Island Health has reported one more case of a rare bacterial infection that was declared an outbreak last month after spreading among homeless people in Victoria, Nanaimo, and Parksville. 

Haemophilus influenza type B (Hib) is, in spite of its name, a bacterial infection that predominantly occurs among infants and children under five, but this year has been spreading among adults who are unhoused and use substances on the Island. Hib can cause life-threatening conditions like meningitis and blood poisoning when left untreated. 

The disease was all but eradicated by childhood vaccinations, and has only surfaced once a year or less over the past decade on Vancouver Island. Since late 2021, there have been nine cases and one Hib-related death, according to Island Health. 

Of those nine people, the health authority said most needed to be hospitalized, and all were given antibiotics to treat their infection. Their ages ranged from mid-20s to mid-70s. 

At last count in December, there were 17 cases of Hib across BC—though no other health authority declared an outbreak—and two related deaths. The provincial health ministry has not answered Capital Daily’s request for an updated BC-wide case count. 

As a preventative step, Hib vaccines were added to the rotation of vaccines on offer at Our Place Society’s monthly vaccine clinic four months ago, along with flu shots and COVID-19 vaccines. Their most recent vaccine clinic, hosted at 919 Pandora Ave., took place on Jan. 17. 

“They can come in and they can choose which shots they want,” Grant McKenzie, communications director at Our Place Society, said. “We are getting, I would say on average, around 20 people per clinic.”

Island Health said they have administered 463 doses of adult Hib vaccine across the health authority to date. 

Access to care

Adam Flegel, who manages the community centre at Our Place Society, said he and others see symptoms of Hib and other illnesses among unhoused people, but they are difficult to diagnose and treat because of a lack of access to care. 

“We're not doctors, so we can't diagnose it [but] we can look out for symptoms,” Flegel said, adding that unhoused people are not comfortable accessing care in conventional health-care spaces. “You have the stigmas, they don't want to be there, they don't feel treated particularly well, so they avoid those kinds of traditional practices.”

The Royal Jubilee Hospital, for example, has garnered a reputation among marginalized populations for discriminating against homeless people, substance users, and racial minorities. 

Vaccine and other health clinics run at Our Place Society are, on the other hand, well attended. According to Flegel, the non-profit works with other groups that provide services for homeless people, to have a doctor offer appointments that people can sign up for once a month, on a Sunday. 

Besides the doctor, the organization runs several other programs which Flegel estimates helps about 50 people per week address their health-care needs, from dental to podiatry.  

“Providing these clinics obviously breaks down those barriers and allows them to do it judgment-free—or maybe not judgment-free, let’s say barrier-free,” Flegel said. “That way, it’s a lot easier to access.”

The Hib outbreak was first declared internally via an email to family doctors, seen by Capital Daily, on Nov. 25.

It noted that symptoms aren’t always present—and that most transmission comes from people showing no symptoms. 

“Individuals may transfer the organism to close contacts through droplet spread by coughing and sneezing,” the memo read. “Sharing of droplet or saliva containing items including food, drink and equipment for substance use is also a risk for transmission.”