Sharp increase in the number of tuberculosis cases in Quebec

The number of tuberculosis cases has increased sharply in Quebec this year, to the point where the government has requested increased monitoring of the situation.

According to data obtained by The Journalthe Quebec Ministry of Health and Social Services reports 329 cases of tuberculosis in 2024, a “significant excess” compared to pre-pandemic years.

After experiencing a drop in cases during the pandemic due to the energy directed towards the coronavirus, tuberculosis, a disease that can be fatal if left untreated, has started to spread again, and with a significant increase. The rate increased from 2.36 per 100,000 inhabitants to 3.95. An increase of 43%.

The contagious disease is “in excess” in seven regions, including Montreal, Laval and the Capitale-Nationale, but it is in Nunavik that the situation is most critical.

“The rate is 100 times higher than that of the general population – approximately 500 people infected per 100,000 compared to 2 to 5 cases – and 6 of the 14 communities are experiencing outbreaks,” mentions the D^r Yassen Tcholakov, clinical head of infectious diseases in Kuujjuaq.

A vaccination campaign is underway in all Nunavik communities.

Migrants and natives more affected

The ministry specifies that the disease is more often detected in people born outside of Canada and indigenous peoples.

“Among the cases where the place of birth was known, 76.7% concerned people born outside of Canada, 16.9% of Indigenous people and 3.6% of non-Indigenous people born in Canada,” specifies the ministry. by referring to Health Canada statistics.

The overcrowding of housing on indigenous reserves would be a risk factor, given the fact that the bacillus responsible for the disease is transmitted after prolonged contact (at least 12 hours) with the sick person. The treatment with antibiotics is very long, six to nine months. A three-month preventive treatment is administered to people who have been in contact with sick people to avoid being contaminated.

Antibiotic resistance

In 2023, the World Health Organization reported that this disease was the second leading cause of infectious death after COVID-19.

The D^r Tcholakov adds that, in some countries such as Angola, Bangladesh, Mongolia and Vietnam, we are even facing a strain resistant to antibiotics. As with the coronavirus, new variants of tuberculosis are appearing and new drugs are needed to limit their progression. But pharmaceutical companies are not putting the same efforts and budgets on tuberculosis as they did to fight COVID-19.

Tuberculosis in Quebec: an increase of 43% since the pandemic

2024 (until September 28): 349 cases of tuberculosis

Incidence rate: 3.95 per 100,000 inhabitants

2023: 292 cas

Incidence rate: 3.33 per 100,000 inhabitants

Annual rate from 2015 to 2019 (before the pandemic): 196 cases

Incidence rate: 2.36 per 100,000 inhabitants

Increase recorded before/after: + 43%

Source: MSSS

Tuberculosis in brief

Tuberculosis is a notifiable disease in Canada and “all reported cases are subject to a public health epidemiological investigation.”

It is caused by the Mycobacterium tuberculosis.

Its active form most often develops in the lungs, but other organs such as the lymph nodes, kidneys and bones can also be affected.

Its main symptoms are:

• a cough that lasts more than 3 weeks, often accompanied by sputum;
• fever;
• great fatigue;
• loss of appetite;
• night sweats;
• weight loss.

The infection is cured by taking several antibiotics daily (isoniazid, rifampicin, pyrazinamide and ethambutol) over a period of six to nine months.