Mumps continues to spread in Manitoba with almost 100 more cases in the last month.
As of April 7, there have been 290 confirmed cases of mumps since Sept. 1, 2016, the highest number in two decades.
A provincial medical officer of health said that number could go as high as 600 before the virus wanes.
"The pool here could even double that number before things settle out completely. We could potentially go to 600. To be honest I am always concerned, but I also know this is progressing as I kind of thought it would," said Dr. Richard Rusk.
Rusk had hoped the virus would taper off more quickly.
"At one point it did look like we may have managed to get on top of things. In reality, once it moved out into the rural areas, things did shift a bit and it will continue to smoulder on," he said.
There are typically four to eight cases of mumps a year in the province.
The new numbers are in the north and First Nations, Rusk said.
"I don't know if this is just part of the normal flow because this is now another place where it hasn't been. Or is it something different? Unfortunately I don't know that yet. We have to do some further analysis," he said.
Rusk said he is encouraged he is not seeing any shift in severity. No new reports of complications such as deafness, encephalitis, meningitis and sterility. He said there were a handful of cases resulting in sterility and deafness earlier in the outbreak.
While a spike in the north is boosting the number of confirmed cases, the numbers in Winnipeg and rural regions continue to decrease.
Manitoba is now in the seventh month of the outbreak. Other provinces, such as Alberta and Nova Scotia, have taken seven to 12 months before things settled down, he said.
The message is the same as the outbreak continues.
"People can still get immunized. This is still the most important message. It's imperative."
Rusk doesn't know how many of the new cases involved people who were already vaccinated. A meeting is scheduled for this Thursday to further analyze the most recent data.