Shelley Walkerley had just begun her first nursing placement when she was broadsided by some perturbing news: she had tested positive for a TB skin test on admission.

Dumbfounded, she figured that she must have contracted it from a relative who lived in Northern Ontario. Fortunately, the illness was in a latent stage and she was treated prophylactically. However, that brush with TB set the stage for a lifelong calling in respiratory diseases which was amplified during her stint in the Chest Clinic at St. Michael’s Hospital. Here is some of her acquired wisdom.

1. TB is alive and well and living in the suburbs.

Many of us think of tuberculosis as some kind of ‘Victorian’ illness that has been wiped out and no longer poses any threat. But as Dr. Walkerley found out the hard way, that is simply not the case. A staggering one-third of the world’s population is infected with TB in a latent form so it’s not surprising that the disease makes its way into Ontario every year. The good news is TB is preventable and it’s curable.

2. Think of it as a social battle as much as a physical one.

An opportunistic disease, TB preys on immigrants and refugees from countries where the disease is widespread, as well as the homeless and indigenous people who live with chronic overcrowding, poor ventilation, malnutrition and stress. Recognizing the need to manage and control TB among homeless persons in the downtown core, Dr. Wakerley worked in the trenches in an outpatient program and has continued as an active member and current Co-Chair of the Ontario Lung Association TB Committee.

3. Fight stigma with facts.

What makes TB such a tricky foe to defeat is that ignorance around the illness continues to abound. People who suffer from TB often face discrimination, rejection, and social isolation in their communities. Because of stigma, individuals with symptoms may delay seeking help, making it much more likely that they will become seriously ill and infect others. Support from family and friends is essential to safeguarding mental health and social functioning.

4. Patients are just the tip of the iceberg.

Family, friends, coworkers, and caregivers are all affected by the disease one way or another. The six-month treatment period can be quite challenging for families as they must cope with the impact of the disease itself, the disruption to daily life, as well as the burden of emotional and financial support.

5. Take advantage of the support system.

At a time of shock, confusion and fear, the healthcare system kicks into action and brings a level of compassion, comfort and knowledge that is tremendously reassuring. The treatments are free and effective and there is a nurse to help patients and families navigate the unknown waters.

– Shelley Walkerley, NP-PHC, PhD, Toronto