'We have not seen it stop': Canada's public health agency to review respiratory illness in Nunavut babies

Her story is one of many across Canada's Arctic: a newborn, struggling to breathe and medevaceddown south.

Christina Baron's story has a happy ending, though some are not as fortunate.

Nellie Baron says one night,newborn Christina was having trouble breathing.

"When she was a few months old, she was breathing hard and wasn't drinking well," Baron said.

She brought her daughter to the health centre in her hometown of Kangiqsualujjuaq, Que., and a decision was made to medevac Christina. She would fly to Kuujuaq, Que., with her motherthen on to Montreal by herself in a Challenger jet.

"She was alone," Baron said.

That was around three years ago.Today, Baron says Christina is doing much better.

Nearly half of newborns in Nunavik were hospitalized with a lung infection in 2009, according to a recent paper published in the Canadian Medical Association Journal Open.

• 'Horribly sick kids:' Arctic regions have highest infant lung infection rates in world

In Nunavut's Kitikmeot region, it's 40 per cent.

"The fact that these babies have severe diseasesome of the highest ratesin the worldthat's not new," said the lead author of the paper, Dr. Anna Banerji with the University of Toronto.

The paper is based off of 2009 data and breaks down the hospitalization rates of newborns by region in Canada's North.

Nunaviktakes precautions

This year, all infants in Nunavik born during the respiratory syncytialvirus (RSV)season and any infant less than three months of age at the beginning of December will be given an antibody called palivizumabtoprevent RSV infection.

The decision was recommended by Quebec's health research institute (INESSS), arguing any infants who live in a remote area where access to health care in the event of a serious medical condition would require air transportation should receive the antibody.

"The logistics of air transportation are complex and difficult, especially air transportation from the most remote villages, and can entail risks for the infant because of the wait times for accessing specialized care,"reads a report by INESSS from August 2016.

Up to five doses of palivizumab will be administered to newborns once a month during RSV season from Dec. 1 to the end of April 2017.

The cost of administering palivizumab isaround $6,500 per infant. But Banerji argues it could save tensof thousands of dollars per case of RSV preventedonce you factor in hospitalization and medevac expenses that would be avoided.

• NunavutMLA outlines 'ludicrous' medical travel situation

"What we want to do is target the babies that would get the sickest with RSV and the babies that are at the highest risk," she said.

Banerji recommends a similar strategy for Nunavut, where the antibody could beadministered to all newborns in the territory outside of Iqaluitwhere the RSV hospitalization rates are loweronce a month during RSV season. It's somethingBanerji has been recommending for years,though the territory has brushed the recommendationaside.

Looking into it

Nunavut'stop doctor says changing the eligibility requirements for administeringpalivizumabwill be one of the things a working group will consider next year.

In January, the Public Health Agency of Canada will send an official to the territory for three months to work with health officials in Nunavut toreview RSV cases.

"It's not just about the vaccine that prevents RSV," said Dr. Kim Barker, Nunavut's chief medical officer.

"There's a number of other issues that complicate things like the overcrowding, the exposure to secondhand smoke," she said, a "perfect storm" to increase the likelihood of any kind of respiratory illness.

Complicating matters is an usually high number of RSV cases in Nunavut in 2016 outside of the typical season.

Barker said the territory had 64 cases of RSV up until September. Since then, there have been an additional 32 cases.

"We have not seen it stop," Barker said.

"When we normally have one or two cases in the fall. To have more than 30 means that we really do have to re-evaluate the program carefully."

Adding to the problem is an ongoing whooping cough outbreak spreading across the territory, and flu season is just around the corner.

"We're certainly seeing RSV and pertussis[whooping cough]circulating in communities. We don't see any influenza just yet but we're hoping that by having everyone vaccinated against influenza that we won't add a third pathogen to the mix."