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TB outbreak spurs public health emergency in California

On 2 May 2024, the city of Long Beach, California declared a local public health emergency due to an outbreak of tuberculosis (TB). As of 29 April, the outbreak comprises 14 active cases of TB, nine hospitalisations and one death. Long Beach public health officials have identified 170 exposed persons and screenings are currently ongoing. Treatment is being provided to all active and latent TB cases. Due to the rarity of TB outbreaks in the US in the 21st century, resources are strained, prompting the public health emergency declaration. Long Beach health officials note that the danger of infection in the general population remains low.

TB is a disease caused by Mycobacterium tuberculosis infection. The bacterium is spread through droplets, called fomites, which are propelled via coughing, sneezing or spitting. These fomites are inhaled and the bacteria infect the lungs. TB can take multiple forms. Latent TB infection (LTBI) is asymptomatic and can remain in stasis for decades. Active TB causes symptoms and is responsible for outbreaks like the one occurring in Long Beach. Symptoms of active TB include persistent cough, weakness, night sweats, fever or chills, chest pain and coughing up blood. Long-term interaction with people with TB increases the risk of infection.

Marginalised populations are at increased risk of infection

The current outbreak is connected to a privately owned single-room occupancy (SRO) hotel. SRO housing is a form of affordable housing often used by and for marginalised populations, such as those experiencing homelessness. Marginalised populations are also at increased risk of TB exposure and infection. People in correctional facilities, nursing homes and homeless shelters have prolonged exposure to infected persons. Additionally, people with HIV, low body weight or substance use disorder are at increased risk of active infection due to having weakened immune systems. Treatment for TB lasts months, and compliance is often difficult with transient populations such as injection drug users and those experiencing homelessness.

GlobalData epidemiologists predict that there will be 6,534 diagnosed incident cases of TB in the US in 2024, although this forecast will be revised upwards if the recent trend of rising TB case numbers continues. Screening for TB is done through symptom checking, antibody tests (often called tuberculin skin tests) and chest X-rays. Anyone who suspects TB infection or exposure should reach out to their local public health department.  

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