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California city declares public health emergency amid tuberculosis outbreak

The City Council of Long Beach, California has declared a public health emergency in response to a local tuberculosis outbreak. 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 served as the final approval for the declaration. Nine tuberculosis patients have been hospitalized and at least one has died, according to the health department. As of Monday, about 175 people had been exposed to tuberculosis as a result of the outbreak. Tuberculosis is a deadly bacterial infection that most often affects the lungs. It is spread through the air when an infected person sneezes, coughs, or spits. The WHO says that 10 million people contract tuberculosis every year.

In a news release last week, the department said that “the population at risk in this outbreak has significant barriers to care including homelessness and housing insecurity, mental illness, substance use, and serious medical comorbidities.” The department added that it is testing people who were exposed. No new cases have been reported since last week.

The outbreak was reported amid a national rise in tuberculosis cases, which have increased since 2020 after 27 years of decline. The U.S. recorded 9,615 active infections last year — a 16% increase over the previous year. “The 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’re needed most right now,” said Jennifer Rice Epstein, the Long Beach Health Department’s public affairs officer. They are currently isolating infected patients.

People experiencing homelessness have a higher risk of tuberculosis for several reasons, including substance use — which can weaken the immune system — and living in densely populated, 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. “Living in poverty, not having good access to nutrition, not having access to sunlight and fresh air — 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.

It is unclear if tuberculosis is becoming more common in the U.S. or more patients are being tested. “We 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’t diagnosed, and they continued to transmit it to other people.”

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