Pangnirtung, a small village on Baffin Island, is battling the largest TB outbreak in Nunavut since 2017, according to data released by the territorial government on Thursday after refusing to reveal the extent of the disease for months.
The Ministry of Health in Nunavut announced on Thursday that 139 cases of tuberculosis have been identified in Pangnirtung in the last 18 months, 31 of which have been active, meaning patients have been ill and infectious. The others were cases of latent or dormant tuberculosis, an asymptomatic version of the bacterial infection that is not contagious but puts patients at risk of developing active tuberculosis in the future.
The Globe and Mail traveled to Pangnirtung earlier this month as part of an ongoing health investigation into Canada’s youngest territory. In interviews, community leaders expressed disappointment at the lack of official information about the tuberculosis epidemic, which Michael Patterson, the country’s chief public health officer, first announced on November 25 without providing a case count.
The size of the outbreak came as a surprise to Pangnirtung Mayor Eric Lawler, who, along with the rest of the neighborhood’s elected council, was unaware of official statistics on the growing health problem in his own community.
“The information had to be provided to us regularly to begin with,” Mr Lauler said on Thursday. “It’s actually more worrying than COVID. Because the numbers are so high, it’s a little unsettling and unsettling that we haven’t taken it more seriously by the government. “
The Nunavut Ministry of Health released the figures in a press release a week after receiving a list of questions from The Globe about the ongoing tuberculosis epidemic in Pangnirtung, a community of about 1,600 people per hour flying north of Iqaluit, the capital.
“I don’t know why they are so secretive,” said Madeleine Kumuatuk, Pangnirtung’s wellness coordinator in the community. “You can’t be secretive and then do prevention. I mean, they have to be true to us.
Ms Qumuatuq was one of several Pangnirtung residents who expressed concern about the pace of the government’s response to the TB outbreak. She pointed out that the health department had rented the public hall – one of Pangnirtung’s few public places – since March 1 for a satellite TB clinic that is still closed.
“We miss a lot of age groups that usually come here to play checkers, billiards, whatever. And teenagers hang out here,” she said. “All this was taken away because they rented the room. But they are not even here yet. “
Danarae Somerville, a spokesman for the Ministry of Health in Nunavut, said in an email that the delay was caused by a shortage of skilled workers “needed to ensure Hamlet’s building has adequate wiring and a network to create staff workstations”. . These workers were blocked in response to a fire that engulfed a government building in another village, she added.
In response to earlier questions about the outbreak, she said the Ministry of Health had sent additional nurses and other front-line staff to Pangnirtung to help manage the outbreak – not an easy feat during a national shortage of nurses, exacerbated by the pandemic.
Active tuberculosis infections, which are caused by bacteria that spread through the air and usually linger in the lungs, can cause fever, weight loss, night sweats, fatigue, and a chronic, sometimes bloody cough. Antibiotics can treat active tuberculosis and prevent latent cases from becoming a serious disease. The infection can be fatal if left untreated.
Tuberculosis is a disease that most Canadians consider a scourge of the past. But it remains a scourge of the present in indigenous communities, especially in Inuit communities, where deep poverty, overcrowded housing and limited access to health care make residents particularly vulnerable.
The Federal Liberal Government, along with the Inuit Tapiri Kanatami, a national Inuit organization, has promised in 2018 to eradicate tuberculosis in Inuit communities by 2030.
The latest data from the Public Health Agency of Canada shows that in 2020 there were 72.2 active cases of tuberculosis per 100,000 Inuit people, compared to a national incidence rate of 4.7 per 100,000.
Although 15 times higher than the national average, the Inuit tuberculosis rate has dropped significantly in 2020, from 188.7 cases per 100,000 in 2019 and from a 10-year average of 184.14 per year. 100,000 from 2010 to 2019 is probably the decline in cases. tuberculosis remains undiagnosed in the first year of the pandemic, disease experts said.
Nunavut, home to the majority of Inuit in Canada, recorded 34 active cases across the territory in 2020, or 86.40 per 100,000, which is less than the average of 66 active cases per year across the territory in the previous four years.
In February, Nunavut’s privacy commissioner ruled in favor of The Globe after the newspaper appealed The territorial government’s refusal to disclose the number of TB cases by community, age and gender.
But the Commissioner’s privacy decisions are not binding in Nunavut. Health Secretary John Maine rejected the call for community-level data, saying at the time that it could risk identifying patients and stigmatizing entire communities.
Neither Mr. Maine nor Dr. Patterson were available for interviews Thursday.
Chris Puglia, another spokesman for the Ministry of Health in Nunavut, said in an email that the department did not plan to publish data on tuberculosis in populated areas, except during epidemics. “Community-level data outside the outbreak do not offer additional protection to public health and could further condemn the disease and create hesitation among people seeking testing,” he wrote.
He added that Dr Patterson’s office had decided to compromise on the Pangnirtung case and to release updates every three months that “could help manage the epidemic”. The Ministry of Health published data at the community level during the last major outbreak of tuberculosis in Nunavut in Kikiktarjuak in 2017-2018. A 15-year-old girl died in that outbreak.
Nunavut Privacy Commissioner Graham Steele said the government should go further and follow its decision on tuberculosis data.
“I continue to believe that the law requires numbers at the community level to be published, not just at a time and place chosen by the government,” he said on Thursday. “It is difficult for the government to keep track of TB policy when it keeps all the figures secret.
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