Feds warn thousands may have been affected by TB epidemic in downtown LA

"The largest outbreak in a decade"

Federal health officials are descending on downtown Los Angeles to combat a dangerous, persistent outbreak of tuberculosis on Skid Row.

Since 2007, LA County has identified 78 TB cases in and around the Skid Row neighborhood — 60 of them among homeless people — and 11 have died. Health workers have identified about 4,650 people who were probably exposed and are trying to track them down for testing and treatment.

Scientists have linked the outbreak to a tuberculosis strain that is unique to Los Angeles. The Centers for Disease Control and Prevention has dispatched scientists to help local officials figure out why the disease is spreading and how to stop it.

"This is the largest outbreak in a decade," said Jonathan Fielding, director of the Los Angeles County Department of Public Health. "We are really putting all of our resources into this."

Why Skid Row

Homeless people are especially at risk of contracting TB and of going undiagnosed: poor hygiene and nutrition, limited access to health care, and constant contact with infected people all raise the odds. Transmission of the airborne disease is common in overcrowded conditions, and the transient population moves constantly among hospitals, shelters, and the streets.

"They go from place to place and the likelihood of passing it along is much greater," said Paul Gregerson, chief medical officer of the JWCH Institute, which runs a homeless health-care program on Skid Row. "It makes everybody more susceptible."

Officials were concerned because the cases were tied to one small geographic area and one vulnerable population — but warned the outbreak could spread beyond Skid Row without aggressive action. Their reassurance to the wider public: TB requires frequent, close contact with an active case, and once treated, patients quickly become non-infectious.

Archive summary, February 2013, based on reporting by the Los Angeles Times, Reuters, and the Associated Press.