
A local tuberculosis outbreak has prompted the Long Beach, California, City Council to declare a public health emergency.
Dr. Anissa Davis, the city’s health officer, issued the emergency declaration last week after the health department found 14 cases of tuberculosis at a hotel with just one room. The declaration will be officially approved by the City Council on Tuesday night.
The health department reports that nine tuberculosis patients have been admitted to hospitals and one has passed away. As of Monday, the outbreak had exposed approximately 175 people to tuberculosis.
A news release issued by the department last week stated that “the population at risk in this outbreak has significant barriers to care, including mental illness, substance use, homelessness and housing insecurity, and serious medical comorbidities.”
The department also stated that those who were exposed are being tested. Since last week, there have been no new cases reported.
Following 27 years of decline, there has been an increase in tuberculosis cases nationwide since 2020, coinciding with the outbreak. 9,615 active infections were reported in the United States last year, a 16% rise from the year before.
The Long Beach health department states that the emergency declaration should free up funds for tuberculosis screening and treatment.
The public affairs officer for the health department, Jennifer Rice Epstein, stated, “Since the health department is primarily funded by grants, we need to have the framework in place to ensure we can get our internal resources where they’re most needed right now.”
According to the Long Beach health department, contagious patients are being segregated, treated, and given temporary housing, food, and transportation as needed.
Homelessness increases the risk of tuberculosis for a number of reasons, including drug abuse, which compromises immunity, and living in close quarters where the disease is more likely to spread. HIV, diabetes, and cancer are examples of underlying health issues that make it more difficult to fight off tuberculosis infections.
Dr. Luke Davis, an associate professor of epidemiology and medicine at the Yale School of Public Health, stated that “living in poverty, not having good access to nutrition, not having sunlight and fresh air—all these are things that will continue to make it much easier for TB to spread and take advantage of vulnerable people.”
According to Davis, he is unsure if there is a real rise in tuberculosis cases or if there is just a rise in diagnoses.
Are we giving more people diagnoses? Indeed, we are. Does that imply that tuberculosis cases are increasing? That is a little trickier to respond to,” he remarked.
However, other medical professionals who treat TB patients claimed that the number of cases is increasing, most likely as a result of decreased access to care, which either delayed diagnosis or allowed some infections to go undiagnosed.
The director of the Johns Hopkins University Center for Tuberculosis Research, Richard Chaisson, stated, “We did millions and millions of tests for Covid and fewer tests for TB.” That indicates that some people had tuberculosis, went undiagnosed, and carried on spreading the disease to others.
The symptoms of tuberculosis typically appear up to two years after infection, so individuals who receive a diagnosis today may have been exposed during the pandemic, he explained.
Chaisson also mentioned how many public health departments are understaffed and underfunded.
“We’re on the wrong track if we don’t increase public health interventions,” he declared.
The U.S. Preventive Services Task Force advises primary care physicians to perform screenings for individuals who are more susceptible to tuberculosis, including those who are incarcerated or living in homeless shelters, as well as those who have traveled to nations where the illness is highly prevalent.
However, according to Dr. Priya Shete, an associate professor of epidemiology and medicine at the University of California, San Francisco, that isn’t always the case.
“Increasing cases over time — this year, last year as well as the next few years — probably should not be unexpected,” Shete stated, adding that “it’s heading to go on like this if we do something drastic to turn the tide.”
When a person with active tuberculosis coughs, sneezes, or speaks, the bacteria that causes the disease can spread through the air. Since it frequently affects the lungs, a lot of people get a severe cough that lasts for three weeks or longer, chest pain, or a bloody or phlegm-filled cough.
The majority of active cases originate from latent infections that were never screened for, identified, or treated; instead, they are not associated with outbreaks. Latent tuberculosis, in which the bacteria exist in the body but do not cause illness, may affect up to 13 million individuals in the United States. If treatment is not received, 5–10% of those latent cases progress to active illness.
Antibiotics are typically taken for at least six months as part of treatment for active tuberculosis, though some regimens can last up to a year.