[Hpn] TB tests identify another victim

Graeme Bacque gbacque@colosseum.com
Tue, 18 Jan 2005 08:15:33 -0500


Jan. 18, 2005. 01:00 AM

TB tests identify another victim
Seven cases have been found

High risk among city's homeless


A public health blitz has found one more case of tuberculosis in the 
city's homeless population, bringing the total to seven cases following 
a screening blitz that began late last year.

Dr. Barbara Yaffe, who oversees infectious disease control, said more 
than 4,000 people have been tested after two workers in a downtown men's 
shelter were found in late October to have active cases and five other 
staff members were found to have been exposed to the disease.

To date, testing has been conducted in all 26 men's, co-ed and 
aboriginal shelters and in 16 of 17 drop-in centres. Six cases had been 
found by mid-December.

None of the cases caught in the blitz were among shelter staff.

Public health staff will shortly begin testing at the last drop-in 
centre, the new temporary shelter on Edward St., and will move on to the 
women's shelter system next month.

"It's very concerning because ... we know it (homeless) is a high-risk 
population both in terms of getting exposed and infected and then going 
on to become sick because they're malnourished, they have underlying 
health issues," Yaffe said. Yaffe said the number of tuberculosis cases 
over the past five years has ranged from a low of six to a high of 24 
cases in 2001.

The latest "massive, active case-finding initiative" reached about 73 
per cent of shelter users and staff, Yaffe said. Homeless people were 
offered TTC tokens as an incentive for testing.

A public health staff bulletin noted that case investigation and contact 
follow-up was conducted for all active cases.

The disease isn't believed to pose a major risk to the general 
population, but it is a deadly presence in homeless shelters. 
Affordable-housing advocates have long warned city officials that its 
shelters are breeding grounds for TB, because they are overcrowded and 
lack ventilation, as well as readily available technology to kill bacteria.

Councillor John Filion, chair of the board of health, said public health 
staff has struggled continuously to ensure there's sufficient funding to 
fight tuberculosis among the city's vulnerable homeless population.

"TB's been one of those issues that we've identified just about every 
year that we need to put more resources into and usually the money isn't 
there. We add a little bit, we shuffle a little bit ... we do our basic 
job, but we don't do it at the level we're required to by the province," 
said Filion (Ward 23, Willowdale).

"It's just one of those many areas in the board of health where you're 
playing catch-up and you just hope you don't catch too many bad breaks 
at the same time," Filion said.

But he said the latest blitz may become an annual event.

"Unfortunately, we need to continue (monitoring) the very high-risk 
population. We need to make it more or less an ongoing item as opposed 
to something we do when we have a problem."

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