Cases of potentially deadly bacterial disease on the rise in Ontario and Manitoba

What to know about rare bacterial infection Infectious disease expert Dr. Isaac Bogoch explains what to know about a rare bacterial infection that can lead to meningitis and death.

Public health officials in three provinces have issued warnings this year about a rare bacterial infection that can lead to meningitis and death. Ontario and Manitoba are seeing a recent rise in cases, with the latest alert coming from Toronto.

"By the time they come to hospital, they can already be very sick because the onset of symptoms can be so rapid," Dr. James Kellner, a pediatrician and infectious disease specialist, told CTV News. "You can go from being well to being really critically ill in less than a day."

While Toronto Public Health has only logged 13 cases of invasive meningococcal disease (IMD) so far in 2024, that's higher than the total number of recorded infections in any year since 2002. Two of the recent Toronto cases were fatal, claiming the lives of an adult and child.

"Compared to normal, that's a big jump," Kellner said from Calgary.

Up to 10 per cent of cases are deadly, according to Health Canada, while 10 to 20 per cent of survivors experience life-altering consequences such as hearing loss, neurological disabilities and amputated digits or limbs. Earlier this year, public health officials also warned about case numbers in Manitoba, Kingston, Ont., and Quebec's Eastern Townships.

"Ontario and Manitoba are reporting increased IMD activity recently, preliminary data from the National Microbiology Laboratory suggest overall the number of cases of IMD nationally has not increased compared to previous years," a Public Health Agency of Canada spokesperson told CTVNews.ca.

Across the border in the U.S., more than 140 cases have been recorded so far in 2024. The disease is found worldwide but most common in the so-called "meningitis belt" of sub-Saharan Africa.

Toronto Public Health is encouraging people to get vaccinated, particularly those travelling to Hajj in Saudi Arabia or attending local and international Pride events.

"Outbreaks can occur during mass gatherings and cases can occur during travel," Toronto Public Health warned on June 7. "Individuals are strongly recommended to contact their health care provider to receive a meningococcal vaccine as soon as possible."

What is invasive meningococcal disease?

Invasive meningococcal disease is a bacterial infection that can lead to dangerous brain and spinal cord inflammation, known as meningitis. In severe cases it can also lead to bloodstream infections and sepsis, which can result in amputations and death.

Initial symptoms can include headache, fever, nausea, vomiting, light sensitivity, stiff neck and later a dark purple rash. Anyone with symptoms should seek immediate medical attention.

"This is certainly here and spreading in our city," Toronto associate medical officer of health Dr. Vinita Dubey told CTV News. "Because it progresses so quickly, even though we have antibiotics to treat it, often because [of] the bacteria, the infection has spread so quickly even the antibiotics don't work and that's why prevention is so important."

The disease is preventable with a vaccine, which is often given free to children at 12 months and in Grade 7. Not all strains, however, are covered and not everyone has received a shot. If you are not eligible for a free vaccine, adults without private insurance can expect to pay about $160 per dose.

The Public Health Agency of Canada says there were approximately 115 cases per year between 2010 and 2021. Cases occur most often during the winter and spring and affect less than one out of 100,000 people in Canada. The disease can affect people of all ages, but is most common in children under the age of five, as well as unvaccinated teens and young adults. The Public Health Agency of Canada urges people to avoid sharing objects like eating utensils and water bottles that could transfer saliva or mucus.

"The Public Health Agency of Canada is closely monitoring invasive meningococcal disease and is working closely with federal, provincial and local public health partners to ensure the health and safety of people in Canada," an agency spokesperson said via email. "Individuals with symptoms of IMD should seek immediate medical attention."

With files from CTV Toronto and The Associated Press