Tuberculosis is a highly-contagious disease most likely to be found among poorly nourished people with weakened immune systems, crowded into unclean living conditions.

Not surprisingly, the deadly disease seems to have found a home among the homeless of Los Angeles’ downtown Skid Row. On Friday, the Los Angeles Times reported that the Los Angeles County Department of Health had asked the federal government to help control an outbreak of TB that has already exposed 4,650 people.  

“This is the largest outbreak in a decade,” Jonathan Fielding, director of the Los Angeles County Department of Public Health, told the Times. The county identified 78 cases of TB, 60 among the homeless on Skid Row over the last five years. Eleven people died.

The federal Centers for Disease Control and Prevention (CDC) dispatched a team to Los Angeles to help identify and treat other possible victims, but also to help contain a transient homeless population that could spread the disease more quickly than usual. The strain of TB in the outbreak has been identified as unique to Los Angeles.

Tuberculosis was once the leading cause of death in the United States. Cases have dropped dramatically in this country since 1953, from 83,304 to 10,528 in 2011, even as the population has grown. The rate of TB per thousand people has declined from 52.6 to 3.4. There were 529 deaths from the disease in 2009.

TB case rates are measurably different by age, race and ethnicity, and country of origin. Older adults are most vulnerable. In 2011, the case rate of foreign-born persons was 11 times higher than among people born in the U.S, according to the Centers for Disease Control. Still, foreign-born TB rates declined 49% between 1953 and 2011.  

–Ken Broder

To Learn More:

Los Angeles Health Officials Concerned about TB Outbreak on Skid Row (by Deena Beasley and Julie Steenhuysen, Reuters)

Downtown L.A. Tuberculosis Outbreak Prompts CDC Response (by Anna Gorman and Andrew Blankstein, Los Angeles Times)

Los Angeles Tuberculosis Cases Draw Federal Investigators (by Stephanie Amour, Bloomberg)

Reported Tuberculosis in the United States, 2011 (Centers for Disease Control and Prevention) (pdf)