Nunavik public health officials move quickly to quash latest TB outbreak

This tuberculosis germ has infected many people in Kangiqsualujjuaq, prompting Nunavik public health officials to take aggressive action to curb the outbreak. (FILE IMAGE)

Nunavik’s public health department plans to take swift action to curb an outbreak of tuberculosis in the Ungava Bay community of Kangiqsualujjuaq.

That includes sending in a portable x-ray machine, epidemiologists trained to investigate infectious disease outbreaks and community health workers, said Dr. Serge Déry, the director of public health for Nunavik.

Since November, tests have found 33 active cases of TB in Kangiqsualujjuaq, Déry said.

There is no reason to withhold identifying the community by name, he said (although in Nunavut public health officials do not release the names of communities where infectious outbreaks take place).

Many more people in Kangiqsualujjuaq, with a population of about 800, have tested positive for TB, but show no symptoms of TB and are not spreading the infection, Déry said.

Most of the 33 positive cases are among adolescents and young adults, he said, including at least one student at Ulluriaq School where TB screening of the student’s contacts has taken place.

Déry said there are no plans to close the school.

However, as first mentioned in a May 9 news release from the Nunavik Regional Board of Health and Social Services, public health officials have urged people in Kangiqsualujjuaq to shut down the popular so-called “gathering houses,” crowded, poorly-ventilated locations where gambling and drug sharing take place — and TB infections can easily be spread.

Déry suggests that anyone in Kangiqsualujjuaq who has suffered from a cough for more than a couple of weeks should come to the health clinic to get checked out for TB.

As well, Dery is asking everyone who does test positive for TB to collaborate with taking the medicine prescribed.

Those who test positive for TB are asked to come every day to the health centre for nine months to take their pills— something some are less willing to do.

But that course of treatment can prevent them from developing the full-blown symptoms of TB, a highly infectious, lethal disease that usually affects the lungs.

Active cases of TB require a more intense treatment with a combination of four drugs for six months.

Déry said the plan is to control the Kangiqsualujjuaq outbreak as rapidly as possible and make sure the outbreak doesn’t spread to other communities.

Publich health officials are also considering whether to start region-wide screening for TB again, he said.

Despite localized outbreaks, the TB rate had dropped so much in Nunavik that health workers no longer routinely screened for TB.

Nunavik no longer vaccinates for TB either, because some Nunavik residents had suffered bad reactions to the vaccine.

TB is generally diagnosed by performing a simple skin test to see if a person has developed a hypersensitivity to the TB germ or by examining a blood sample.

Region-wide screening might be unnecessary because many communities haven’t seen any TB cases for years, Déry said.

“Why would we make them go through that [screening] when they have no tuberculosis? So far there’s no sign that TB has spread beyond Kangiqsualujjuaq,” he said. “But with time we’ll see if we need to put more resources more action in place.”

As for why Kangiqsualujjuaq has seen yet another TB outbreak, five years after its last outbreak, when 12 people tested positive in the community, Déry isn’t sure.

The community’s overcrowded housing and other conditions, which make it easier for TB to spread, are similar to those found in other Nunavik communities, he said.

While overcrowding encourages the spread of the disease, TB also preys on people whose general well-being is already weakened by poor diet, smoking and alcohol abuse.

According to the World Health Organization, each person with active TB can infect 10 to 15 people a year on average.

Most people infected with the tuberculosis bacillus, or germ, don’t become ill or even know they are infected because germ can lie dormant in a person’s lungs for many years.

But, without treatment, TB can eventually kill by gradually eating away at the lungs or, in rare cases, by spreading to other organs.