Voluntary TB clinic to run until mid-December in Nunavik community
Of 35 cases reported in the region this year, 27 are in Salluit
A community-wide screening clinic aimed at stopping the spread of tuberculosis in the Nunavik community of Salluit will continue until mid-December, the region’s director of public health said this week.
Health officials launched a mass screening Nov. 9, hoping to stem an outbreak of the infectious disease, which has spread to over two dozen patients in the Hudson Strait community of about 1,300 people.
But Nunavik public health department won’t say just yet if more cases have been diagnosed since the beginning of screening, opting to first inform the community.
In the first half of 2015, Salluit reported three cases of TB. But between June and October, another 24 were diagnosed.
“Because we saw such a rapid increase, we decided to introduce the screening,” said Dr. Serge Déry, the public health director.
Over the past week, the Nunavik Regional Board of Health and Social Services brought in extra health care staff to host the clinic.
As part of the screening process, Salluit residents answer a health questionnaire and undergo skin tests and chest x-rays to verify if they’ve contracted the infection.
Everyone in Salluit — excluding children aged two and under, who have already received a vaccination against TB — are asked to go to the clinic between now and mid-December, Déry said.
“There is no obligation — this is on a voluntary basis,” Déry said.
“I think people from Salluit understand if we don’t do this mass intervention, it will just mean a more widespread infection.”
Déry defended the public health department’s decision to only publicize the outbreak after 27 cases had been diagnosed.
He said that once people are diagnosed, they are treated at Inuulitisivik health centre in Puvirnituq or at Montreal’s McGill University hospital until they are no longer contagious, so there is no threat to the general public.
Patients are typically isolated for a three-week period before they can return home, Déry said, where they continue taking medication for a six-month period.
“In some ways, we’re lucky because, up until now, we’ve never seen a resistant strain [of TB],” he said
On the one hand, TB is very treatable, once it’s diagnosed, he said. On the other hand, Déry said social conditions in Nunavik play a major role in the ongoing presence and transmission of the disease.
“For sure, we could improve the diagnosis capacity by having x-ray machines in each of the communities,” Déry said.
The same could be said for lab accessibility, he added, which is now only available at the Tulattavik and Inuulitisivik health care centres in Kuujjuaq and Puvirnituq.
“But what we have to realize is that TB is a social disease. It does not impact all populations in the same way,” Déry said.
“The housing problem in Nunavik is directly associated with tuberculosis. If 20 people are living in the same house, those people are much more at risk than in a home with just two people.”
Mass screenings in Nunavik aren’t common, but those that have been held have proved successful.
The last mass screening took place in Salluit was in 1982, and the community did not see any more cases of the infection for another 25 years, Déry said.
Community-wide screening was conducted again more recently in Kangiqsualujjuaq, in 2012, to respond to an outbreak of 67 cases in the Ungava Bay community.
Overall, it hasn’t been a bad year for TB in Nunavik, Déry said; in addition to Salluit’s 27 cases, there have only been eight other cases reported in the region, all of them in Kangiqsualujjuaq.
The symptoms of TB include:
• a major cough that lasts for more than three weeks;
• loss of appetite;
• night sweats;
• weight loss;
• expectoration — the bringing up of phlegm from the lungs.
But many 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.
Without treatment, however, TB can eventually kill by gradually eating away at the lungs or, in rare cases, by spreading to other organs.
There have been no deaths associated with TB in Nunavik in recent memory, Déry noted.
But all Salluit residents are encouraged to visit their local health centre to be screened in the coming weeks.
“We really need the collaboration of everybody, we need everyone to come out,” Déry said. “Even if you’re asymptomatic now, you can still carry the infection.”
Health officials in Salluit hope to wrap up the screening by Dec. 19.