Nunavut declares years-long tuberculosis outbreaks over

Globe and Mail

a day ago

Nunavut's health department declared an end to years-long tuberculosis outbreaks in two Baffin Island communities on Thursday.
Pangnirtung, a hamlet 45 kilometres south of the Arctic Circle, had the largest outbreak of TB in the territory in at least seven years. The outbreak was declared in November, 2021, and resulted in 47 active TB cases and 225 latent or 'sleeping' infections, which are asymptomatic and non-contagious.
The outbreak in Pond Inlet, located on the northern tip of Baffin Island, was declared in March, 2023. A total of 13 active and 117 sleeping cases, which can turn into potentially fatal active TB disease, were confirmed over the two-year period.
Ekua Agyemang, Nunavut's chief public health officer, said an outbreak, according to Canadian standards, can be declared over when there have been no new, active cases identified over two incubation periods, which is roughly two years.
She said it is 'exciting news' to finally announce an end to the two outbreaks.
'It shows the resilience of the community and their willingness to come together to work with us, as well as our partners, NTI (the territorial Inuit organization), and everyone else who has been supportive during this journey,' Dr. Agyemang said.
TB is a contagious bacterial disease that can be fatal if left untreated. While TB is rare in most of Canada, it disproportionately affects Inuit communities. In 2023, the rate of TB among Inuit peoples was over 37 times that of the overall Canadian population.
The majority of Nunavut's population is Inuit.
From the archives | How a Nunavut hamlet's tuberculosis outbreak unfolded without adequate government support
Dr. Agyemang said early identification and treatment was key to slowing spread and eventually ending the outbreaks. She said part of this effort required training for health care workers so they could recognize, test and treat TB. A community-wide screening program also took place in the fall of 2023.
Community engagement played an important role as well, part of which focused on breaking down stigma and fear of TB due to Canada's history of TB sanatoriums and colonial violence, Dr. Agyemang said.
'Getting people to talk about it, getting survivors to talk about it, getting people who have had the treatment to talk about it, went a long way to break down the stigma, the fear, and encourage people to be to be screened,' she said.
The federal government vowed in 2018, during the major territorial outbreak in Qikiqtarjuaq, to eliminate TB in Inuit communities by 2030. The outbreak in Pangnirtung, south of Qikiqtarjuaq and home to roughly 1,500 people, was the largest publicly reported outbreak since.
A Globe and Mail investigation published in June, 2022, found that front-line nurses in Pangnirtung were begging for help the previous summer as TB cases multiplied, and as senior health officials dragged their feet on publicly declaring an outbreak.
There are still active outbreaks in Nunavut – in Naujaat, located at the northern end of Hudson Bay, and Arviat, on its western shore. Dr. Agyemang said the strategies used in Pangnirtung and Pond Inlet are being replicated in those areas.
She said while the outbreak is considered over in both of the Baffin Island communities, meaning there is little risk of TB transmission, surveillance will continue. This includes through preschool, Grade 6 and employment screening programs.
'We only know what we know,' Dr. Agyemang said.
'There are people in the community that over the course of the two years, four years, never came into contact with the health care centre and might have TB. We don't know about them but we know that we've done our due diligence.'