Tuberculosis Emergency in California After Death in Homeless Shelter Outbreak; Follows Chicago Migrant Shelter Cluster and Earlier IM Doc Anecdata

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Yours truly is always careful about publicizing IM Doc’s sightings from among his patients/his hospital’s patients, since there is serious risk of bias in these small samples. However, IM Doc has been reporting for some time of cases of tuberculosis, including drug-resistant and latent tuberculosis among immigrants he has been treating. The levels he has seen does not seem at all good given his patient load.

His pattern was confirmed by an set of cases in a Chicago migrant housing shelter, reported in April, and just now, an outbreak in a California homeless shelter, deemed an emergency apparently due to a fatality.

Note that tuberculosis is typically not easy for healthy people to catch. For them, it requires protracted exposure….the sort you can get in close living situtions. IM Doc did not discuss the situations of his afflicted patients, but I am highly confident his community does not have a migrant shelter, and probably not a former homeless shelter either. So his afflicted patients likely entered the US infected, or perhaps could have picked it up locally via overcrowded housing.

And as the press has kinda-sorta been acknowledging, Americans on average seem less robust, with many getting frequent “flus”. We have more concrete evidence of general worse health in the UK, with Prime Minister Rishi Sunak trying to deter NHS doctors from issuing supposedly over-frequent “sick note” to allow workers with infections to stay home.

And as we’ll discuss at the end, if we had a functioning public health system, this problem ought to be a fraction of what it is.

From Fox News on April 3: Tuberculosis breaks out at Chicago migrant shelters following measles cases. The subhead does point out that Chicago also had 55 confirmed cases of measles. From the article:

Chicago health officials have announced that a “small number” of tuberculosis (TB) cases have been reported at some migrant facilities following a recent outbreak of measles among migrants living in the Windy City’s shelters.

The Chicago Department of Public Health (CDPH) said the TB cases were reported in “a few different shelters” in the city. However, officials did not disclose the exact number of confirmed cases or which shelter locations they originated from, Fox 32 Chicago reports.

The agency says its medical teams are ramping up contact tracing to address the health issue. Tuberculosis is an infectious bacterial disease that mainly affects the lungs.

Perhaps I am not epidemologically savvy, but the fact that the cases came from multiple migrant centers does not sound at all good. Of course, neither does the reticence to provide case counts.

From a new CNN story, Tuberculosis outbreak declared public health emergency in Long Beach, but overall risk remains low, officials say :

City Health Officer Dr. Anissa Davis declared a public health emergency Thursday in response to the outbreak, according to a city announcement, and the declaration is expected to be considered for ratification by the Long Beach City Council on Tuesday. In its investigation of the outbreak, the city health department has identified about 170 people who have probably been exposed to tuberculosis. But overall, “the risk of TB for people who live, work, study or visit in Long Beach remains very low,” the announcement said. Tuberculosis, or TB, was found among several people associated with a single room occupancy hotel in Long Beach, according to the announcement. As of Monday, 14 cases were associated with the outbreak. and nine of them had been hospitalized at some point in their illness. One person has died.

Other accounts pointed out that even though tuberculosis cases are up markedly year to year, they are below the level of 2013. But I wonder how good data capture is among uninsured patients who do not wind up being hospitalized.

The Twitterverse tends to be excitable, but the official account of an outbreak in only one location (presumably containable) does not exactly square with declaring an emergency. The mass (or at least large-ish scale) claimed below, by contrast, does go with that branding:

The Twitterverse has also been touting the idea that the rise in tuberculosis cases is due to the increase in immigration under the Biden Administration. But IM Doc was seeing this pattern before the recent rash of coverage.

From IM Doc, February 1. The tuberculosis comment was a “business as usual” aside in a long e-mail:

We unfortunately had 4 people as patients in the past week test positive for COVID inside the office – so it is obviously coming into the office. I was in close quarters with all these people. I have insisted upon UV lights in the patient rooms ( we also have now multiple TB illegal immigrants coming and going – 1 of whom is Multi Drug Resistant – does it help COVID? Who knows? We are no longer looking into anything at the federal level or the university level).

From March 23:

3 more immigrants this week. One with active TB, one with latent TB, one with multi resistant gonorrhea. The ID consultant does not even know how to treat. He is now in hospital on IV drugs costing 20 grand a day.

They are not being screened at all at the border. They all 3 were working in restaurants, the two Tb patients as wait staff. What could possibly go wrong? I always thought you could not hire illegals. Guess I am wrong.

From IM Doc on Saturday, in response to the Long Beach outbreak:

This problem is not getting the attention it should. I am now up to 11 illegal immigrants with active NOT latent TB, 3 of them are multi drug resistant. I do not have exact number on hand but I would guess another 10 or so with latent TB. It does not surprise that people are dying from this, there is no treatment at times that will work, they are very stressed because of their plight, and this is totally expected.

And they are walking through your WalMarts and Targets. They are in your churches and concerts. If you are standing right next to them and they are coughing and you happen to be on steroids, or immunosuppressed or a cancer patient, etc, well good luck.

