'If you have one case, you have to find all the contacts'

Nunavik fights gonorrhea with dose of prevention


Nunavik public health officials say they've made headway in quashing a year-long outbreak of gonorrhea by encouraging condom use and hiring extra health staff.

Dr. Serge Déry, the public health director for Nunavik, thought gonorrhea was on its way out – until he saw the number of cases in Nunavik rise to 65 throughout 2007.

"When we used to have four cases in a year, suddenly we had 10 a month. Now, we see it's going down," Déry said.

If untreated, gonorrhea, a sexually-transmitted infection, can cause nasty discharges of pus, infertility in women and blindness in babies.

The numbers of cases leapt from one case in July 2007 to 21 cases last February, according to figures from Nunavik's public health department.

The good news is that there were only 11 new cases of gonorrhea detected last month.

But, despite the downward trend, with 110 cases as of last month, the rate of gonorrhea in Nunavik for 2008 will likely score about 30 times higher than in the rest of Canada and three times as high as in the Northwest Territories.

The only nearby jurisdiction with a gonorrhea rate similar to Nunavik's is Greenland, where the rate is even higher.

Nunavut saw a progressive drop in the number of gonorrhea cases between 2000 and 2004.

But Nunavut's public health officials have no current numbers on how many cases of gonorrhea there are in the territory.

It's likely the rate of gonorrhea has risen since then, as it has throughout southern Canada.

Spread by sexual contact, gonorrhea thrives in moist, warm areas of the body such as the cervix, urinary tract, mouth, or rectum.

The infection can cause pus discharges in men and women and lead to infertility in women.

Infected women can also pass gonorrhea onto their babies, who risk blindness if their eyes aren't treated immediately after birth.

To combat the rising frequency of gonorrhea in Nunavik, public health officials pulled out all the stops last winter, Déry said.

There were community radio programs on gonorrhea prevention, backed up by public service announcements and an agreement with local co-op stores to carry stocks of free condoms on the higher store shelves where youth could reach them.

"At the clinics, they're always available free of charge, but a young person of 16 or 17 who wants to get a condom is not going to go the clinic," Déry said. "At the store, they pick up a couple when they buy a soda pop."

Quebec also paid for the hiring of a specialized public health nurse at Puvirnituq's Inuulitsivik hospital to work exclusively on gonorrhea prevention, detection and treatment.

Most cases of gonorrhea in Nunavik have been recorded among youth in the region's Hudson Bay coast communities.

"If you have one case, you have to find all the contacts, otherwise they will continue to infect others," Déry said.

Because many of those who are infected with gonorrhea also suffer from chlamydia, another sexually-transmitted infection, doctors usually treat patients for both infections, using antibiotics.

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