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Officials struggle to contain spike in TB

Number of cases in city clinics, emergency rooms rises significantly

By: Jen Skerritt

Posted: 03/12/2010 1:00 AM | Comments: 0 (including replies)

WINNIPEG health officials are racing to contain a recent surge of tuberculosis infections that have cropped up in medical clinics and emergency rooms and helped Manitoba top the list as the worst-affected province.

Medical officer of health Dr. William Libich said doctors and public health nurses have seen a significant increase in the number of TB cases in Winnipeg -- particularly among the homeless and people who live in the inner-city. Provincial disease statistics show Winnipeg recorded 85 TB cases in 2009 -- up from 33 in 2006.

The spike helps explain why Manitoba recently recorded the highest rate of TB of any other province, but Libich cautioned the increase doesn't necessarily mean the TB problem is getting worse.

Libich said doctors and nurses are doing a better job of aggressively tracking down people who may have been exposed to infectious TB. He defended the TB-control program against attacks officials are missing cases, saying the Winnipeg Regional Health Authority inherited a program that was under-resourced and often lost track of patients who are now showing up as relapsed cases.

"That's going to come back and haunt people who have inherited (TB control) in the years to come," Libich said. "We know we're doing a good job and things are moving in the right direction."

The response comes on the heels of new statistics made public this week that show the number of Manitobans infected with TB hit a 30-year high last year. The data raised alarm among some medical experts and First Nations leaders who questioned whether enough is being done to address the root cause and spread of the disease.

TB is an infectious disease that experts say is a byproduct of overcrowded homes, malnutrition and poor overall health. The airborne disease is rampant in many northern Manitoba communities where cramped living quarters help it spread.

Libich said he's concerned by the amount of TB in Manitoba, and declined to speculate whether the problem will get worse before it gets better. A disproportionate number of TB cases are among First Nations, and Libich said there is a lot of migration between aboriginals in Winnipeg and northern reserves.

He said local health officials are working with federal health officials to trace TB infections that surface in Winnipeg back to reserves, and vice versa.

"Certainly I would say we do have transmission in the city," Libich said. "We're also finding a lot of emergency providers are finding cases."

The latest provincial disease statistics reveal Manitoba recorded 156 TB cases in 2009 -- the highest number recorded in a single year since the late 1970s. In the past four years, TB cases have jumped by 50 per cent, leaving Manitoba with higher rates of the disease than any other province.

The data was released just months after a Free Press series revealed some Manitoba First Nations have recorded some of the highest rates of TB in the world since the mid-1970s. Some northern communities have recorded more than 600 cases of TB per 100,000 people. By comparison, Canada's national rate is five cases per 100,000.

The Public Health Agency of Canada released data from its Tuberculosis in Canada 2008 publication, revealing the rate of the airborne contagious disease among aboriginals in Manitoba was 51.2 per 100,000 people, compared with 1.2 for non-aboriginals.

jen.skerritt@freepress.mb.ca

To learn more about TB in Winnipeg and Manitoba, visit the interactive TB website at winnipegfreepress.com/tb to read the Free Press' six-part TB series and watch videos, see slide shows and scroll through 100 years of TB history in Manitoba.

Republished from the Winnipeg Free Press print edition March 12, 2010 B1

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