Tuberculosis In Nunavut

• Tuberculosis Control’s primary goal is to reduce the incidence of TB in Nunavut through surveillance, education and clinical services.
• The Tuberculosis Consultant advocates multidisciplinary projects to create comprehensive prevention and treatment strategies for Tuberculosis.
• Ensure prompt and appropriate treatment for all diagnosed to prevent globally emerging Multi Drug Resistant TB (MDRTB).
• Evaluates the on-going TB management and control program for its effectiveness.

Background:
Tuberculosis is one of the main public health concerns of Nunavut, with the tuberculosis incidence rate in the Territory being almost seventeen times that of the Canadian average. And though the number of new cases is declining, the reservoir of infection in the aging Nunavut residents still prevails. TB elimination remains an ongoing battle. Environment and socio-economic conditions all contribute to its spread.

Fact sheets:

1. Facts about TB:

• TB - Tuberculosis is a disease caused by bacteria (germs) that are breathed into the lungs.
• TB germs spread through the air when someone who has TB sneezes, coughs, laughs, sings or speaks, just like the common cold.
• You could have TB germs in your body and not even know about it.
• TB germs can attack any part of your body but they usually attack the lung.
• Many people when infected with TB germs do not get TB disease or get sick.
• When infected with TB germs, you can take medicines to prevent getting the disease or getting sick.
• Left untreated, one person with TB disease will infect 15 people in a year’s time.
• TB is curable.

2. Who should get tested for TB?

• If you live or have frequented, close contact with someone who has TB disease.
• Have any signs of disease - cough a lot, feel weak, have a fever, lose weight, cough up blood, sweat a lot at night, do not feel hungry.
• Have HIV, the virus that causes AIDS.
• Those on immunosuppressive medications or with medical conditions like diabetes, renal disease and other chronic diseases.
• Live or work in a health care facility, correctional facility, shelter, or group home.
• Came to Nunavut from a country where TB disease is common.
• Use needles to inject drugs.

3. Difference between TB infection and TB disease

TB INFECTION TB DISEASE
You usually have a positive skin test. You usually have a positive skin test.
You have no symptoms and you do not feel sick. You are sick and have symptoms which include
A bad cough that lasts longer than 2 weeks

• Pain in the chest
• Coughing up sputum or blood.
• Weakness or fatigue
• Weight loss
• No appetite
• Sweating at night
• Fever
• Chills
• You cannot spread TB to others. You may spread TB to others.
• Chest X ray and sputum tests are normal. You may have abnormal Chest X ray and/or positive sputum result.

Frequently asked questions about TB.

1. What is a Skin Test?
- A simple skin test can help show if there are TB germs in your body. This test can be done at the health center and public health clinic.

2. How is the skin test done?
- The nurse injects a harmless substance (Tuberculin Protein) under the skin on your forearm. After 2-3 days you return to the nurse to get your arm checked out for swelling. * It is very important to return to the nurse to get the test read.

3. What does the skin test show?
- If your result is positive, it means you have the TB germs in your body and the nurse will do more tests to see if you have TB disease. These tests include a Chest X ray and a test of the phlegm you cough up. And if you have the TB disease you may have abnormal Chest X ray and /or positive sputum result.
And if your result is negative you may need another skin test after 10 to 12 weeks.

4. If I am not sick and only infected why do I need to take medicines?
-When you are infected, your TB germs are in a sleeping state but they are alive. These germs can come out of their sleeping state and begin to grow into active TB disease if you become sick with other illness and your body becomes too weak to fight the germs. So to kill these germs you must take a TB medicine for 9 months to reduce your chances of developing active TB disease.

5. Is TB curable?
- Yes, TB is curable.
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6. How is TB disease treated?
- TB disease is treated with 3 or more drugs.
- These medicines are to be taken for at least 6 months as the TB germs die very slowly. You will probably start feeling well after only a few weeks of treatment but you must continue to take your medicine until all the germs are dead.
- The nurse will ask you to come to the health center to take your medicine. They do that so that you do not forget to take the medicine and it becomes their responsibility to remind you.

7. What will happen if you do not take medicine exactly as you are told?
- You may get sick.
- Your TB germs may become resistant to the TB medicine. This means the TB medicine may not work.
- Your treatment may take longer.
- You could spread TB to others.