TB death in Quebec's far north spurs public health awareness campaign

The public health department in Nunavik, Que., says people infected with tuberculosis don't always seek medical treatment because of the perception people carry of the disease.

Coroner says stigma of tuberculosis may have prevented Jimmy Baron, 22, from seeking treatment

Tuberculosis affects the lungs, but Coroner Jean Brochu said some of the symptoms such as coughing and fatigue may have been masked by the fact that Jimmy Baron, 22, was a smoker. (CBC)

Public health officials in the far north of Quebec are planning to launch a tuberculosis awareness campaign, following the death of a 22-year-old Inuk man last June from the infectious disease that has all but disappeared from southern Canada.

Jimmy Baron lived in Kangiqsualujjuaq, Que., the easternmost village in Quebec's Inuit territory of Nunavik, with a population of just under 1,000.

Coroner Jean Brochu said the young man died on June 3, 2017, after being in close contact with another person infected with TB, which affects the lungs and other organs.

In his report on Baron's death, Brochu said Baron didn't follow the recommendations of the local health centre, "and did not show up for an appointment for a chest x-ray."

Brochu said Baron may have ignored some of the symptoms of TB, which include coughing, nighttime sweats and fatigue, because of his smoking and alcohol addiction.

The coroner also suggested that "many people feel marginalized when they receive a diagnosis," and therefore don't seek treatment, which may have been the case for Baron.

A mobile tuberculosis clinic has been set up in Qikiqtarjuaq, Nunavut, where the tuberculosis rate has risen to 10 per cent. (Travis Burke/CBC)

Disease easily treatable but complex 

Dr. Marie Rochette, the co-ordinator for infectious diseases at Nunavik's public health agency, said Baron's death came as a surprise, given that tuberculosis is easily treatable.

"It's a disease that can be cured. We have good treatment, and it can also be prevented," she said.

Rochette said despite people's perceptions, it is not easily transmittable. A person has to be in close contact with an infected person for several hours at a time, but a simple social gathering is not dangerous, said Rochette.

"We saw people who don't want to talk to people with TB because they don't want to be infected," she said.

Rochette said she and her team are working on a communications strategy for the region, to help destigmatize TB and encourage people to be tested and, if need be, treated.

Latent in most people

Rochette said tuberculosis resurfaced in the town of Kangiqsualujjuaq in 2012, with cases showing up in 2014 and 2015.

The real problem, she said, is that TB can be latent, or symptom-free, in many people, only progressing to become an active disease in a small number of people.

"We can have the germ in our body without knowing it, and it can develop in the two years following the infection," Rochette said.

In rarer cases, the infection can be latent for as long as 30 years.

Quebec has one of the lowest rates of tuberculosis in Canada, with three cases per 100,000 people.

However, the infection rate is 120 times higher in the Quebec territory of Nunavik, which has a rate of 360 cases of tuberculosis per 100,000, according to a report released by Quebec's Ministry of Health.
Public health officials in Nunavik says tuberculosis often goes diagnosed because people are afraid of the stigma attached to the disease. (Catou MacKinnon/CBC)

With files from Catou Mackinnon