TB and Measles Scare in Canada Now

No, Andrew Speaker, the XDR-strain-carrying Atlanta lawyer did not visit Calgary in Canada, still a TB scare has been set off there. Its health officials are testing 200 people who may have been exposed to tuberculosis while visiting a city hospital.

At the same time say a teenage Japanese student suspected of having measles remains in isolation in Vancouver, while 38 others and two of their chaperones are being monitored for symptoms. However, Calgary Health Region's Dr. Robert Cowie yesterday stressed the risk of contracting TB is low and the measures are being taken as a precaution.

"It is not highly infectious - we're just being ultra careful," said the director of the region's tuberculosis clinic. "This particular situation is a low-risk environment." Cowie said 200 people who visited the emergency department at the Peter Lougheed hospital March 27 may have been exposed to a patient with pulmonary tuberculosis.

Letters were sent this month to those people requesting they contact the health region to be tested for possible infection, said Cowie. "It takes eight to 12 weeks before the test for tuberculosis infection becomes positive after someone has been exposed," he said. As of this week, he said about 30 people have been tested and none are positive.

Cowie said the CHR calls for public testing for possible tuberculosis infection as often as 10 times each year. "There's probably no time in the year when we aren't following up with someone who's been exposed to tuberculosis," he said. He said anyone who tests positive for infection would be placed on a four-month course of treatment to ward off the disease.

The patient with pulmonary tuberculosis who attended the emergency department in March was unaware they had the disease, said Cowie. The patient is receiving treatment, which takes up to nine months, he added. Tuberculosis is an infectious disease spread through close contact over an extended period of time and is not easily spread to others, said Cowie.

In 2006, there were 56 confirmed cases in the region. In Vancouver meantime, a group of Japanese students were detained at the Vancouver International Airport on Thursday when they tried to board a plane to Tokyo and screening revealed that one of them, a girl, had measles-like symptoms. Dr. Theresa Tam, of the Public Health Agency of Canada, said they are conducting tests to see if the young girl with a low fever has measles.

She has since been quarantined in a hotel close to the airport. Thirty eight others of the group and their two chaperones are also put up in the same hotel and their condition is closely monitored.

Those who aren't being isolated have been given medication to help prevent the disease, minimize symptoms and reduce transmission, Dr.Tam said.

"In Canada, measles is virtually eliminated, as it is in the Western Hemisphere, and if that is the case then one case of measles is actually an important event and it's important for public health authorities to do what is necessary to try to prevent further transmission," Tam noted. The students have been told to cover up when sneezing and coughing and not share food or drinks.

Tam said people who have measles aren't infectious until the end of the incubation period.

"We knew they were beginning to approach the end of the incubation period," she said of the students. "Because of that one person having some symptoms it's a signal that the end of the incubation period might be over and that the other students could potentially begin to develop symptoms and that's why it was a very precautionary measure that we decided to detain them."

Measles is a contagious disease that spreads through coughing or sneezing. Symptoms include a mild fever and a rash on the forehead and behind the ears and a dry cough. Dr. Howard Njoo, director of the health agency's centre for emergency preparedness and response, said officials don't know if the other students are incubating the disease and may be infectious, but precautions were necessary.

"They were about to board a long-distance flight, which is a very unique circumstance -- being in an enclosed space for over 12 hours with other people who in a sense could not get out of that situation." He said the students not in isolation have been advised to stay away from mass-gathering events in closed spaces but they can still go to a restaurant, for example.

Njoo said public health legislation allows provinces and territories to control the spread of infectious disease in their jurisdiction through a local medical health officer or provincial authorities who can issue orders to prevent an infectious person from travelling.

Federal officials can invoke the Quarantine Act, as they did in this case, to stop someone from boarding a plane and leaving the country to expose others to an infectious disease.

Revised international health regulations that will come into effect in a few weeks will allow for a concerted global effort to prevent the export of infectious diseases, Njoo said.

Source-Medindia
MED/B