A travel advisory has been issued in the United States for Manitoba as a hepatitis A outbreak in the province worsens, with more than 100 new cases reported in the past month.
The U.S. Centers for Disease Control and Prevention issued the Level 1 notice.
“That response is really just echoing the communications that we’ve been sharing with our partners and through jurisdictions in Canada,” said Dr. Brent Roussin, Manitoba’s chief provincial public health officer.
“It’s just providing information that an outbreak exists here. It’s not deterring any travel, there is no reason to consider that.”
The notice came June 4, the same day that the province reported 784 hepatitis A cases associated with the outbreak that first began in April 2025. That number was an increase from 658 reported on May 6.
Nearly 25 per cent of the infections have been in Winnipeg, with 186 reported.
There has also been 165 hospitalizations since the outbreak began, with eight admissions into the intensive care unit and four deaths.
The outbreak began in 2025 in some northern communities, largely related to improper access to sanitation and water, Roussin said. But it has since spread across the province.
Overcrowded areas, such as people in precarious housing and living in shelters, are some of the most prominent populations facing the virus in Winnipeg, Roussin added. People who inject drugs or use other substances are also at risk.
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Hepatitis A is a virus that affects the liver and can create symptoms including nausea, vomiting, dark urine and some can get jaundice.
While not part of its routine vaccination program, the province continues to expand hepatitis A vaccine eligibility. The shot can prevent illness both before and shortly after exposure to the virus.
The Tataskweyak Cree Nation (Split Lake Cree First Nation) was added to the list of eligible communities on May 28. Prior to that, Cross Lake First National (Pimicikamak Cree Nation), Ebb and Flow First Nation and Bloodvein First Nation became eligible earlier in May. War Lake First Nation (also known as Ilford)’s became eligible in April, with Peguis First Nation in February.
The Island Lake area, including Garden Hill, St. Theresa Point, Wasagamack and Red Sucker Lake First Nation, was the first region to be included starting in May 2025.
Anyone travelling to, working in or who have household visitors from these communities are also eligible. Inmates of correctional facilities, as well as staff and volunteers of non-health care community-based organizations in Winnipeg serving people experiencing homelessness also qualify.
“We’re always looking at where are we seeing transmission occur, who’s likely going to be at risk for the next transmission cycle,” Roussin said.
It’s unlikely the outbreak will be slowing down, but infectious diseases specialist Dr. Isaac Bogoch said he doesn’t anticipate vaccines will be needed beyond the communities and groups currently eligible.
He said based on data available, it doesn’t appear to be spreading into the general population overall so it’s unlikely to spread too far outside the province either.
“It appears this is among a community that is predominantly in shelters, in low-income and low-resource settings and settings that have poor infrastructure for sanitation and hygiene,” Bogoch said. “So I think a targeted vaccine approach is probably the best approach at the moment.
“If the population is largely restricted to Manitoba, then it’s probably going to stay in Manitoba.”
Bogoch added while death is rare and children and youth may have little to no symptoms, an adult who gets the virus can become quite ill and why vaccines are an important tool.
“It’s the kind of thing where some people say, ‘it’s not going to kill you but you’ll wish you were dead,’” he said.
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