One more active tuberculosis case discovered but risk to public remains low, city health officer says
The city declared a health emergency in May after nine people were hospitalized and one died; health officials have fallen short of screening and treatment goals due to staffing problems.
Since Long Beach officials first announced a public health emergency to address an outbreak of tuberculosis, one more person with active TB has been discovered, bringing the total to 15 cases, city Health Officer Dr. Anissa Davis said this week.
The City Council on Tuesday voted to continue the state of emergency as the health department works to find and screen people who may have been exposed and provide treatment to people with latent cases. Those goals have been hampered by what a report to the council called a “dire staffing shortage.”
Tuberculosis symptoms can include a long-lasting cough, fever and night sweats, and loss of appetite. It is treatable with a 12-week course of antibiotics.
TB is caused by a slow-growing bacteria, and not everyone who is infected with the bacteria will develop active disease because a person’s immune system may keep it in check for years. (People who test positive but have no symptoms and do not have TB disease are said to have latent TB infection.)
The local outbreak was traced to a hotel that was serving as long-term housing, city officials have said. Anyone who has contact with a person with active TB disease could be at risk of infection, but Davis noted that it takes hours of exposure or close contact to spread.
“It continues to be contained in our population of concern, which is folks experiencing homelessness, substance use, mental health and other serious medical comorbidities, so the risk to the general public is really low,” she said.
It’s unclear when the city will be able to end the health emergency. The city’s Health and Human Services Department’s TB clinic is trying to fill open jobs for a physician, nurse practitioner and two public health nurses; in the meantime, existing department staff have taken on extra duties and Davis is hoping to extend mutual aid staffing from the Los Angeles County Department of Public Health.
The staff shortage means Long Beach health officials have checked out about 27% of “high priority” contacts, or people who may have been exposed. The goal is 85%, according to the council report.
The evaluation entails asking about symptoms, giving either a blood or skin test for TB, and potentially taking a chest x-ray and screening a person’s sputum (what’s produced when someone coughs).
City health workers have exceeded their goal for getting at least 70% of people with latent infections to begin treatment, but are significantly lagging in ensuring everyone completes it.
Davis said people who are getting treatment must see a doctor once a week to take their medication under supervision. Keeping track of and getting to appointments can be challenging for people who lack housing or have other health issues, so the city is offering help with transportation, a place to stay and other essentials, Davis said.
It’s also unknown how much ending the emergency will cost; it has already exceeded an original $100,000 estimate, Davis said, but she didn’t have the current total cost.
Even with the staffing issues, she said, “I feel like we’re making great progress and we just need to keep working.”
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