In a follow-up on the hepatitis A outbreak in Manitoba, Canada, as of June 4, there have been 784 cases of hepatitis A virus reported since September 2024, mainly spread through person-to-person contact. Inadequate infrastructure for sewage and water in some remote communities has contributed to ongoing transmission. There have been 165 hospitalizations, eight intensive care unit admissions and four deaths.
Manitoba Health, Seniors and Long-Term Care announced this week updated criteria concerning eligibility for free vaccines.
The updated criteria are in response to the ongoing hepatitis A outbreak in Manitoba. The outbreak initially affected several communities in northern Manitoba and has evolved in recent months to include cases in several communities across Manitoba. In addition, an increasing number of cases have been identified in Winnipeg, particularly among people experiencing homelessness and those with connections to other outbreak communities.
Hepatitis A and the Hep A vaccine
Under the updated program, children born on or after Jan. 1, 2010, who are at least six months of age, are eligible for two vaccine doses if they:
live in an Indigenous community in Manitoba;
travel regularly to Indigenous communities; or
have household visitors from Indigenous communities.
All individuals aged six months and older from the following group remain eligible for a single dose of hepatitis A vaccine under the outbreak eligibility criteria:
community members in the Island Lake area (Garden Hill, St. Theresa Point, Wasagamack and Red Sucker Lake First Nations), Peguis First Nation, War Lake First Nation (also known as Ilford), Bloodvein River First Nation, Ebb and Flow First Nation, Cross Lake First Nation (Pimicikamak Cree Nation) and Tataskweyak Cree Nation (Split Lake Cree First Nation);
anyone travelling to or working in these communities;
people who have household visitors from these communities;
staff and volunteers of non-health-care community-based organizations in Winnipeg that serve people experiencing homelessness; and
inmates of correctional facilities.
Hepatitis A is an acute liver infection caused by the hepatitis A virus (HAV). The infection can easily be spread to others by drinking water or eating food that has been contaminated by the feces (stool) of an infected person. Hepatitis A is common in areas where there is poor sanitation.
Some people infected with hepatitis A, especially young children, have no symptoms. Others can develop a range of symptoms from mild to severe. If symptoms do develop, the onset is abrupt, and can include the following:
fever
loss of appetite
tiredness
nausea and vomiting
stomach cramps or abdominal pain
diarrhea
dark urine and/or clay-coloured stools
jaundice (yellowing of the skin and eyes)
Symptoms of hepatitis A usually develop within 14 to 28 days after being exposed to the HAV but can occur up to 50 days after the exposure.
Depending on the severity of the illness, those with mild symptoms often recover within one to two weeks. The illness can be more severe in some people, especially in those that have a weakened immune system, those with chronic liver disease, and people over the age of 60 years. Those with a severe illness can have symptoms for several months.
Hepatitis A does not cause chronic liver disease. However, in rare cases, it can cause fulminant hepatitis (acute liver failure), which may be fatal.
People infected with hepatitis A can spread the disease to others during the two weeks before symptoms develop, and generally up to one week after jaundice or other symptoms develop. Those without symptoms can also spread the disease to others while they are infected.
