Update on Blastomycosis Inquest

The Coroner’s Inquest into the Blastomycosis outbreak in Constance Lake First Nation concluded on November 19, 2025, following several weeks of testimony and review. The outbreak occurred in late 2021 and early 2022, resulting in five deaths and over 50 infections in the Constance Lake First Nations community – a community of approximately 750 people. The inquest examined the circumstances surrounding these deaths and issued recommendations aimed at preventing similar events in the future.

PHO’s Participation
PHO was first notified of its involvement in the Inquest in April 2024, prompting the organization to begin preparing materials and support for the inquest team. Recognizing the importance of fully contributing to the process, PHO sought and was granted standing under section 41 of the Coroners Act. This allowed PHO to participate meaningfully in the proceedings, including the ability to cross-examine witnesses and offer expert insight where appropriate. Two PHO-affiliated experts provided testimony:

• Dr. Julianne Kus, fact witness regarding outbreak response
• Dr. Austin Zygmunt, educational testimony on epidemiology, diagnostics, and public health management

To ensure its participation was culturally informed, PHO worked closely with its Director of Indigenous Strategy and Engagement, reflecting the organization’s commitment to meaningful partnership with Indigenous communities.

Key Recommendations Relevant to PHO
The jury delivered several recommendations for health system partners, including PHO. These recommendations emphasize the importance of strengthened collaboration across Indigenous, federal, and provincial organizations to support more coordinated, culturally safe, and effective public health responses. We paraphrased the original content to provide a high‑level summary.

Indigenous Rights and Cultural Safety

• Commit to Joyce’s Principle.
• Publish plans to implement Truth and Reconciliation Commission of Canada’s Calls to Action 22 and 23 within six months.
• Provide mandatory Indigenous Cultural Safety and trauma‑informed care training for PHO staff, leaders, and healthcare partners.
• Formally endorse Indigenous health transformation and First Nations self‑determination.

Public Health Response and Coordination

• Participate in provincial and federal debriefs following complex outbreaks affecting Indigenous communities.
• Develop secure information-sharing processes aligned with OCAP data principles.
• Provide education and resources for clinicians and public health professionals on diagnosing and managing Blastomycosis.

Diagnostics and Surveillance

• Explore access to Blastomyces urine antigen testing in Ontario.
• Improve access to clinical diagnostic methods for Northern Ontario communities.
• Develop a standardized Ontario Investigation Tool for Blastomycosis, including culturally informed land‑based exposure questions.

Reporting Requirements

• Submit a 6‑month implementation report to the Coroner’s Office (date subject to extension).
• Provide a 12‑month status report to all parties, including Constance Lake First Nation and Notre‑Dame Hospital.

Next Steps
PHO is coordinating internally to address the recommendations and prepare for required reporting. Work is underway to meet the 6 and 12‑month reporting commitments, reflecting PHO’s continued commitment to improving public health systems and supporting partners in implementing meaningful change.

Check out our new Indigenous Engagement webpage to stay up-to-date on PHO’s ongoing engagement with Indigenous communities in Ontario.