Northern Sask. TB outbreak spread quietly for months, doctor says

Dr. Nnamdi Ndubuka said he suspects the spread began in the spring.

Zak Vescera, Saskatoon StarPhoenix 3 minute read November 23, 2021

A tuberculosis outbreak that has infected two dozen people in Saskatchewan’s far north quietly began months ago, a top public health official says.

Dr. Nnamdi Ndubuka, the medical health officer of the Northern Inter-Tribal Health Authority, said 24 people have tested positive and close to 300 priority contacts have been identified in the Fond du Lac and Black Lake Denesuline First Nations, remote communities roughly 800 kilometres north of Saskatoon.

Ndubuka said weeks of rigorous contact tracing, screening and investigation indicate the cases in Fond du Lac may have begun as early as the spring, highlighting the need for regular screening and the resources the COVID-19 pandemic has sapped from controlling other infectious diseases.

“Within the COVID pandemic, our attention has really been diverted from other health services. But unfortunately, as the attention has been on COVID, some of the work in these other areas has been put on the back burner,” Ndubuka said.

Tuberculosis, eradicated in much of Canada, persists in some northern Indigenous communities in Saskatchewan due largely to socioeconomic factors like cramped housing and limited access to routine health care services, he said.

The most recent outbreak was declared Oct. 8 after 13 positive cases were identified on the two First Nations, including several among children.

Ndubuka said three infected people are in hospital, one in intensive care, a signal the disease was progressing and spreading well before authorities detected it.

“It means transmission occurred for quite some time within the community,” Ndubuka said.

He believes the first case in Fond du Lac may have happened as early as March, and the first case in Black Lake could be traced back to May, he added.

“Those are indications the outbreak is quite unique. It’s not just about the number of cases, it’s also the outcome among cases that have been identified.”

Athabasca Health Authority CEO Allan Adam, whose organization delivers health services in the province’s most northern communities, said the authority was aware of nine cases in Black Lake and 15 in Fond du Lac. The AHA, Indigenous Services Canada and NITHA have collaborated in a massive testing and tracing effort, which Ndubuka said is crucial to their understanding of the outbreak.

He said the organization’s key message is that tuberculosis’s spread is fuelled by inadequate housing and other socioeconomic factors that persist in the province’s north.

“It is very preventable,” Ndubuka said.

Adam said work is ongoing to educate the community about the telltale signs of tuberculosis, which include a persistent cough, night sweats and fever.

Adam said the outbreak is a reminder of how far authorities have to go in suppressing the illness.

Tuberculosis rates were on a hopeful decline in Saskatchewan for many years, but preliminary Saskatchewan Health Authority data says roughly 100 cases were detected in 2020, the first increase in years.

Some speculate the actual numbers are higher because so many public health resources were dedicated to tracing and snuffing out COVID-19.

“TB was supposed to have been eradicated a long time ago, but it’s still here,” Adam said.

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