Flu-like illnesses continue to hit hard in Manitoba's First Nations communities, especially St. Theresa Point, where a two-month-old flown to Winnipeg Monday night became 27th medical evacuee from the community.

Two people from the community, located about 500 kilometres from Winnipeg, have been confirmed to have swine flu and two others are in critical condition, including a woman who was pregnant but has since miscarried.

More than 200 people from St. Theresa Point have fallen ill since the start of last week. The majority of the ill are being treated in the community.

Those with the most severe symptoms are in Winnipeg.

Winnipeg health system under strain

The increased demand on the province's health system due to severe flu symptoms has also begun to show up in the city, where at least one surgery was cancelled at a city hospital and others have been shifted from St. Boniface Hospital to Victoria Hospital.

'What's wrong with having a field hospital over here and making sure people are looked after by physicians? It's an emergency situation, right?'—David McDougall, chief St. Theresa Point First Nation

There are also plans to move some Winnipeg patients to Brandon if more flu victims need to be treated.

Currently, there are 26 people — 23 adults and three children — in intensive care units of Manitoba hospitals, using ventilators to aid their strained breathing from flu-related reasons.

It is expected many of them will be confirmed as cases of swine flu, or the H1N1 influenza A virus, Manitoba's chief medical officer of health, Dr. Joel Kettner, said at a press conference Monday afternoon.

Another 25 children are in hospitals with respiratory illnesses and are being tested for swine flu, according to health officials.

Typically, at this time of year, there are very few — if any — cases of severe flu, said Kettner.

WHO concerned about Manitoba aboriginal population

At a press conference in Geneva on Tuesday, the World Health Organization acting assistant director-general, Keiji Fukuda, said the organization is on the verge of declaring the swine flu outbreak a pandemic.

There are more than 26,000 confirmed flu cases around the world and 140 deaths. Fukuda also said the organization is particularly concerned about the number of flu cases appearing recently within Manitoba's aboriginal population.

More than half of the 26 people in Manitoba's intensive care units are of aboriginal descent with an average age of 35, said Kettner.

At Split Lake Cree First Nation, about 950 kilometres northeast of Winnipeg, the community's clinics are packed and so many children are sick with flu that the school has had to be closed, said health director Mike Moose.

He said the community wasn't prepared to deal with the outbreak.

"[Manitoba Health officials] gave us a binder … and said, 'This is what you have to have done.' We pretty much had no resources to get these plans in place."

Frustration on First Nations

The situation has percolated into frustration for some First Nations. St. Theresa Chief David McDougall is grateful for the help his community is receiving but believes more could be done.

"What's wrong with having a field hospital over here and making sure people are looked after by physicians? It's an emergency situation, right?" he said.

On Sunday, a 1½-year-old toddler was flown to the children's hospital in Winnipeg from Garden Hill First Nation, an isolated reserve in northern Manitoba. The child's parents became angry with the treatment he was receiving at the community's nursing station.

According to Chief David Harper, the boy was taken the station several times last week, but the nurses continued to prescribe the same treatment — cold baths and Tylenol.

Harper said the boy has now been confirmed to have swine flu.

"There was no proper medical treatment in Garden Hill. We have a concern and will be raising the issue to the minister of health," he said Tuesday.

Garden Hill is the same reserve where a six-month-old boy died in March after being airlifted to Winnipeg. The feverish boy had been taken into the reserve's nursing station on at least three separate occasions by his mom, who was told to give him Tylenol and cold baths.

He was finally airlifted after suffering a seizure while at the station. His death occurred before the world began taking notice of a swine flu outbreak in April, so he was never tested for the illness.

Three swine flu deaths in Canada

As of Monday, Canada had 2,446 confirmed cases of swine flu. Of these, the more severe cases are disproportionately concentrated among people from northern and aboriginal communities, as well as among those with underlying health conditions.

There have been three deaths linked to swine flu in Canada so far.

'There is some uncertainty with the numbers that will contact the disease. I am certain that we have very skilled people managing this challenge.'—Premier Gary Doer

So far, 40 people in Manitoba have tested positive for the H1N1 flu virus and many others are suffering from a variety of other flu symptoms.

Premier Gary Doer said the province's health system has the right people in place to manage an outbreak of the flu virus in Manitoba. What Doer is less certain of is how many more cases will appear and how authorities will cope with more patients.

"There is some uncertainty with the numbers that will contact the disease," he said. "I am certain that we have very skilled people managing this challenge."

To ensure the best response to the outbreak, co-operation between provincial and federal health authorities is essential, especially in remote areas like First Nation reserves, said Doer.

Last week, Manitoba Health Minister Theresa Oswald exchanged sharp words with her federal counterpart, Leona Aglukkaq, over the flow of information between the two departments.