SOMBA K'E/YELLOWKNIFE - As the North's tuberculosis rates ripple through the national medical community, the GNWT is applauding its public health system for keeping this territory's disease outbreak under control.

An editorial published Feb. 14 by the Canadian Medical Association Journal echoed the grim reality health officials have long faced when it comes to fighting the deadly - but completely treatable - airborne disease in Nunavut, where TB rates are 62 times the national average. In 2010 alone, Nunavut reported a peak of 100 new active cases. The authors of the editorial, including editor-in-chief Dr. Paul Hebert, called Nunavut's continual TB outbreaks a national embarrassment.

"Although the Government of Canada's strategy provides hope for the people of the North, the eastern Arctic would benefit from greater investments in health such as adequate housing, food security and paying jobs to ensure its long-term prosperity," it read.

"This is not just Nunavut's problem — it is Canada's problem."

Although today TB infections dominate the developing world and are largely unheard of in the rest of Canada, the disease isn't

only a problem in Nunavut.

In NWT, the rate of TB is between five and 10 times higher than Canada's average. A third of NWT residents have been infected with TB at least once, according to Cheryl Case, a communicable disease specialist with the Department of Health and Social Services.

"Many of them have been cured along the way, but there's still a fair number that live with that latent TB infection that have never been treated," she said. "We have to back up to that phase of the disease and treat and cure everyone with latent TB infection before we can really state proudly that we have eliminated TB in the Northwest Territories."

In 2010, 11 new active cases of the disease were reported in NWT. Seven of those were among Deline residents after a sudden TB outbreak hit the Sahtu community of 565 in late 2009. That's comparable to incidences of the disease in 2008, when there were 13 confirmed cases of TB in the NWT, which were attributed to an outbreak that began in Yellowknife and surrounding areas in March 2007.

Currently, eight NWT residents are undergoing treatment for TB. The rest of the reported cases have been cured. But Case said the territory still has a long way to go before it eradicates the disease completely.

"It's possible to have TB elimination in the Northwest Territories, but we're going to have to dig a little bit further than treating the active cases of TB," she said.

"We spend a lot of time in our program trying to determine who contracted TB and we also treat anyone of those contacts that would have been infected with TB. Our priority there is to treat them when they have the infection as opposed to waiting for them to have the disease."

Treatment takes up to nine months, much of it overseen by public health nurses and community health representatives once patients are no longer infectious and have returned home - even though health officials continue to battle the palpable resentment that some community residents still carry from decades ago when infected family members were sent away to quarantine, some never to return.

"That's a long, sad history behind many people in the Northwest Territories. But the sanitariums are long gone and our aim in the Northwest Territories is to be able to support treatment at home," she explained. "The whole secret of success is to continue treatment while they (patients) remain in their own natural and comfortable environment."

TB travels through the air, thriving in cramped living conditions, to infect the lungs and can be fatal - especially in those with weakened immune systems due to prior illnesses. Those with latent TB infections - carriers - can develop active TB and usually do so within two years of contracting the germs, resulting in a bad cough, fever, night sweats and chills. That's why the NWT is focusing on screening residents most vulnerable to TB infection - including the homeless and those with substance abuse issues or poor nutrition - a strategy that will be set out in the NWT's tuberculosis manual due to be released next month in time for World TB Day on March 24. Case said effectively combating the disease depends on a strong public health system and practitioners who know how to diagnose the disease quickly - a challenge for NWT's health system because of high turnover among medical professionals.

"As new practitioners come up, we try to ensure that they know about the TB epidemiology in the Northwest Territories and share that knowledge of best practice," she said. "It involves many, many hands."

"TB is a medical concern as well as a social concern."

We welcome your opinions. Click here to e-mail a letter to the editor.