The City Council of Long Beach, California, is poised to authorize a public health emergency in response to a local outbreak of tuberculosis.<\/p>\n\n\n\n
The city’s health officer, Dr. Anissa Davis, declared the emergency last week, after its health department detected 14 tuberculosis cases at a single-room occupancy hotel. The City Council vote on Tuesday night will serve as the final approval for the declaration.<\/p>\n\n\n\n
Nine tuberculosis patients have been hospitalized and one has died<\/a>, according to the health department. As of Monday, about 175 people had been exposed to tuberculosis as a result of the outbreak.<\/p>\n\n\n\n In a news<\/a>\u2002release<\/a> last week, the department said that \u201cthe population at risk in this outbreak has significant barriers to care including homelessness and housing insecurity, mental illness, substance use and serious medical comorbidities.\u201d<\/p>\n\n\n\n The department added that it is testing people who were exposed. No new cases have been reported since last week.<\/p>\n\n\n\n The outbreak was reported amid a national rise in t<\/a>uberculosis cases<\/a>, which have increased since 2020 after 27 years of decline. The U.S. recorded 9,615\u2002active infections last year<\/a> \u2014 a 16% increase over the previous year.<\/p>\n\n\n\n The emergency declaration should free up resources for tuberculosis screening and treatment, according to the Long Beach health department.<\/p>\n\n\n\n \u201cThe health department is mostly grant funded, so we need to have the structure in place so that we can get our internal resources where they\u2019re needed most right now,\u201d said Jennifer Rice Epstein, the health department\u2019s public affairs officer.<\/p>\n\n\n\n The Long Beach health department said it is isolating patients who are infectious, treating them and providing them with temporary housing, food and transportation as needed.<\/p>\n\n\n\n People experiencing homelessness have a higher risk of tuberculosis for several reasons, including substance use \u2014 which can weaken the immune system \u2014 and living in crowded conditions where it is more likely to spread. Underlying health problems, such as diabetes, cancer and HIV, also make it harder to fight off tuberculosis infections.<\/p>\n\n\n\n \u201cLiving in poverty, not having good access to nutrition, not having access to sunlight and fresh air \u2014 all these are things that are going to make it much easier for TB to spread and take advantage of vulnerable people,” said Dr. Luke Davis, an associate professor of epidemiology and medicine at the Yale School of Public Health.<\/p>\n\n\n\n Davis said he’s not sure whether tuberculosis is actually becoming more common or whether it’s a matter of increased diagnoses.<\/p>\n\n\n\n \u201cAre we diagnosing more people? Yes, we are. Does that also mean there\u2019s more TB out there? That is a little bit more difficult to answer,\u201d he said.<\/p>\n\n\n\n But other doctors who treat tuberculosis patients said case numbers are indeed rising, most likely because reduced access to medical care delayed diagnoses or allowed some infections to go undetected.<\/p>\n\n\n\n \u201cWe did millions and millions of tests for Covid and fewer tests for TB,” said Richard Chaisson, director of the Johns Hopkins University Center for Tuberculosis Research. “What that means is that people had tuberculosis, it wasn\u2019t diagnosed, and they continued to transmit it to other people.\u201d<\/p>\n\n\n\n Tuberculosis symptoms usually manifest up to two years after someone is infected, so people who are diagnosed now could theoretically have been exposed during the pandemic, he said.<\/p>\n\n\n\n What\u2019s more, Chaisson added, many public health departments are stretched for funding and staffing.<\/p>\n\n\n\n \u201cWithout increased public health interventions, we\u2019re on the wrong course,\u201d he said.<\/p>\n\n\n\n The U.S. Preventive Services Task Force recommends<\/a> that primary care doctors screen people at increased risk of tuberculosis, such as those in homeless shelters or correctional facilities and people who previously lived in countries with high prevalences of the disease.<\/p>\n\n\n\n But that doesn’t always happen, said Dr. Priya Shete, an associate professor of medicine and epidemiology at the University of California, San Francisco.<\/p>\n\n\n\n “Increasing cases over time \u2014 this year, last year and the next few years \u2014 probably shouldn’t be unexpected,” Shete said, adding that “it\u2019s going to go on like this unless we do something drastic to turn the tide.”<\/p>\n\n\n\n The bacterium that causes tuberculosis can spread through the air when someone with an active case coughs, sneezes or speaks. It often targets the lungs, so many people develop a bad cough that lasts three weeks or longer, experience chest pain or cough up blood or phlegm.<\/p>\n\n\n\n Most active cases aren\u2019t linked to an outbreak \u2014 rather, they develop from a latent infection that was never screened, diagnosed or treated. Up to\u200213 million people<\/a> in the U.S. have latent tuberculosis, meaning the bacteria live in the body without making them sick. Around 5% to 10% of those latent cases develop into active disease if they are left untreated.<\/p>\n\n\n\n Treatment for active tuberculosis usually involves taking antibiotics for at least six months, though some courses can take a year or longer.<\/p>\n\n\n\n