THUNDER BAY -- The Thunder Bay District Health Unit is declaring an HIV outbreak in the city's homeless and under-housed population.
The public health organization on Tuesday issued the declaration after a recent spike of cases within the last two months has brought the number of HIV positive cases reported to eight since the beginning of the year, with two other cases currently under investigation.
The health unit, which speculated that there are likely further cases that have yet to be diagnosed, in a written news release said transmission is through sexual activity and sharing needles for drug use.
The HIV declaration comes more than a year after the health unit announced it was investigating a tuberculosis outbreak in the same marginalized and vulnerable population.
“The HIV outbreak, especially with the concurrent tuberculosis outbreak, is a crisis situation impacting individuals, families and communities already experiencing significant burden associated with infectious disease, mental health, and addiction issues as well as broader social, historical and systemic issues," said health unit medical officer of health Dr. Janet DeMille in a written statement.
DeMille, who conceded it's hard to understand exactly what has happened, said the situation could be a combination of new cases along with increased testing detecting previously undiagnosed cases.
"We do have some evidence that there has been an increase in the spread of HIV even within the last year, and it might be that it became more obvious with increased testing that's happened over the last couple of months," DeMille said.
"When I look at these numbers and the cases over the last couple of years, it was a fairly low number of cases, yet a lot of testing was happening so there was a lot of negative testing happening. It does appear something changed and it may have been in the last six months or even in the last year, where we've seen more transmission of the virus."
Though there are treatment options, HIV does not have a cure. The virus attacks the body's cells that fight infection, leaving a person afflicted with HIV more susceptible to other infections and diseases. HIV can advance to AIDS, which is considered a late stage of the infection after the body's immune system has been significantly damaged.
DeMille, who believes there will be further spread, said the declaration is an indication of the severity and significance of the situation.
"It really stresses the importance of ongoing work and engagement with that population and looking at specific measures we can enhance," DeMille said.
"We do a lot of work with the Thunder Bay Drug Strategy and other health care partners and we have harm reduction programming and distribute supplies through that. It just really means looking at what we might have to do differently and what we might have to do better to really support this population and reduce that transmission."
An enhanced HIV and tuberculosis strategy is being developed, the health unit added, with ongoing engagement with community partners meant to strengthen a community-wide approach that focuses on prevention, testing, harm reduction and improving access to health care and services.
In the statement, the health unit said the general population is not considered to be at increased risk.
"Very particular activities are required to actually transmit the virus from one person to the other. The general public, or anyone interacting with that population, is not at risk of acquiring HIV," DeMille said, adding sexual activity and sharing drug paraphernalia are the most likely methods for the virus to spread.