setting up immunization clinics.

She says one of the most interesting take-aways from the outbreak was the use of social media during the campaign.

“It played a big role. I was at a clinic where a mom brought her daughter in and she said she learned about it on Facebook. It was an interesting experience for me to see the role social media played in this,” she says.

She says some of the questions received via social media helped staff clarify their messaging or put new information out.

“It’s helpful to know what people are thinking and asking,” she says.

To contact a reporter for this story, email Charlotte Helston or call 250-309-5230 or email the editor. You can also submit photos, videos or news tips to the newsroom and be entered to win a monthly prize draw.

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News from © iNFOnews, 2018