The Wellington-Dufferin-Guelph area saw a significant increase in the number of tuberculosis cases in 2023.
From 2022 to 2023, the number of cases doubled, with 12 active infections compared to six the year prior.
There were 261 untreated latent (inactive, not contagious) infections up from 132, and 59 treated latent infections up from 59.
“We’re probably treating more infections today than we were 10 years ago. This number would have been quite unusual,” said Medical Officer of Health Dr. Nicola Mercer during Wednesday’s board of health meeting.
“The numbers are still on the smaller side compared to some other parts of Ontario,” she said. “But we had a doubling of our numbers, and that’s really quite significant for us.”
Mercer said that while TB is treatable, it’s a challenging disease, and one that’s been around for a long time.
It often mimics other illnesses – so much so that people don’t always know right away that they have tuberculosis, Mercer said.
“And sadly, many people present to us in later stages of the disease; they didn’t seek treatment early.”
Tuberculosis spreads through the air, and primarily attacks the lungs, although it can impact other parts of the body including the kidneys, spine and brain.
Symptoms vary but typically involve a cough that lasts at least two weeks, fatigue, weight loss and fever.
TB is often associated with social determinants of health. For instance, living in a crowded space increases the chances of contracting tuberculosis, Mercer said.
In response to the increase in numbers, public health has made some changes to the regional treatment program, including extensive additional staff training around tuberculosis treatment.
It also made the process more accessible for patients through things like electronic documentation and changes to how medications are packaged and distributed. Before, staff on the public health TB team dispensed all medication, but in 2023 they partnered with a local pharmacy to support the dispensing process and free up nursing time.
Over the pandemic, the team also transitioned to a virtual directly observed therapy process for patients so that they could remain at work or at home.
Observed therapy is a strategy used for tuberculosis patients to ensure they adhere and can tolerate the prescribed treatment. For instance, a health care worker will watch the patient swallow each dose of medication.
“Observed therapy is a very important component of the treatment for tuberculosis, because some of the medications can be very challenging on the individual,” said director of community health and chief nursing officer Rita Isley during the meeting. “So having, initially, daily interactions when they’re having their medication and slowly weaning them off those interactions is important to have… the best health outcomes.”
Treatment for TB ranges from six months to two years or longer, with a variety of medications.
Latent infections are typically treated as well to prevent them from becoming active; their treatment is typically shorter with fewer medications.
Isley said the populations tending to become ill with tuberculosis are newcomers, and that testing was reduced over the pandemic, both of which can account for the increase in cases.
“So we’re going to be working really hard in our community to do some education with our healthcare providers to ensure that they understand and consider tuberculosis when they are seeing and treating patients in the community.”