Canada’s most populous province of Ontario is a hotspot for new and dangerous strains of tuberculosis, and this summer it was linked to an outbreak at a Maple Leaf Sports and Entertainment facility.
Health officials have identified and treated 60 cases in the past three months of infections that appeared to have originated from a single health care facility in Toronto’s northeast. In all, officials believe that approximately 20 to 30 cases came from one of its gyms, the Toronto Sports and Entertainment Complex, which serves as home to the professional basketball team the Raptors and is also the organizer of the NBA All-Star Game.
Many of the patients with an active tuberculosis infection — who showed symptoms of coughing up blood — first began to be diagnosed in June at the All-Star Game, said Dr. Gino Ciccone, head of infectious diseases at the Ministry of Health and Long-Term Care. Dr. Ciccone said that the apparent outbreak had been ongoing for years, but that public awareness of TB, including the need to routinely test for it, had been delayed and that information was “delayed across the board” in 2015, a year when a nation-wide outbreak of the disease led to an increase in the number of cases.
The outbreak is now considered a major public health concern in Ontario, with 70 new cases so far this year.
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The cause of the outbreak has not been determined. Dr. Lorraine Duchesne, a public health nurse with Toronto Public Health, said that officials are still investigating whether a widespread infection, or a single patient, is to blame, but said that if it is the latter, health officials suspect it may have resulted from a contraction of a second-hand item such as cigarettes that had previously been used on the patient and someone else.
Dr. Bacchus Michaud, Toronto’s deputy medical officer of health, said that health officials are also trying to figure out whether the outbreak could have spread through Toronto’s large gay community, but he said that so far, there is no evidence that it has. Dr. Duchesne said that health officials are also trying to determine whether the strain of tuberculosis involved is the same as that in Australia, where the disease is spreading through gay men and animals alike. In addition, officials are investigating whether the TB infection could also be linked to “community transmission,” or how it was spread from one person to another.