Question Period Note: Blastomycosis in Lac Seul

• The health and wellbeing of First Nations communities remains our top priority.
• The Government of Canada is committed to ensuring First Nations communities have adequate access to health services such as testing and treatment.
• ISC has been working with Lac Seul First Nation and partners to address the current situation in the community.

Prior to 2022, no cases of blastomycosis have been reported from Lac Seul to ISC. However, the community is situated in the region where rates of blastomycosis are the highest in the province. Blastomycosis is a fungus that lives in the soil, primarily along the Great Lakes and particularly in Northwestern Ontario.

Epidemiological Update
As of November 30, 2022, two confirmed, and 2 probable cases from Lac Seul have been reported.. One individual diagnosed with blastomycosis has sadly passed away though the details on the cause of death are pending. There are no individuals currently in hospital. Preliminary epidemiologic evidence suggests that this is not the same pattern, or size of outbreak that was seen in Constance Lake.

Response
On November 21st, Sioux Lookout First Nation Health Authority held a meeting with community leadership and partners including ISC to discuss the new cases of blastomycosis. Since that initial meeting, SLFNHA has held a community awareness presentation on the radio in the community. Previously, SLFNHA and NWPHU had presented an educational seminar on blastomycosis to health care workers. To shorten the time from presentation to diagnosis, ISC has shared medical directives that guide diagnosis of blastomycosis, developed by the Hearst Hospital, with SLFNHA and NWPHU. SLFNHA along with partners and ISC are supporting the community with communication materials to encourage those people with symptoms to seek a diagnosis with consideration for blastomycosis as a potential cause. Clinical investigation into the new cases has been initiated and is ongoing.

On November 28th, a follow-up meeting with community leadership and partners was held to provide an update on blastomycosis in the community. Since the previous meeting, more information from the clinical investigations had been obtained. Plans were made to continue the investigations into the recent cases as well as the organize environmental aspects of the investigation with partners. Partners such as the province and the health unit have been asked to support the response and investigation which may include looking at weather data.

ISC and partners have emphasized that it is extremely difficult to identify the source(s) of infection as the fungus may only be present for a brief period of time when climactic conditions are correct. Concerns were expressed by partners whether further environmental investigation was a good use of resources. Stretched resources was a concern expressed by partners during the environmental meeting including the Incident Commander from the community who is dealing with other pressing matters such as the recent deaths. Recognizing that blastomycosis is endemic in the area, and assuming that there are few or no more cases, FNIHB is currently awaiting direction from incident command and leadership on the direction for ongoing environmental investigations. The clinical and epidemiologic investigations continue as well as surveillance and education efforts in the community.

If pressed on support ISC is offering partners
• ISC has had several meetings and continues to work with partners including the community, Sioux Lookout First Nations Health Authority, the Ministry of Health in Ontario, and Northwestern Health Unit to collaborate on a unified approach and reinforce correct approaches to diagnosis.

• ISC and partners will meet with the Lac Seul Chief and Health Director on Monday, December 5, 2022, to further discuss the Blastomycosis within the community.