Vancouver Island TB Cases

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Source: http://www.canada.com/nanaimodailynews/news/story.html?id=e7f97d84-e8e6-41c9-8f7c-46494c0a9695
New case of TB in Alberni Valley
Number of cases in Vancouver Island outbreak now totals 36
Julia Caranci, AV Times
Published: Friday, June 06, 2008

Another new case of active tuberculosis has been diagnosed in the Alberni Valley, bringing the new total to 36 cases, the Vancouver Island Health Authority (VIHA) announced on Friday.

Speaking to the Times on Friday afternoon, VIHA Central Island medical health officer, Dr. Lorna Medd, said the latest diagnosis is of a Port Alberni resident that was tracked down through the current contact tracking process.

Until December last year, the number of cases had remained steady at 33, and health officials were hopeful the outbreak was winding down.

But thus far this year, three more cases have been identified, the latest was officially diagnosed on May 31, Medd confirmed.

"I would like to be able to say it's stopped, but we are diagnosing more cases," Medd said. "What I am seeing is individual cases occurring over time."

She added the good news is health officials appear to be getting to the new cases earlier.

This means they get treated earlier, which in turn means there is far less chance of them spreading the illness to their close contacts.

Health officials recently admitted they do not consider the outbreak fully under control, but it was expected that most active cases of the disease had already been located.

Health teams are currently pursuing every possible contact of those diagnosed with the active disease, and offering skin tests and X-rays, and prophylaxis to anyone who has tested positive.

Those who test positive are given the option of taking a course of antibiotics to prevent the disease from taking root.

For active cases, it's a three-drug regimen, over a longer period of time, plus close observation.

Currently, 31 of the 36 people diagnosed with the active disease have completed their treatment regime -- the remaining five are currently being treated.

Since May 2006, over 2,000 individuals in the Port Alberni area of Vancouver Island have been screened for tuberculosis, and 35 cases of active TB have now been reported.

The Vancouver Island Health Authority continues to work closely with the British Columbia Centre for Disease Control, the Nuu-Chah-Nulth Tribal Council, local physicians and public health nurses to manage and monitor the situation.

Medd added regular screenings for TB will take place in Port Alberni over the summer months, and will be advertised in the local media.

Health officials continue to insist the outbreak does not present a risk to the general population.

JCaranci@avtimes.net

 

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Re: Vancouver Island TB Cases

Source: http://www.theglobeandmail.com/servlet/story/LAC.20080901.BCTUBERCULOSIS01/TPStory/National

Tuberculosis outbreak may take five years to contain

SHANNON MONEO

Special to The Globe and Mail

September 1, 2008

VICTORIA -- It may take up to five years to squelch a tuberculosis outbreak that has plagued the central Vancouver Island community of Port Alberni since late 2005 when a homeless, mentally ill addict was identified as having the disease.

His was the first of what grew into 40 TB cases.

"People who are homeless, who have mental illness, may go back to areas where they can get re-infected," said Lorna Medd, medical officer for the Vancouver Island Health Authority.

The treatment for the disease involves regularly taking several types of pills for six to nine months. Once a person is cured, they can get re-infected if their immunity is low and they are exposed to the TB bacteria.

Of the 40 confirmed cases, most have occurred amongst the Nuu-chah-nulth people who live in the Alberni Valley. Aboriginal people, on and off reserves, continue to be the focus in the bid to stop the current "major outbreak," Dr. Medd said. But she stressed that this latest TB scare is "not about ethnicity, it's about social determinants of health."

The underpinnings are disenfranchisement, homelessness, drug and alcohol addictions and mental illness, Dr. Medd said from Nanaimo.

When someone with infectious TB coughs or sneezes, those nearby can catch TB by breathing in the germs, which attack the lungs and other areas of the body.

Those with compromised immune systems are more likely to go from having TB infection to full-blown TB disease, signs of which may include chest pain, coughing, shortness of breath, loss of appetite, weight loss, fatigue, fever and night sweats.

According to a report prepared by Kevin Elwood, director of tuberculosis control at B.C. Centre for Disease Control in January, 2007, Port Alberni's TB infection was spread in a Port Alberni hotel, as well as crack houses and alleys.

In 32 cases, the infected range in age from 15 months to mid-70s and reside in the Alberni Valley, while the remaining eight live outside the area but had contact with a valley resident.

Four of the TB victims died, but Dr. Medd said their deaths were "lifestyle-related." Since May, 2007, there have been seven new cases. The average per year for the area is five.

Nuu-chah-nulth Tribal Council President Tom Happynook said if it wasn't for the work done by Nuu-chah-nulth health services staff, the Alberni TB outbreak could have been worse.

"The outbreak is serious. It has had a big effect on our people. Our NTC health service staff gave it a high priority," he said.

While the TB outbreak was first detected more than two years ago, Mr. Happynook said that it's been only in the last year that the regional health authorityVIHA has ramped up its response.

The tribal council, which represents about 8,000 people from 14 first nations, used a dedicated two-person TB team along with about 20 more nurses and health-care workers, who have gone into the community to find people suffering from TB.

"Our staff know where our people are living. Our people are far more comfortable reaching out to our staff," Mr. Happynook said.

The Vancouver Island Health Authority, which uses rigid health-care policies, has a lot to learn from the tribal council's health department, Mr. Happynook said.

"I hope VIHA is open to building a strong relationship to provide services our people need, no matter where they live. It's important for them to support goals and objectives we have as opposed to trying to impose their goals and objectives on us," he said.

VIHA and the Nuu-chah-nulth have been working closely to combat the TB outbreak and VIHA will continue to be sensitive to the needs of its clients, Dr. Medd said.

To improve the relationship, a community and cultural co-ordinator will be jointly hired this fall by VIHA and the Nuu-chah-nulth to work with a scientific outbreak co-ordinator.

Since the TB outbreak, the town of Port Alberni has also been spurred to develop a plan to eliminate homelessness and improve health-care accessibility.

About 90 per cent of people who are exposed never develop TB disease, Dr. Medd said. If they're healthy enough, their bodies build walls around the TB germs, in effect imprisoning the bacteria within the body.

The Bacille Calmette-Gu?rin vaccine was given to health-care workers in B.C. until the mid-1970s.

In the 1990s, the Nuu-chah-nulth stopped using the vaccine because it does not provide sufficient protection, Dr. Medd said.

By 2003, all first nations communities in B.C. discontinued BCG use.

 

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Re: Vancouver Island TB Cases

Source: http://www.bclocalnews.com/vancouver_island_central/albernivalleynews/news/80379097.html

New TB case found in Port Alberni; 'outbreak is not over': VIHA
Published: December 30, 2009 4:00 PM
Updated: December 30, 2009 5:01 PM


An active case of tuberculosis has been confirmed in the Port Alberni area, bringing to 45 the total number of cases diagnosed since an outbreak was declared in October 2006.

"This is the first active case diagnosed since January 2009," Vancouver Island Health Authority Medical Health Officer Dr. Charmaine Enns said in a press release.

"It serves as a reminder that the outbreak is not over. Any resident who has been notified by public health officials that they have been in close contact with someone with active TB disease is urged to follow up on recommendations for completing screening for TB," she added.

Screening for TB involves skin testing or a chest x-ray, or both in some cases.

Since May 2006, more than 3,000 individuals in the Port Alberni area have been screened for TB, Enns said.