The expected "second wave" of H1N1 flu has hit on the west coast of Vancouver Island, according to the Canadian Medical Association Journal.

The CMAJ website quotes Tofino family doctor John Armstrong as saying the largest outbreak has been in Ahousat, on Flores Island--part of the Ahousaht First Nation whose chief, Shawn Atleo, is now national chief of the Assembly of First Nations.

But a "big community effort kept a lid on that," as Aboriginal leaders and health officials held public meetings and urged measures to contain the spread, Armstrong says. "But now that school is starting, it's changed again. We're also seeing the same flu patterns in other communities."

Armstrong says there has not been a flu-related death within the area he serves: Tofino and the nearby communities of Hot Springs Cove and Ahousat. But another BC doctor says privately that one Vancouver Island death is "suspected" as being caused by H1N1, although "it is not yet officially confirmed by health authorities in Vancouver."

News of the Vancouver Island outbreak comes as Manitoba First Nations have protested the delivery of body bags to their reserves by Health Canada as part of "flu kits." That has become an instant political issue, with Liberal leader Michael Ignatieff reportedly outraged by the Conservative government's treatment of H1N1 on First Nations reserves.

Crawford Kilian is a contributing editor of The Tyee.