It may be easy for many Canadians to disregard tuberculosis (TB) as an irrelevant disease; after all, it is curable and only found in the developing world…right? Today, Monday March 24th, is World TB Day and readers should be reminded that TB remains a global threat. One third of the world’s population are carriers of TB and 1.3 million people are killed by the disease annually according to the World Health Organization (WHO).
The current regimen for someone diagnosed with drug susceptible tuberculosis is a gruelling 6 month course of multiple antibiotics. When patients are prescribed inadequate treatment, or are given poor-quality medicines, or fail to take the prescribed doses, drug-resistant strains of TB can appear. The treatment for resistant strains is much longer, more toxic, and less successful. Every year more drug resistant strains appear; there have been several reports in the last few years of strains resistant to more than 10 antibiotics. As there are very few new TB antibiotics being developed, these strains pose a great threat to the treatment and control of TB.
The risk of TB and drug resistant TB is not limited to distant countries – given the millions of travelers that cross internal borders each year. Let’s not forget the incident that occurred in 2007 when an American with multidrug-resistant TB took 7 flights between 6 countries over 12 days, including a visit to Montreal, potentially exposing thousands of people. It is therefore with enlightened self-interest that Canada, and Canadians, should contribute to the fight against TB, both within and beyond our borders.
Canada has a long and largely successful history of combating TB, but we must not consider TB a disease of the past, as it is commonly perceived. Some regions of Canada have rates of TB that are among the highest in the world. In 2012 we experienced two major outbreaks of TB in Nunavut and Nunavik. In these parts of Canada TB rates have been increasing each year for the past decade. Sir William Osler, the most eminent medical scholar and member of the McGill Medical Faculty described TB as “a social disease with medical aspects”. More than ever, we should remember those immortal words and intensify our efforts to eliminate the ‘White Plague’.
Dr. Marcel Behr
Director, McGill International TB Centre
Microbiologist-in-Chief, McGill University Health Centre (MUHC)
Investigator in Infection and Immunity, Research Institute of the MUHC
Dr. Dick Menzies
Associate Director, McGill International TB Centre
Montreal Chest Institute, McGill University Health Centre (MUHC)
Investigator in Respiratory Health, Research Institute of the MUHC
McGill International TB Centre: www.mcgill.ca/tb