“Social network analysis” key to stopping future TB outbreaks

An outbreak of tuberculosis has hit the Yukon, but health professionals believe the effects of future outbreaks can be reduced by mapping the social…

An outbreak of tuberculosis has hit the Yukon, but health professionals believe the effects of future outbreaks can be reduced by mapping the social networks of TB patients.

“We have identified an outbreak of TB this year, with 10 active tuberculosis cases being diagnosed since the beginning of 2008,” said Brendan Hanley, the Yukon’s medical officer of health, speaking at the November 14 meeting of the Yukon Medical Association.

“Remember tuberculosis?” read Hanley’s PowerPoint slide, depicting etchings of 18th-century tuberculosis victims.

By determining the social contacts and frequented social spots of diagnosed TB patients, health professionals can identify community members most at risk of getting the disease — and treat them before they become carriers.

Correct diagnosis of tuberculosis is extremely important, as a missed case can lead to hundreds of contacts, some of whom will inevitably become infected with the disease, said Hanley.

Social networking analysis should give professionals some hand in “pre-empting” future cases of the disease. Before, infections were simply treated on a one-on-one basis, without any thought of the wider social causes.

The most recent outbreak “sufficiently alarmed” Yukon medical representatives. They asked for assistance from the public health agency of Canada, who has assisted in drafting the recent findings in a report.

Since 2004 there have been 24 confirmed cases of TB among Canadian-born Yukon residents. All cases except one have occurred in three Yukon communities, which were not named for the purpose of anonymity.

“All cases in a given community were linked, even over a number of years,” said Hanley.

Some doctors questioned the territory’s preparedness for a more far-reaching disease outbreak, tuberculosis or otherwise.

“We all remember the SARS scare a couple of years ago, and how ill-prepared we were for something of that magnitude hitting the Yukon — are we any better prepared now?” said Dr. Wayne MacNicol.

If a devastating influenza outbreak was to occur tomorrow, the Yukon is more prepared than it was “three years ago,” said Hanley.

“There would still be gaps, and we would be dependent, as we would be anyway, on our colleagues in bigger jurisdictions,” he said.

“There are so many committees on pandemic planning federally … that there is now a committee to co-ordinate the pandemic committees,” added Hanley.

Alcohol has been found to be strongly linked to incidences of the disease, partially as a result of the subsequent decreased use of prophylactics.

Overcrowded living conditions are also a factor, increasing the risk of person-to-person transmission.

Studies have shown that First Nations are more at risk than other Canadians of getting TB, with some of the root causes relating to “poor socio-economic standards,” reports Health Canada on its website.

In the early decades of the 20th century, malnutrition and confinement to crowded reservations contributed to staggering tuberculosis death rates among Canadian First Nations, with TB death rates running as high as 8,000 per 100,000 for children in residential schools.

Contact Tristin Hopper at

tristinh@yukon-news.com

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