Some scientists are concerned the swine flu virus may be gaining resistance to the antiviral drug Tamiflu. (Michael Probst/Associated)

Health officials in Ontario and Manitoba are taking different approaches to treating outbreaks of swine flu.

At the Sandy Lake First Nation in northwestern Ontario, 10 people have tested positive for the H1N1 virus.

The province has stopped testing in the community because the influenza strain is so prevalent. The doctor at the local nursing station even prescribed the antiviral drug oseltamivir, sold under the trade name Tamiflu, to a whole family that showed symptoms.

"We should be treating anyone with ILI, with influenza-like illness," Dr. Lisa Letkaman said. "Cough, fever and, you know, aches or the rest of the symptomatology."

Since the weekend, about 300 people have come to the nursing station with flu symptoms, and more than 150 have been treated with Tamiflu — the most aggressive use of the antiviral medication in the country.

"It helps with the symptoms for him not to get really sick, and it kind of makes me feel a little better," said Barb Kakepetun, the mother of a young flu patient.

In contrast to the calm in Ontario, there is confusion at the Garden Hill First Nation in Manitoba, said CBC News reporter Lyndsay Duncombe, who visited both communities.

People lined up for hand sanitizer and disinfectant wipes that Chief David Harper bought himself, concerned the supplies he had on hand weren't enough.

Band leaders said oseltamivir is not being prescribed as early or as often as it is in Ontario.

Antivirals for prevention

But some experts said that Ontario's approach could be risky because stockpiles may get used up before a second wave of the flu hits, and the virus may develop resistance to the medication.

"Not everybody by any means who comes in with an influenza-like illness is getting prescribed antivirals, even if they're there within the first 48 hours," said Dr. Joel Kettner, Manitoba's chief medical officer of health.

Chief Adam Fiddler of Sandy Lake First Nation is pushing for more prescriptions to use as a prevention for people at risk, noting doctors and nurses working in his community have received doses of Tamiflu to prevent them from getting sick.

The Ontario government is considering the option.

In Canada, preventative treatment has never been used in a community setting, so the idea is being discussed at the highest federal and provincial levels, Letkaman explained

At St. Michael's Hospital in Toronto, three patients were diagnosed with the virus over the weekend after becoming infected inside the hospital.

All of the patients were treated and are recovering. About 10 to 20 patients who were not infected were given Tamiflu as a preventive measure, as were 40 to 50 staff members who worked in the respirology unit where the outbreak occurred.

The unit remains closed to further admissions, and special precautions will continue at the hospital for another 13 days.