Tuberculosis, syphilis on the rise in Montreal: Public Health

A radiographer points to an X-ray of a patient with tuberculosis. (AP Photo/Lefteris Pitarakis)

Montreal’s Department of Public Health says it saw an increase in the number of people diagnosed with tuberculosis and syphilis in 2024.

“Tuberculosis is a significant public health problem because of its airborne transmission, its potential for serious health complications and the complexity of its treatment,” a report by public health on Montreal’s epidemiological standings states.

• READ MORE: New cases of mpox diagnosed in Montreal: public health

Active tuberculosis is low across Canada, according to the department, but it does disproportionately affect certain groups, such as Canada’s Indigenous populations and those born in endemic regions outside the country.

“Several jurisdictions in North America and around the world have observed an increase in tuberculosis in 2023 and 2024, after a decline during the COVID-19 pandemic,” the report notes, citing the Centers for Disease Control and Prevention (CDC).

In 2024, Montreal saw a particularly sharp rise, with an increase of 53 per cent in new cases compared with the average of the previous decade.

Public health explains that from 2014 to 2023, an average of 123 cases were recorded annually (six cases per 100,000 people).

In 2024, that number rose to 203 cases (or nine cases per 100,000 people).

“This significant increase in the last year breaks with the stability observed in previous years,” the report states.

Additionally, the department says that pulmonary tuberculosis accounts for two-thirds of cases, a proportion that has remained relatively stable from one year to the next over the last 10 years.

• READ MORE: Quebec declares end to measles outbreak after no cases reported for 32 days

The distribution of tuberculosis cases by sex and age has also remained stable between 2015 and 2024.

On average, five per cent of cases were in people under the age of 17; 33 per cent were in those aged 18 to 34, 25 per cent were in those aged 35 to 49, 18 per cent were in those aged 50 to 64 and 19 per cent were in those aged 65 and over.

A little more than half (56 per cent) of tuberculosis cases were in men.

About 89 per cent of Montreal’s cases since 2015 involved people born outside Canada, and most contracted the disease outside the country. Some 48 per cent of last year’s cases were among people who were not covered by the province’s health insurance plan, up from nine per cent in 2015.

While some of those patients may have private insurance, or temporary health benefits under the interim federal health program, the authors say many still face “significant barriers” to care, urging the province to develop new programs to reach them.

“The growing proportion of people without (provincial health insurance) coverage is an invitation to consider the creation of strategies and programs, as other Canadian provinces have done, to reduce access barriers for the management and treatment of tuberculosis among people without adequate insurance, to facilitate the work of clinical and public health teams and, in so doing, protect the entire population,” the report says.

While tuberculosis levels are low in Canada overall, the report authors said the illness disproportionately affects certain groups, including Indigenous people and those born in countries where the disease is endemic.

Rise in syphilis

Syphilis, a sexually transmitted infection (STI), has also seen a resurgence in Montreal and elsewhere in the world over the last 25 years.

Public health notes that infectious syphilis rose from 348 cases in 2014 to 556 cases in 2024 in Montreal, an increase of 60 per cent in ten years.

In 2024, the number of reported cases of infectious syphilis was ten times higher in men than in women (556 versus 56).

However, over the last 10 years, the number of cases among women has increased by 367 per cent (from 12 to 56) compared with a 49 per cent increase among men (from 336 to 500).

• READ MORE: Quebec has achieved herd immunity against HPV: study

“The marked increase in syphilis among women suggests that the epidemic is spreading to the heterosexual population,” the department said. “This transmission dynamic is contributing to the rise in cases of congenital syphilis in Montreal (when a mother with untreated syphilis passes the infection to her baby during pregnancy or birth).”

In the Montreal area, one case of congenital syphilis was reported in 2020, three in 2021, seven in 2022, six in 2023 and six in 2024, for a total of 23 cases over five years.

Contrastingly, no cases were reported between 2011 and 2019.

Montreal’s Department of Public Health says last year, it also followed a measles outbreak, a cyclical round of whooping cough during the summer months, a rise of Group A streptococcus and a second Mpox outbreak.

With files from The Canadian Press