Nunavut won’t immediately change policy on infant lung infections

By The Canadian Press

IQALUIT, Nunavut – Nunavut’s medical health officer says the territory won’t immediately change its policy on prevention of lung infections in newborns despite having some of the highest rates anywhere in the world.

“What we’re going to need to do is sit down and look at all of our data before we make any more decisions,” Dr. Kim Barker said Friday.

The Canadian Medical Association Journal Open published a study on Tuesday that found some parts of the Canadian Arctic had astronomical rates of serious lung infections among weeks-old babies.

The study, by Anna Banerji of the University of Toronto, found more than 40 per cent of all babies born in Nunavut’s westernmost region in 2009 were later admitted to hospital with lung infections. In the area around western Hudson Bay, the figure was 24 per cent.

And in Nunavik, or Arctic Quebec, nearly half of all newborns were hospitalized.

Overall, lung infections for newborns just months old were 40 times southern rates.

Banerji’s work documented cases of babies less than six months old spending weeks in intensive care and suffering permanent lung damage. Some needed CPR or last-ditch interventions. Some died.

In the worst-afflicted areas, up to one in every 30 children born ended up in intensive care, struggling to breathe.

Banerji argued the rates were so high a preventative drug should be given to all newborns in the worst-afflicted areas, instead of only to premature infants or those born with heart or lung problems. Such treatment would also save the health system money, she said.

Barker said some things have changed since 2009.

The drug, known as palivizumab, is now being given to all children in the territory born at less than 36 weeks. The previous criterion was 34 weeks.

Standards for when the drug is given to babies with cardiac or lung problems have also changed, Barker said.

The doctor added that the territory plans to attack the incidence of infection by focusing on social factors. She said Nunavut will encourage more mothers to breast feed, will try to reduce infant exposure to tobacco smoke and will vaccinate more people against other infections such as the flu — factors referred to in Banerji’s study.

“It’s not just about the administration of a vaccine. There’s a lot of other things that contribute to children becoming infected and severely unwell.”

Nunavut’s overcrowded and substandard housing also contributes to such infections.

Banerji’s work suggests the territory could save about $36,000 for every baby that stays out of hospital. A course of palivizumab costs about $6,500.

Barker said her department will consider the figures in light of more recent data.

“It’s an important question and something we need to look at very carefully.”

Nunavut has invited a group from the Public Health Agency of Canada to visit the territory in January to consider the drug’s costs and availability.

“(They’ll) help us look at our eligibility criteria to see if we need to make any changes,” she said.

Nunavik recently decided to make palivizumab available to all newborns.

— By Bob Weber in Edmonton. Follow @row1960 on Twitter.

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