What is known about the tuberculosis cases in migrant shelters in Chicago

The Chicago Department of Public Health announced last Tuesday that it had detected a number of tuberculosis cases among newly arrived migrants staying in the city’s shelters. The news came amidst the fight against another measles outbreak within the same facilities, raising public health concerns.

Although the exact number of tuberculosis cases has not been disclosed, Jacob Martin, the Chicago Department of Public Health’s Public Information Coordinator, explained in a statement that they were aware of “a small number of tuberculosis cases among newcomers.” So far, it has not been specified how many cases have been diagnosed or in which shelters the infected persons are being held.

Tuberculosis remains one of the deadliest infectious diseases in the world. According to the World Health Organization (WHO), around a quarter of the world’s population has been infected by the tuberculosis bacillus, and between 5% and 10% of these individuals develop symptoms. In 2022, 1.3 million people lost their lives after contracting this infection.

Members of the local council have warned the Chicago Department of Public Health and other officials about the impact of not taking the necessary measures in this situation. In a post on his X account, Alderman Raymond Lopez shared a photograph of the tuberculosis diagnosis of three migrants, accompanied by a message expressing his dissatisfaction with the way this situation has been handled. “And now here we are: measles, now tuberculosis both ‘confirmed’ in Chicago. Shame on every mouthpiece that worked so hard to keep this secret,” he wrote.

Faced with this situation, which primarily affects vulnerable communities, Chicago Mayor Brandon Johnson’s administration must act swiftly. Just as it happened in 2020 during the Covid-19 pandemic, diagnosing respiratory illnesses more effectively can reverse the impact on the number of people who contract the disease and lose their lives.

What is tuberculosis?

Tuberculosis (TB) is a respiratory disease caused by the bacterium Mycobacterium tuberculosis. This condition most commonly affects the lungs, although not exclusively. The kidneys, spine, lymph nodes, and brain can also be affected.

How is it transmitted?

Pneumologist Ricardo Sandoval, member of Mexico’s National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), asserts that this disease is spread when an infected person sneezes or coughs and someone else inhales the bacteria. However, not all individuals who contract tuberculosis become ill.

What are the main symptoms?

Dr. Sandoval points out that the symptoms of active tuberculosis are the following:

• Cough
• Chest pains
• Weakness or fatigue
• Weight loss
• Loss of appetite
• Fever
• Night sweats
• Chills

In situations such as the one experienced in Chicago, it is important to clarify that this disease is not transmitted by:

• Shaking hands with someone
• Touching a person who is infected
• Sharing a house
• Sharing a bathroom

Treatment

This disease is preventable, curable and can be treated with medication, explains Dr. Miguel Ángel Salazar, a member of the Tuberculosis and Pleural Diseases Clinic at the Mexico’s National Institute of Respiratory Diseases (INER). But if someone does not receive the necessary care, it can become a serious or fatal condition.

There are four antibiotics commonly used to eradicate it:

• Isoniazid
• Rifampicin
• Pyrazinamide
• Ethambutol

Dr. Salazar emphasizes that for the treatment to be effective, medications must be taken daily for a period of six to nine months. It is dangerous to stop treatment prematurely or without medical advice because the bacteria can develop resistance to medications, leading to drug-resistant tuberculosis.

This is why the current implications of tuberculosis continue to dominate medical discussions. According to the WHO Global Tuberculosis Report 2023, tuberculosis was the second leading cause of death worldwide by a single infectious agent in 2022, after Covid-19. The report states that global targets against tuberculosis have not been achieved or remain unmet. The same document claims that tuberculosis causes an average of more than 3,000 deaths per day.

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