Pangnirtung TB clinic an important chance to get screened: health officer

Tuberculosis screening is a straightforward process and Nunavut’s chief public health officer hopes residents in Pangnirtung — where an outbreak has been ongoing for 19 months — will get tested at an upcoming clinic.

“TB in the territory is endemic, and by using that word I mean it is widespread,” said Dr. Sean Wachtel.

Tuberculosis rates in Nunavut can be anywhere from 70 to 300 times higher than in the rest of the country, Wachtel said.

An outbreak was declared in Pangnirtung in November 2021, and since then the number of cases have continued to grow.

The territorial Health Department has also declared outbreaks this year in Pond Inlet and Naujaat.

The clinic in Pangnirtung is scheduled to run from September through November.

Wachtel said TB screening is a straightforward process.

Patients arrive at the clinic, then depending on their medical history, they’ll be given either a skin test or a blood test for TB.

They will come back to get the results typically 48 to 72 hours later and may be given chest X-rays.

“We’re really looking very hard for any evidence of either sleeping TB or active disease,” Wachtel said.

People with cases identified will be offered treatment tailored to their condition, and there will be extensive followups in the community for one to two years afterward.

Sometimes after doing a chest X-ray on a patient, a standard investigation to look for TB in the lungs, doctors can identify other potential problems in the lungs.

Tuberculosis is caused by a particular type of slow-growing bacteria that can affect any part of the body, including the lungs, stomach, heart and the lining of the brain.

It can cause abscesses, which are local infections in the body, and can also affect the joints.

There are two types of TB infections: One is the active disease, usually treated by a combination of several different antibiotics given over the course of six to 12 months with monitoring of the condition.

However, the majority of people infected have what’s called “sleeping TB” or a latent TB infection.

“They are not infectious,” Wachtel said of people with sleeping TB. “They feel well, they have no symptoms, so they typically don’t have the fever, the sweats and so forth.”

The prevalence of sleeping TB infections makes community screening clinics particularly helpful in getting ahead of outbreaks.

Symptoms of TB can vary depending on where in the body the infection is, Wachtel said, and sometimes it can be in several places at once.

Common symptoms of an infection affecting several places at once include night sweats, poor appetite and weight loss, he said.

If the infection is in the lungs, it may cause coughing up blood, as well as breathlessness and chest pain. If it’s in the stomach, people might experience nausea or stomach pain, whereas an infection in the lining of the brain might present as a headache, confusion, nausea or vomiting.

The screening clinic will be put on by the Department of Health in partnership with Nunavut Tunngavik Inc., which will contribute funding and Inuit cultural competency training.

Wachtel stressed that TB is a very treatable illness.

“We are, of course, very cognizant of the history of the way people were taken away from communities in the past and that has generated a lot of trauma in the population,” Wachtel said.

“A lot of fear about the disease, a lot of stigma about having it. That’s very unfortunate.”