Quebec 'closely monitoring' tuberculosis in Nunavik, minister says, as doctors call for more resources

Quebec's health minister says the province's public health service is "closely monitoring" the number of tuberculosis cases in Nunavik, in the wake of a letter from the mayors of the region's 14 Inuit communities calling for the declaration of a public health emergency.

"We take this situation very seriously," Health Minister Christian Dubé's office told CBC News. "We will continue to follow the recommendations of public health experts on this subject."

Public health experts who spoke with CBC News said they are facing resource shortages and need help in order to adequately address the rising numbers of active tuberculosis cases in the region. Quebec's health department told CBC that as of June 7, there have been 56 cases so far this year of tuberculosis reported in Nunavik — even higher than the 40 cases the region's mayors referenced in their letter.

Six Nunavik communities currently have outbreaks of tuberculosis, and the region is on track to set a grim record for the third year in a row on the number of cases in the region, said Yassen Tcholakov, the clinical lead on infectious diseases for the Nunavik Regional Board of Health and Social Services.

"We have rates that are comparable to the countries with the most [tuberculosis]. If you take certain communities in isolation, those rates are comparable to the most dire setting in countries that have extremely minimal health resources," he said.

He said tuberculosis, while treatable, kills most infected patients within a few years if left untreated. Those who are treated are sometimes left with lifelong problems like scarring on their lungs.

If nothing changes, he expects the number of cases in Nunavik to keep growing.

"When I hear people calling for a public health emergency, I hear a cry for help — and an observation that the health system is not reaching the expectation of what the population would like to see," Tcholakov said.

In a separate statement to CBC News, the Ministère de la Santé et des Services sociaux du Québec said it has mobilized teams to determine the best way to follow up on the requests mayors made on Monday.

Neither the minister nor the department committed in their statements to declaring a public health emergency. The department wrote that it is taking "the time to carefully analyze the situation" before acting.

"We are aware that the increase in tuberculosis cases adds to the already numerous challenges [Nunavik] faces regarding access to quality, continuous and safe care and services," the department stated.

Faiz Ahmad Khan, a respirologist at the McGill University Health Centre who also works at the health centres in the Nunavik communities of Puvirnituq and Kuujjuaq, said there has been a "chronic shortage" of medical resources in general in Nunavik for years — an issue that also impacts the tuberculosis response.

"I think the mayors have raised a very legitimate demand," he said, with regard to the call for a public health emergency. Such a declaration would give health centres the ability to request the resources they need, he said.

Khan said resource shortages mean that sometimes entire families have to fly out just to get screened for the disease. In some communities, people also have to fly just to get an x-ray in order to be diagnosed. All of that delays treatment.