Nunavik public health ups the fight against TB in Kangiqsualujjuaq

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

KUUJJUAQ — With the tally of active tuberculosis cases detected in Kangiqsualujjuaq now at 46 (up from 33 earlier this month), the Nunavik public health department continues to fight the outbreak in the Ungava Bay community of 800.

Among the tools to speed up detection and treatment: a portable x-ray machine, which took lung images from more than 60 people last week to see if they have any signs of TB, an infectious disease that usually strikes the lungs first.

The new x-ray machine will allow on-site doctors to check out the 360 contacts of the community’s active TB cases more quickly and recommend treatment when necessary — without flying anyone out to Kuujjuaq or Montreal.

When x-rays show any indications of TB, the images will be sent to Montreal on Nunavik’s tele-health network for a second expert opinion.

Taking x-rays to detect TB will also be more effective than administering the skin test that can also reveal if a person has developed a hypersensitivity to the TB germ, said Dr. Serge Déry, Nunavik’s director of public health in a May 25 interview in Kuujjuaq.

The Tulattavik hospital in Kuujjuaq and the Inuulitsivik hospital in Puvirnituq will also receive Xpert TB-detection devices, similar to a machine recently installed at the Qikiqtani General Hospital in Iqaluit.

The machines, about the size of a microwave, perform an automated test for TB and evaluate antibiotic resistance in 90 minutes.

These will help eliminate long waits and delays that occur when samples are sent to labs, Déry said.

Meanwhile, anyone in Kangiqsualujjuaq who has a cough that’s lasted longer than three weeks — even if they’re not on the list of people who have been in close contact with the 46 infected people in the community — is being urged to come to the health clinic to be checked out.

Most people infected with the tuberculosis bacillus, or germ, don’t become ill or even know they are infected because the 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.

People who test positive for TB but don’t have any symptoms will start a nine-month course of antibiotics.

Those with active TB can look forward to an intensive six-month treatment which starts with two weeks of treatment in an isolated environment, so no one else gets infected. Tulattavik, which already has two isolation rooms, is getting a third and other isolation rooms have been reserved in Montreal hospitals for TB-infected residents of Kangiqsualujjuaq.

The good news is that after two weeks of treatment, people with active TB are no longer contagious, Déry said.

But “anyone who’s contagious or thought or suspected to be contagious” won’t leave Kangiqsualujjuaq for treatment on commercial flights, but will travel by charter or medevacs.

There are also plans to restart vaccinating children born after 2004 in Kangiqsualujjuaq against TB, Déry told Nunatsiaq News.

The Bacille Calmette-Guérin or BCG vaccine offers an 80 per cent protection against TB for 15 years.

Its use was stopped in Nunavik in 2004, Déry said.

But, as part of the renewed campaign to squash the TB outbreak in Kangiqsualujjuaq, children up to age seven, that is, kids born after 2004, will receive that vaccination.

About 120 doses will be required to vaccinate the young children in Kangiqsualujjuaq, Déry said.

As for the so-called “gathering houses” in Kangiqsualujjuaq, those crowded, poorly-ventilated locations where gambling and drug sharing take place — and TB infections can easily be spread — have been closed, Déry said, although some say they’ve just moved to other locations.

Keep away from those places, is Déry’s message.

For now, the outbreak appears to be contained in Kangiqsualujjuaq.

Déry plans to be in Puvirnituq next week to speak to the Kativik Regional Government’s regional council about what’s being done to fight TB in Kangiqsualujjuaq and the rest of Nunavik.