California city declares a health emergency amid tuberculosis outbreak

The Long Beach, California City Council is close to authorizing a public health emergency in response to a local tuberculosis outbreak.

City health officer Dr. Anissa Davis declared a state of emergency last week after her health department detected 14 cases of tuberculosis in a single-room hotel. The City Council’s vote Tuesday evening will serve as final approval of the declaration.

Nine tuberculosis patients were hospitalized and one died, according to the Health Ministry. As of Monday, about 175 people had been exposed to tuberculosis as a result of the outbreak.

In a press release last week, the department said that “the population at risk in this epidemic faces significant barriers to care, including homelessness and housing insecurity, mental illness, substance use substances and serious medical comorbidities.”

The ministry added that it was testing those exposed. No new cases have been reported since last week.

The outbreak was reported amid a nationwide rise in tuberculosis cases, which have increased since 2020 after 27 years of decline. The United States recorded 9,615 active infections last year, an increase of 16% from the previous year.

The emergency declaration is expected to free up resources for tuberculosis testing and treatment, according to the Long Beach Health Department.

“The Department of Health is primarily funded by grants, so we need to have the structure in place to be able to send our internal resources to where they are most needed right now,” said Jennifer Rice Epstein, public affairs manager for the Department of Health. Ministry of Health.

The Long Beach Health Department said it is isolating contagious patients, treating them and providing them with temporary housing, food and transportation if necessary.

Homeless people are at higher risk of tuberculosis for several reasons, including substance use – which can weaken the immune system – and living in crowded conditions where the disease is more likely to spread. Underlying health conditions, such as diabetes, cancer and HIV, also make it more difficult to fight TB infections.

“Living in poverty, not having good access to nutrition, not having access to sunlight and fresh air – all of this will facilitate the spread of TB and benefit vulnerable people,” said Dr. Luke Davis. , associate professor of epidemiology and medicine at the Yale School of Public Health.

Davis said he’s not sure if tuberculosis is actually becoming more common or if it’s a matter of increased diagnoses.

“Are we diagnosing more people? Yes we are. Does this also mean there is more tuberculosis? This question is a little more difficult to answer,” he said.

But other doctors who treat tuberculosis patients said the number of cases was indeed increasing, likely because reduced access to medical care was delaying diagnoses or allowing some infections to go unnoticed.

“We’ve done millions and millions of tests for Covid and fewer tests for tuberculosis,” said Richard Chaisson, director of the Tuberculosis Research Center at Johns Hopkins University. “That means people had TB, it went undiagnosed and they continued to pass it on to other people.

Symptoms of TB typically appear up to two years after infection, so people diagnosed today could theoretically have been exposed during the pandemic, he said.

Additionally, Chaisson added, many public health departments face funding and staffing challenges.

“Without an increase in public health interventions, we are on the wrong track,” he said.

The U.S. Preventive Services Task Force recommends that primary care physicians screen people at increased risk for tuberculosis, such as those in homeless shelters or correctional facilities and people who previously lived in prisons. countries where the prevalence of the disease is high.

But that doesn’t always happen, said Dr. Priya Shete, an associate professor of medicine and epidemiology at the University of California, San Francisco.

“The increase in cases over time – this year, last year and future years – probably shouldn’t be unexpected,” Shete said, adding that “it’s going to continue like this unless we do something drastic to reverse the trend.”

The bacteria that causes TB can spread through the air when a person with an active case coughs, sneezes, or talks. It often targets the lungs, so many people develop a bad cough that lasts three weeks or more, experience chest pain, or cough up blood or phlegm.

Most active cases are not linked to an outbreak; rather, they develop from a latent infection that has never been detected, diagnosed or treated. Nearly 13 million people in the United States have latent tuberculosis, which means bacteria lives in the body without making them sick. About 5-10% of these latent cases develop into active disease if left untreated.

Treatment for active TB usually involves taking antibiotics for at least six months, although some treatments can take a year or more.

News Source :
Gn Health

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