Long Beach, a vibrant coastal city in Southern California, is proactively addressing a localized tuberculosis (TB) outbreak. City Health Officer Dr. Anissa Davis declared a local public health emergency on May 2, 2024, to enhance the city’s response and preparedness. This declaration is scheduled for ratification by the Long Beach City Council on Tuesday, May 7.
Currently, the outbreak is contained within a specific population, posing a low risk to the general public. The affected individuals face significant challenges in accessing healthcare, including homelessness and unstable housing, mental health issues, substance use, and serious pre-existing medical conditions.
Understanding the Outbreak in Long Beach
Recent cases of TB disease have been identified among individuals associated with a single room occupancy (SRO) hotel in Long Beach. As of April 29, the outbreak has been linked to 14 cases of TB disease. Tragically, one person has passed away, and nine individuals have required hospitalization during their illness. To maintain patient privacy and adhere to HIPAA regulations, the name of the hotel will not be disclosed. It is important to note that this is a private hotel and is not operated by or under contract with the City of Long Beach. The Health Department is actively contacting individuals who resided at the hotel or may have been exposed.
The Long Beach Health Department’s TB Control Program is providing comprehensive care to all individuals affected by this outbreak. This includes treatment for TB disease, as well as necessary support such as temporary housing, food assistance, and transportation. TB disease treatment is a lengthy process, requiring multiple medications over several months, administered under the direct supervision of TB Control staff.
Investigations have revealed that approximately 170 people have likely been exposed to TB. Health Department personnel are diligently screening contacts for TB through symptom evaluations, blood or skin tests, and chest X-rays. It is anticipated that the number of cases and contacts will rise as screening efforts continue. Individuals diagnosed with active TB disease or latent TB infection will receive appropriate treatment. The scale of this outbreak necessitates a level of response that exceeds the Health Department’s routine operations. Effective outreach and engagement with the population of concern demand substantial staff time and numerous interactions.
Managing the screening and treatment of this large group requires significant resources. The declaration of a public health emergency is crucial as it streamlines the Department’s ability to rapidly secure resources and implement further measures to contain the outbreak effectively.
The Significance of the Emergency Declaration
City Health Officer Dr. Anissa Davis issued the local health emergency declaration for tuberculosis under the authority of the Health and Safety Code.
The Department’s resources have been stretched to their limits in managing this response without an emergency declaration. The intensive clinical care, outreach, screening, and social support required are placing a considerable strain on existing capacity.
This declaration empowers the City to take all necessary actions to implement preventative measures to safeguard public health from TB. These actions include, but are not limited to:
- Mobilizing City resources to address the emergency.
- Accelerating emergency planning and response strategies.
- Streamlining staffing and resource allocation.
- Facilitating coordination with other relevant agencies.
- Expediting the City’s procurement of essential supplies for TB identification and treatment.
- Enabling potential future reimbursement from State and federal government sources.
- Enhancing public awareness throughout Long Beach regarding TB.
Understanding Tuberculosis: Facts and Risks
For those who live, work, study, or visit Long Beach, the overall risk of TB remains very low.
Tuberculosis (TB) is a serious disease caused by the bacterium Mycobacterium tuberculosis. Similar to COVID-19, TB is spread through the air when an infected person coughs, sneezes, or talks. However, TB is less easily transmitted than COVID-19 and typically requires prolonged exposure between an individual with TB disease and close contacts like family, friends, or everyday contacts. Overcrowded and poorly ventilated environments increase the risk of TB transmission. It is important to note that not everyone exposed to TB will become infected, and not everyone infected with the bacteria will develop active illness. Individuals at higher risk of developing TB disease generally fall into two categories:
- People recently infected with TB bacteria.
- People with medical conditions that weaken the immune system.
People experiencing homelessness, individuals who use illicit substances, and people with HIV are also at a higher risk of TB infection compared to the general population.
Fortunately, TB disease is both curable and preventable through early detection and treatment. Latent tuberculosis infection (LTBI) occurs when a person is infected with TB bacteria but is not yet sick. Medication is available for individuals with LTBI to prevent the progression to active TB disease. Active TB disease typically presents with symptoms such as a persistent cough lasting two weeks or longer, fever, night sweats, weight loss, or fatigue. Active TB disease is curable with a course of multiple medications.
For further information about TB, resources are available from the California Department of Public Health and the Center for Disease Control.
