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Health official: 'This outbreak of TB is not a threat to the public at large'

By Hayley Fox
Published: Tuesday, February 26, 2013, at 09:00AM
Skid Row Eric Richardson / blogdowntown

The L.A. County Department of Public Health said this new particular strain of TB is unique to Skid Row, with only a few cases reported elsewhere.

While the outbreak of tuberculosis (TB) has spurred local health officials to call in state and federal agencies, the L.A. County Department of Public Health (DPH) assures residents this is not a a county-wide threat.

"This outbreak of TB is not a threat to the public at large," said L.A. DPH Director and Health Officer Jonathan E. Fielding, MD, MPH.

Health officials are calling the current TB situation in Skid Row an "outbreak," but that doesn't mean the cinematic scene we often think it does. The National Guard hasn't been called in and there's no squadron of scientists lining the streets in yellow HazMat suits.

In fact, Fielding said that the health department was surprised when this information became "news" because, "there’s nothing necessarily really 'new' about this."

He said that there's no evidence that this strain of TB is any more virulent than others strains, and all forms of the disease are hard to become infected with in the first place.

“Transmission [of TB] is not like it is with influenza or the common cold,” said Fielding.

It's not passed through a handshake, clothing or glassware, but is spread through direct germ contact -- like if someone sneezes or coughs on you, repetitively. And, the DPH says you have to have close contact with an infected person for a "significant period of time" to really be at risk.

Officials are looking for 4,600 people who have been exposed to this particular strain of tuberculosis on Skid Row, but only 300 of this group had “prolonged exposure” and are considered at high risk. This select group of hundreds were identified as being present in a local shelter during the recent infectious period there.

The outbreak of this specific strain of TB began in 2007 and over the last five years, there have been 78 cases of it identified. Of these, 60 victims were homeless. Most of them are male and 20 percent of the homeless victims are HIV positive.

Of these 60 homeless cases, 11 have died since 2007.

As health officials identify homeless individuals that are infected with TB, Fielding said these patients are put into special housing where they can receive medication and directly observed therapy -- a TB control strategy that includes multiple components.

After a few weeks for treatment when the patients are no longer contagious, they'll be released into the public population but still receive the ongoing therapy.

The L.A. DPH said it is partnering with the Los Angeles Homeless Services Authority, the Union Rescue Mission, the Los Angeles Mission and the Midnight Mission to help control the spread of TB in their shelters. They've also issued a "cough alert" where any person that is suspected of having TB is recommended for a clinical referral.

A team of CDC officials will be arriving in Los Angeles on March 4 and staying for about three weeks. This team includes eight people from the Division of TB Elimination Outbreak Investigation Team.

According to the CDC, this Skid Row outbreak goes against national trends as statistics from 2011 show that TB has reached an all-time low in the United States with a total of 10,528 cases reported. The L.A. County Department of Public Health also said that across the County as a whole, TB numbers have been decreasing.


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