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inn The decriminalization and potential increased use of marijuana in Canada in is unlikely to pose a TB risk for most Canadians, but serious consideration should be given to monitor the impact in high-TB burden communities and populations. These are settings where high TB incidence rates, high prevalence of smoking and crowded indoor spaces co-exist and can lead to explosive transmission. There have been calls from the WHO and others for clinical and program-level integration of anti-smoking and TB elimination work Footnote 3Footnote 6. The cluster described in detail above is not the only recent example of smoking-related TB transmission in Toronto.
Smoking is one of few potentially reversible Local sex finder in peto factors for TB, and affects multiple points in the natural history of the disease. Our case study illustrates that TB transmission can happen even outdoors, particularly in confined spaces with an overhang, the kind of partly-enclosed spaces outside buildings used by many workplace smokers to shelter from the weather. We established and advertised an active case-finding clinic on-site to all employees in the building systematic screening for active TB in a pre-determined target groupoffering tuberculin skin test TST testing and sputum collection to smokers and non-smokers who frequented smoking areas near the building from the time Case 1 was infectious to the time of the investigation.
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