The CDC added a new hepatitis A travel notice for Canada on June 4, 2026, alerting American travelers that Manitoba is experiencing an active hepatitis A outbreak. The notice arrived as the outbreak — which began in April 2025 in the Island Lake area of northeastern Manitoba, a cluster of remote First Nations communities — has expanded dramatically, spreading across the province and into Winnipeg, Canada's seventh-largest city and a major destination for American tourists visiting the Canadian Prairies.
The scale of this outbreak is substantial. As of late May 2026, 658 people have been infected since the outbreak began, 142 have been hospitalized, five have been admitted to the intensive care unit, and four have died. Manitoba health officials reported 601 confirmed cases as of April 26, with 131 in Winnipeg alone. The province has identified potential exposure sites in Winnipeg, including a Burger King at 333 Home Street — where exposure occurred between April 8 and April 23 — and Augustine United Church at 444 River Avenue on April 19.
For American travelers who visit Winnipeg, cross into Manitoba for summer festivals, fishing, or other activities, or who transit through the region, this outbreak presents a real and vaccine-preventable exposure risk.
Why This Outbreak Began and Why It Is Spreading
Manitoba declared the hepatitis A outbreak in April 2025, with the Island Lake area — including the communities of Garden Hill, St. Theresa Point, Wasagamack, and Red Sucker Lake — experiencing the largest initial burden. These communities, which are remote First Nations reserves accessible primarily by seasonal ice roads or aircraft, face documented deficiencies in water infrastructure and sewage treatment — precisely the conditions under which hepatitis A spreads most efficiently.
A Winnipeg internal medicine specialist, Dr. Glen Drobot, told CBC News in February 2026 that he had encountered four hepatitis A patients in his practice in a matter of weeks — unprecedented in more than two decades of practice. He described the provincial response as "muted" given the scale of transmission. The province countered that it had activated contact tracing, immunization campaigns, and coordination with federal Indigenous Services Canada partners.
What has driven the outbreak's expansion from remote communities to urban Winnipeg is the movement of people — workers, family members, travelers — between the affected northern communities and the city, combined with the long incubation period of hepatitis A that allows people to be infectious before they know they are sick. Hepatitis A has an average incubation period of 28 days, meaning people can unknowingly expose others in restaurants, churches, workplaces, and households for nearly a month before symptoms appear.
What Hepatitis A Does and Why Vaccination Is the Only Real Solution
Hepatitis A virus (HAV) infects the liver, causing acute inflammation that produces jaundice (yellowing of skin and eyes), dark urine, severe fatigue, nausea, vomiting, abdominal pain, and loss of appetite. The disease can range from a mild illness lasting a few weeks to a severe, debilitating illness lasting months. In healthy adults, most cases eventually resolve without treatment — but approximately 20 percent of adults with symptomatic hepatitis A are hospitalized, and approximately 0.5 to 1 percent of cases are fatal, with death risk increasing substantially in adults over 50 and those with underlying liver disease.
Unlike hepatitis B and C, hepatitis A does not cause chronic infection. But it causes a more severe acute illness in adults than in children, and the combination of the disease's severity and the availability of a highly effective, two-dose vaccine that provides lifelong protection makes every hepatitis A death in a vaccinated population preventable.
The hepatitis A vaccine is highly effective — providing 94 to 100 percent protection after two doses. In the United States, the two-dose Havrix or Vaqta series is recommended for all children at age 1, for unvaccinated children and adults, and for travelers to regions with hepatitis A activity. Americans who have not received both doses of hepatitis A vaccine and who plan to travel to Manitoba — or anywhere in Canada where the outbreak is spreading — should receive vaccination before departure. A single dose provides substantial protection within 2 to 4 weeks.
Frequently Asked Questions
Q: How many people have been infected in the Manitoba hepatitis A outbreak?
A: As of late May 2026, 658 confirmed cases, 142 hospitalizations, 5 ICU admissions, and 4 deaths. The outbreak has been ongoing since April 2025.
Q: Is there a risk to American travelers visiting Winnipeg or Manitoba?
A: Yes. The CDC issued a travel notice on June 4, 2026. The outbreak has spread from remote northern communities to Winnipeg, where restaurant exposure sites have been identified.
Q: How does hepatitis A spread?
A: Through contaminated food or water, or close contact with an infected person. It spreads through the fecal-oral route — meaning microscopic amounts of infected fecal matter contaminate food or water that is then consumed.
Q: Is there a vaccine for hepatitis A and should I get it?
A: Yes — the two-dose hepatitis A vaccine is highly effective (94–100%) and provides lifelong protection. Unvaccinated Americans traveling to Manitoba should receive at least one dose before departure. A single dose provides substantial protection within 2 to 4 weeks.
Q: What are the symptoms of hepatitis A?
A: Jaundice (yellow skin and eyes), dark urine, extreme fatigue, nausea, vomiting, abdominal pain, and loss of appetite, typically appearing 15 to 50 days after exposure. Most cases resolve, but severe illness can last months.
