The world’s economic crisis might be at the top of everyone’s minds, but there’s another side to financial hardship besides job losses and budget cuts. The millions of men, women, and children living in poverty around the globe are more prone to illness than their better-off neighbours. One disease in particular—tuberculosis—could spread as a result of the bleak financial state. And no corner of the map is immune, including ours.

“Poverty plays a big part in TB,” says Dr. Kevin Elwood, the province’s director of tuberculosis control, in a phone interview. “That doesn’t just mean cash in pocket but also poor nutrition, overcrowding, bad housing, and poor access to health care. Traditionally, TB is a disease of the disadvantaged.”

Although many people associate the lung disease with impoverished nations, TB also exists—and in some places is thriving—closer to home.

“There’s a perception that TB has disappeared here,” Elwood says. “But we do have TB; the misperception is understandable because Canada is a low-prevalence country.”

Port Alberni has been dealing with an outbreak since 2006. At least 41 cases have been reported there, primarily in the Nuu-Chah-Nulth community. The average number of cases for central Vancouver Island is typically five a year, according to the Vancouver Island Health Authority.

Canada’s Native population is disproportionately affected by the illness, which is caused by the Mycobacterium tuberculosis organism. According to Health Canada, the rate of TB in First Nations communities is 20 to 30 times higher than that in Canadian-born non-Native groups.

People with substance-abuse problems living in the Downtown Eastside are also susceptible to TB.

About 70 percent of patients who visit Vancouver’s TB Clinic, which is operated by the British Columbia Centre for Disease Control, are foreign-born or immigrants, Elwood says. “They’re usually from disease-prone areas or their infections were acquired abroad then were reactivated when they came to Canada,” Elwood explains.

“They’re especially vulnerable during their first five years in another country. It could be because of the stress of the process, but nobody knows exactly why that is.

“Still, we do see Canadian-born people who don’t have any risk factors,” Elwood adds.

Those cases are the ones that grab headlines. Ontario public-health officials issued an alert this past October, for instance, after a man with TB rode on a Greyhound bus and put other passengers at risk.

In May 2007, Atlanta lawyer Andrew Speaker, who had been diagnosed with extensively drug-resistant tuberculosis, took a flight from Europe to Canada against doctors’ orders. Although no one on the flight contracted the illness, his decision caused international outrage.

Also known as the white plague, king’s evil, and consumption, TB can be spread from person to person through droplets in the air from coughing, sneezing, or even spitting, according to the B.C. Centre for Disease Control. It’s not as infectious as other diseases, such as chicken pox or the flu, but close contact with someone who has TB can lead to transmission.

TB commonly attacks the lungs, but it can affect any part of the body. Symptoms, according to the BCCDC, include persistent cough, weight loss, fatigue, fever, night sweats, chills, chest pain, and shortness of breath. People might cough up blood or phlegm.

The organism is a tricky one: Not everyone who carries TB will become sick, as the bacteria can lie dormant in the body for years. As many as 95 percent of people who are infected are symptom-free and don’t even realize they’re sick.

For about five to 10 percent of people who have acquired the bacteria, though, the disease can take a serious toll. People with compromised immune systems, such as children, the elderly, and those with HIV or AIDS, can become severely ill or die. Deaths usually occur in low-income countries, and according to the World Health Organization, TB remains one of the top 10 causes of global mortality.

About 1.5 million people died from TB in 2006, according to the WHO. Another two billion are infected with the organism that causes TB. Still another 200,000 people died from HIV-associated TB. In Africa, the WHO states, TB is the biggest killer of people with HIV. Without treatment, 90 percent of those coinfected with HIV and TB usually die within months.

Wiping out tuberculosis—as the WHO had hoped to do by 2000—is increasingly complicated because of growing numbers of multidrug-resistant and extensively drug-resistant cases. Such strains have shown up all over the world, according to the U.S. Centers for Disease Control.

TB is diagnosed through a tuberculin skin test. To counter multidrug resistance, treatment involves taking several antibiotics at once for six to nine months. Some people require drugs with direct observation. However, in B.C., Elwood says, this is rare.

In fact, for most cases in our province, Elwood has reassuring words.

“TB is a totally curable disease,” Elwood says. “The key is early diagnosis and, of course, access to medication and treatment.”

The World Health Organization’s Stop TB program aims to cut the number of deaths from TB in half by 2015. Although a vaccine, called Bacille Calmette-Guérin vaccine, exists, it was created in 1921 and has become highly ineffective.

Clinical trials of a new tuberculosis vaccine began earlier this fall in Kenya, according to the WHO, which also notes on its Web site that international health workers and activists are worried that the world’s financial crisis will worsen funding shortages. Earlier this year, the organization reported that it was lacking at least US$328 million for its fight against TB.