Faced with a growing number of cases of a highly contagious strain of tuberculosis among downtown LA’s homeless population, the Los Angeles County Health Department has asked federal officials for help. To date, county health officials have identified 78 cases of the particularly virulent strain of the disease, resulting in 11 deaths. Of those cases, 60 have been identified as homeless living around Skid Row, making it the “largest outbreak we’ve seen” among LA’ homeless population in a decade, said Dr. Jonathan Fielding, director of the Los Angeles County Department of Public Health.
Dr. Fielding noted that as many as 4,500 homeless may have been exposed to the disease. Earlier this month, he asked the Centers for Disease Control and Prevention (CDC) to send health officials to Los Angeles to help identify other possible victims. A health department spokesman said that CDC officials have agreed to help; however, they have not yet arrived in the city. A CDC spokeswoman deferred comment to Los Angeles officials, and was unable to comment further to a request made by the Wall Street Journal on February 21.
Skid Row is populated by approximately 5,000 homeless live. LA’s homeless have been gathering in that vicinity for decades. The city offers about 3,000 shelter beds; however hundreds of the homeless still sleep on city streets at night.
Tuberculosis is a larger problem in developing nations; however, LA County health officials have been coping with growing numbers of tuberculosis cases among the city’s homeless population for years. Dr. Fielding noted that most of L.A. County’s cases of the disease are brought in by foreign travelers. County officials have been coping with growing numbers of tuberculosis cases among the city’s homeless population for years. He explained, “Many people think that TB is something of the past. Unfortunately it’s not. This is a population at particular risk. We need to protect them.”
County officials stress that the outbreak should not be c cause for alarm across the entire city, since it is confined to a specific area. The outbreak among the homeless comes as cases of tuberculosis have actually declined among the general population countywide—from 816 cases in 2007 to 625 in 2012. Despite that, the outbreak is disturbing because homeless people are especially vulnerable, because of the conditions in which they live. As a transient population, they are less likely to get treatment and more likely to spread the disease to others in shelters or on the street. On a positive note, Dr. Fielding said most of the homeless have been exposed to one particular strain of the organism, which responds well to treatment.
TB is a contagious bacterial infection that mainly involves the lungs, but may spread to other organs. It is caused by the bacteria Mycobacterium tuberculosis. You can get TB by breathing in air droplets from a cough or sneeze of an infected person. This is called primary TB. In the United States, most people will recover from primary TB infection without further evidence of the disease. The infection may remain dormant (inactive) for years. However, in some people it can reactivate.
Most people who develop symptoms of a TB infection first became infected in the past. However, in some cases, the disease may become active within weeks after the primary infection.
The following individuals are at higher risk for active TB:
- People with weakened immune systems, for example due to AIDS, chemotherapy, or antirejection medicines given after an organ transplant
Your risk of contracting TB increases if you:
- Are in frequent contact with people who have the disease
- Have poor nutrition
- Live in crowded or unsanitary living conditions
The following factors may increase the rate of TB infection in a population:
Increase in HIV infections
Increase in number of homeless people (poor environment and nutrition)
The appearance of drug-resistant strains of TB
In the United States, there are approximately 10 cases of TB per 100,000 people. However, rates vary dramatically by area of residence and socioeconomic class.
- The primary stage of the disease usually does nott cause symptoms. When symptoms of pulmonary TB occur, they may include:
- Cough (sometimes producing phlegm)
- Coughing up blood
- Excessive sweating, especially at night
- Unintentional weight loss
Other symptoms that may occur with this disease:
- Breathing difficulty
- Chest pain