Montreal public health reports sharp increase in tuberculosis, syphilis cases
Posted May 12, 2025 3:22 pm.
Last Updated May 14, 2025 11:44 am.
Montreal public health officials are calling for better access to tuberculosis care following a sharp rise in the number of cases reported last year.
The regional health authority reported 203 cases of tuberculosis in 2024, compared to an average of 123 cases per year over the previous decade, marking a 53 per cent increase.
“This significant increase in the last year breaks with the stability observed over the previous years, which followed a downward trend observed over several decades until the early 2000s,” says an annual report published online last week.
Montreal Public Health Tuberculosis by CityNewsToronto on Scribd
Sharp rise prompts concern from health officials
Dr. Geneviève Bergeron, medical chief of the Infectious Disease Prevention and Control Division at Montreal’s Regional Public Health, said the increase in tuberculosis and other infections reflects important shifts observed over the past year.
“We published a report that covers the major trends that we’re seeing in 2024,” she said. “And then those were some of the major changes that we’ve noticed that we wanted to bring attention to.”
Tuberculosis affecting vulnerable groups
The report noted that tuberculosis continues to disproportionately affect certain populations, particularly people born in countries where the disease is more common, and Indigenous communities in Canada.
Dr. Bergeron explained, “It mainly affects adults for tuberculosis.
“Also, Indigenous people in Canada have a higher risk of contracting tuberculosis as well.”
Gaps in health coverage create treatment barriers
About 89 per cent of Montreal’s tuberculosis cases since 2015 have involved individuals born outside of Canada, with most contracting the disease before arriving. In 2024, 48 per cent of cases involved people without provincial health insurance, up from nine per cent in 2015.
Dr. Bergeron highlighted the challenges posed by inadequate medical coverage.
“What we’re seeing additionally is that a larger proportion of the cases do not have adequate medical coverage, health insurance,” she said.
“And that complicates the work because they are barriers for people to access treatment, screening and follow-ups necessary for this condition.”
The report urges the province to develop new programs to help remove those barriers.
“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.
Public health urges Quebec to follow other provinces
Dr. Bergeron emphasized the importance of adopting models already in place elsewhere in Canada.
“We’re working very closely with our provincial partners on this and there are a number of different solutions that could be put forward,” she said.
“For instance, in other provinces, Canadian provinces, there are different programs that allow for all cases of tuberculosis to be treated free of charge for the person. So a program like this would be tremendously helpful here in Quebec. But there are other strategies also that could be put in place to improve access for people that are affected by tuberculosis.”
In response to the rising number of tuberculosis cases, the Ministry of Health and Social Services (MSSS) issued a statement to CityNews acknowledging that the increase in active tuberculosis cases observed in recent years could present additional challenges for regional public health authorities, who must ensure they limit the impact on their populations.
The MSSS reported that Quebec ended 2024 with an excess of tuberculosis cases compared to the average number of cases in the pre-pandemic years from 2015 to 2019.
In 2025, the number of reported cases remains high, but similar to that of 2024, still exceeding the pre-pandemic average.
The MSSS is closely monitoring the situation, and discussions are ongoing with the MSSS, regional public health authorities, and the RAMQ to find solutions for people whose immigration status leaves them without health insurance coverage, with the goal of protecting public health.
Syphilis cases also on the rise
The report also found that syphilis cases in Montreal have risen by about 60 per cent over the past decade — from 348 cases in 2014 to 556 in 2024. While the majority of infections still occur among men, the number of women affected is growing, suggesting wider transmission in the heterosexual population.
Dr. Bergeron noted that Montreal’s experience reflects broader international patterns. “The trends that we’re seeing in Montreal are not specific to Montreal. We’re seeing a reflection of larger international trends,” she said.
“We are seeing a surge of cases of tuberculosis and syphilis in Montreal, which represents the larger trends that we’re seeing worldwide as well.”
She reiterated the particular risk that syphilis poses to certain populations. “The risk of contracting syphilis is higher among men than women, but the consequences are higher for women that can bear children because of the risk of transmission during pregnancy.”
Increased vigilance for other infectious diseases
In addition to tuberculosis and syphilis, the report outlines several other infectious disease trends in Montreal in 2024, including measles, whooping cough, invasive group A streptococcus, and mpox.
“We’ve described an increase in whooping cough, which is a cyclical disease,” said Dr. Bergeron. “There was also an increase in invasive group A strep infections that have been more frequent since the pandemic. That is something that we also saw in other parts of the world, but that’s also a disease that we take very seriously.”
Regarding measles, Bergeron emphasized the importance of vaccination: “There was an outbreak in Quebec of measles. And measles are very contagious airborne disease that can be severe. And the, our most important line of the fence is vaccination.”
She noted that the risk of future outbreaks remains: “We are at risk of having other situations related to measles because we’re seeing an increase of measles worldwide in the U.S. and other Canadian provinces. And whenever there’s someone contagious, if other people around them are not vaccinated, then the risk of transmitting the disease is very high.”
On mpox, she said: “We just want to put the message forward that it’s important to get vaccinated for Mpox for people that are at-risk.”
Collaboration needed to close healthcare gaps
Dr. Bergeron emphasized the importance of collaboration with the provincial government to address the gaps in health insurance coverage and improve access to care for vulnerable populations.
“We’re working with the province because we’re working very closely with them to find solutions to this issue. And the province is aware and very much sensitive to the issue and also wants to find solutions,” she said.
