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While many people associate TB with the dramatic and archaic depictions from historical television or movies, it's still very much alive — and just as deadly as it was in the 18th century.
What is Tuberculosis?
According to the Canadian Lung Association (CLA), TB is a "serious disease caused by breathing in bacteria called Mycobacterium tuberculosis." While the condition usually infects the lungs, it can attack other parts of the body including the kidneys, spine and brain.
TB is very contagious. Infected individuals spread the disease through the air, similar to COVID-19. Symptoms develop and progress slowly. Without treatment, people can be very sick for a long time.
"The reason why TB is really important is because without treatment, half of people with TB can die within two years," Elizabeth Rea, Associate Medical Officer of Health with the Tuberculosis program at Toronto Public Health, told Yahoo Canada.
"So it can be a really severe, potentially fatal disease if you don't have good access to diagnosis and treatment."
Why are we seeing a spike in Tuberculosis cases?
As a result of the COVID-19 pandemic, Canada's ongoing endeavour to reduce and eliminate TB came to a halt.
According to Dr. Tom Wong, Chief Medical Officer of Public Health for Indigenous Services Canada, crucial care including "contact tracing, prevention, early diagnosis, treatment and care for tuberculosis" were redirected to fight COVID-19.
As a result, Rea explained, this redeployment "almost certainly" caused the increase in TB.
"The bigger impact of COVID in Canada is that huge amounts of the healthcare infrastructure that supported TB was diverted to COVID," Rea said. "So laboratories, physicians and public health work were redeployed to COVID, leaving less access to diagnosis and treatment for TB."
Additionally, Rea says as TB spreads through the air, issues such as indoor crowding and lack of ventilation have added to the surge in cases.
"If I have TB, and I live in a house with two bedrooms and 17 people, it's going to be easier for my TB to spread. If you layer on the difficulty of getting access to diagnosis and treatment, you can see how quickly that can turn into an outbreak," Rea described.
This is especially true for people living in remote rural communities, such as Inuit and First Nations communities — where Canada is seeing the largest spike in cases.
What Canadians should know about Tuberculosis
Many health professionals like Rea are concerned about the increase in TB cases.
"This is very concerning, especially for a country like Canada, one of the wealthiest countries in the world. We should not have TB going in the wrong direction," Rea said.
Here's what you need to know about TB, including symptoms, risks and prevention.
Signs and symptoms
There are a few notable signs and symptoms of TB, but they can often be confused for other conditions.
"When it's in your lungs, the classic symptom is a new or worsening cough," Rea said. "This can last a long time, for two weeks or more. It's a very slow infection."
Additional symptoms include:
Shortness of breath
Fever and night sweats
Lack of appetite
If the condition develops, it can cause weight loss and you might cough up blood.
If you or someone who know is showing signs of TB, or fear you may have been in contact with someone carrying TB, contact a health professional as soon as possible.
Who is at risk for Tuberculosis?
There are a variety of factors that increase your risk of contracting TB.
If you've spent time with an infected individual or you're from a country where TB is common (Latin America, the Caribbean, Africa, Asia, Russia and Eastern Europe), you're more likely to get sick.
In Canada, groups most likely to suffer are First Nations and Inuit communities.
Wong added these groups are affected due to "social determinants" including inadequate housing, many people living in close quarters and a lack of access to nutritious and affordable food.
Rea echoed the dire situation.
"It's hard to underemphasize how terrible this is. In Canada, one of the wealthiest countries in the world, people are living in situations where outbreaks of TB can happen," Rea said.
Treatment for TB is centred on antibiotic use over an extended period of time.
"It's a minimum of six months on special antibiotics, four different antibiotics to be exact," Rea explained. "That's a long time to treat an infection."
According to the Government of Canada, the antibiotics are usually given by a trained health care worker who assists patients with their medicine and provides them with a treatment plan.
If you suspect you might have TB due to travelling or exposure to a sick patient, you can take antibiotics to prevent the bacteria from becoming active or the infection from getting worse.
Although TB requires a long and vigorous treatment period, Rea said that it's a very curable disease.
"TB causes so much illness and death around the world, but it is very much a treatable, curable disease," Rea said. "The whole issue with TB is making sure that people have access to diagnosis and treatment no matter where they live."
How can I prevent Tuberculosis?
While no method is foolproof, there are a few ways that can reduce your chance of contracting TB.
The Canadian Lung Association (CLA) explained there is a preventative vaccine called Bacille Calmette-Guerin, which is mainly used to protect babies and young children against TB if they are living in a high risk area.
"In Canada, very few people get the BCG vaccine. Babies in First Nations and Inuit communities with high rates of TB are the only ones who routinely get the BCG vaccine," said the CLA.
Additionally, smoking puts you at a higher risk as its side effects make it tougher for your body to get rid of TB.
But as mentioned above, there are preventative antibiotics you can take before you get sick.
According to Rea, "if you've been around places where there might be more TB, there's a test for it and you can take antibiotics to deal with it before you even get sick."
The future of Tuberculosis in Canada
While TB is growing in Canada, there is hope the disease will be completely eradicated in the future.
But in order to do so, Rea believes Canadian citizens and the government need to direct their attention toward TB and develop an action plan for the future.
"The very first step is people recognizing that TB is here in Canada, the same way it's in other parts of the world. We need access to diagnosis, treatment and prevention... and we need a real plan from the federal government about how we're going to decrease or get rid of TB," Rea said.
World TB Day is recognized every year on March 24, where there's events and education to raise awareness of the condition. It's the perfect time to learn more about the disease, but Rea encouraged people to do their part whenever they can.
"Definitely get involved every March, but you don't need to wait to help make a difference. Awareness and action is key," Rea added.