Official City of Long Beach Statement Regarding Public Health Emergency in Response to Local Tuberculosis Outbreak; Risk to Population at Large Remains Low

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PRESS RELEASE

Today, May 2, 2024, City Health Officer Dr. Anissa Davis declared a local public health emergency to strengthen the City's preparedness and ability to respond to a localized tuberculosis (TB) outbreak. This declaration will be considered for ratification by the Long Beach City Council on Tuesday, May 7.

The outbreak is currently isolated to a distinct population and the risk to the general public is low. The population at risk in this outbreak has significant barriers to care including homelessness and housing insecurity, mental illness, substance use and serious medical comorbidities.

About the Outbreak
Several individuals associated with a single room occupancy (SRO) hotel in Long Beach have recently been identified with TB disease. As of April 29, 14 cases of TB disease have been associated with this outbreak; nine people have been hospitalized at some point in their illness; and one person has died. To protect patient privacy and comply with HIPAA regulations, the name of the hotel will not be released. The facility is a private hotel not operated by or contracted with the City of Long Beach. People who were staying at the hotel at the time or could have otherwise been exposed have been or will be contacted by the Health Department.

The Health Department's TB Control Program provides treatment to everyone with TB disease who is affected by this outbreak and also supports them as necessary with temporary housing, food and transportation. Treatment for TB disease requires months of multiple medications, and medicine is given under direct observation by TB Control staff.

Through the course of this investigation, staff have identified approximately 170 people who have likely been exposed to TB. Health Department staff are in the process of screening contacts for TB via symptom review, blood or skin test and a chest x-ray. The Health Department will continue to screen individuals associated with this outbreak and expects the number of cases and contacts to increase. Those who are found to have active TB disease or latent TB infection will be provided treatment. The level of attention needed to contain the outbreak is well beyond the scope of the Department's day-to-day work. The population of concern requires outreach and engagement, necessitating significant staff time to perform multiple interactions.

Screening and treating such a large number of people requires many resources. Declaring a public health emergency streamlines the Department's ability to quickly secure resources and take additional action to contain the outbreak.

About the Emergency Declaration
Pursuant to the Health and Safety Code, City Health Officer Dr. Anissa Davis declared the local health emergency related to tuberculosis.

The Department requires many resources for the intensive clinical, outreach, screening and social supports necessary to respond to this outbreak. The Department has exhausted their resources to manage this response without an emergency declaration.

The declaration allows the City to take all actions necessary to implement preventive measures to protect and preserve the public health of the city from TB, including, but not limited to:

• Mobilizing City resources
• Accelerating emergency planning
• Streamlining staffing
• Coordinating with other agencies
• Expediting the ability of the City to purchase necessary supplies to identify and treat TB
• Allowing for possible future reimbursement by the State and federal governments, and
• Raising awareness throughout Long Beach about TB.

About Tuberculosis
The risk of TB for people who live, work, study or visit in Long Beach remains very low.

Tuberculosis, also known as TB, is a serious illness caused by the bacteria Mycobacterium tuberculosis. Like COVID-19, TB spreads through the air, such as when an infected person coughs, sneezes or speaks. However, TB is not as quickly transmitted as COVID-19, and usually requires prolonged exposure between the person with TB disease and family, friends or everyday close contacts. Crowded and poorly ventilated environments are risk factors for tuberculosis transmission. Not everyone exposed will become infected and not everyone infected with the bacteria becomes sick. Generally, persons at high risk for developing TB disease fall into two categories:

• Persons who have been recently infected with TB bacteria
• Persons with medical conditions that weaken the immune system

People experiencing homelessness, people who use illicit substances and people with HIV are also at an increased risk of becoming infected with TB germs compared to the general population.

Fortunately, TB disease can be cured and prevented through detection and treatment. People who have been infected but are not yet sick have what's called latent tuberculosis infection (LTBI). People with LTBI can take medication so that they do not later get sick with active TB disease. People with active TB disease will usually feel sick and have symptoms like a cough that lasts for two or more weeks, fever, night sweats, weight loss or feeling tired. People with active TB disease can be cured by taking several medications.

For more information about TB, people are encouraged to visit information pages created by the California Department of Public Health and the Center for Disease Control.

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