As a physician, I can assure you, this level of problems is entirely a situation that has arisen during the Biden years only. I know, I worked in an inner city hospital. This degree was just not happening before. They were screened at the border before this current border madness started. THIS IS A PUBLIC HEALTH ISSUE. THIS IS NOT A SLAM ON IMMIGRANTS. THEY MUST BE SCREENED AND TREATED AT THE BORDER. And like so many other ignored public health lessons, we are going to get to learn this lesson all over again. It is certain that a few TB immigrants got through back then,I saw them too, but nothing even in the universe of the level going on now. This is by all accounts affecting largely the Latino community. Back home, there are many American citizen Latinos that are getting TB. Way out of proportion to previous years. It is thought the main conduit is large Catholic masses where citizens and illegals show up together. I wonder if AOC is going to show up at the funerals of these victims and start screaming and yelling and crying like she did a few years ago.

But the Biden Administration is not willing to do much of anything that would require creating a competent border bureaucracy, as in one able to give IDs to all entering immigrants, give them blood tests, and house them for the few days it would take to get the results back. To be blunt, that sort of housing would have to be an awful lot like incarceration to make sure they did not gain entry to the US until they had gotten a clean enough bill of health and/or had been treated. And if they had tuberculosis or STDs, who would pay for the treatment? Where would they be housed while getting it? How would they be fed? Or would they be turned back as too much trouble? That’s probably not a legal basis for rejecting asylum-seekers, but the wink and nod is that most of these asylum-seekers are economic migrants. But that still would not justify running roughshod over the ones who have a real case.

Of course this problem could be handled if the US wanted to, but that would take bureaucratic competence and a willingness to spend money, neither of which is much in evidence. The other option is to throttle way back on the number of migrants being allowed in, so as to reduce the numbers of infected people who arrive. And as IM Doc says, this is a public health issue, not an immigration issue per se, but it is inevitably going to be debated in that frame, in part because public health has become discredited via its subordination to business interests.

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41 comments

  1. PlutoniumKun

    One problem is that there is an understandable, but in my opinion quite dangerous, reluctance among medical professionals to make a big deal about infectious diseases in immigrants for fear of giving fuel to racist or anti immigrant forces. Two anecdotes on this:

    Two decades ago a friend from a city in the English Midlands fell very seriously ill with a rare, drug resistant form of TB while working in Spain. She was very fortunate to survive, she did so almost certainly because a Pakistani doctor in her hospital recognised it for what it was while she was being treated for pneumonia. What struck me was that the ‘official’ story told by the doctors – that she had probably contracted it on a trip to Goa several years before – was very obviously not true. She lived in England in a heavily South Asia area with a known high proportion of illegal immigrants, and almost certainly got it from someone local recently arrived from that region. But there was an obvious reluctance by the medical staff to acknowledge this. But they were worried enough by it to discreetly track down all her close contacts for testing.

    A nurse friend stayed with me for several months while working in a local hospital in Dublin. As an agency nurse, she got the worst jobs. She was placed in an unmarked unit within the hospital – even most staff didn’t know it existed. It was where long term patients, mostly with TB were being treated. What was surprising was that the majority were illegal immigrants who had knowingly taken a flight to Ireland either on holiday or transit visas (knowing, for historical reasons, there was a good record of treating TB here) that they could not be sent back once they’d declared themselves as suffering a highly infectious disease at the airport. Most were from east Asia, including (allegedly) a prominent Korean gangster. For entirely understandable reasons, the existence of this ward, and the issue of highly infectious people being incentivised to hop on long haul flights, was kept very quiet. All this was long pre-covid. My guess is that this incentive to travel for some infected people still exists.

    There has long been a known connection between HIV infection and TB. It does not seem unreasonable to surmise that covid similarly lowers our resistance to the disease. The damper parts of the world are full of old TB sanatoriums and hospitals, usually located well away from the regular population (one of them is a short walk from my home, in the middle of a park. TB was a truly terrible scourge of humanity for centuries, it would be an epic tragedy if it returned due to the incompetence of our public health authorities.

    1. Revenant

      The long, sucking withdrawal of the public health tide can add active community spread of multiresistant TB in Western cities to its achievements :-(

      This has been warned of in a low-key way for years. Pre-Covis, there was consternation at the number of immigrants presenting with TB – usually family reunification cases bringing over elderly, sicker relatives, rather than young primary immigrants.

      A particular alarm bell was rung in East London (home of Banglatown in Tower Hamlets etc) by the London Chest Hospital, which is based there and was an easy referral point and also a source of hospital and GP expertise (it was on every medical student’s rotation at the Bart’s and Royal London).

      The TB and HIV link is that chaotic homeless people and addicts often have TB and HIV and fail to take their meds. Unless you are rigorous about competing the TB course and maintaining your HIV status, you run the risk of knocking out the weak strains when you first comply and then selecting for the worst strains of TB when you stop complying and, with uncontrolled HIV you don’t have an immune system to help….

      The UK had a functioning public health system pre-Covid, TB is a notifiable disease and the borders are effective because we are an island. Yet still we have allowed TB to become a serious problem in inner cities. The middle classes imagine this is only in certain populations but because of public services, it is in our schools and hospitals and in their low-paid nannies and cleaners and taxidrivers and takeaway staff and waiters etc….

      I should add that the UK also abolished population level vaccination for TB! The BCG vaccine programme was considered to have eradicated TB and only people interacting closely with high risk groups are vaccinated. I don’t think this includes doctors and nurses in general. So the extent of community transmission us currently suppressed by the fact that many people over forty were vaccinated as schoolchildren. But with every year, the UK-born population is more susceptible. This issue is a ticking timebomb.

      1. Joe Well

        I was wondering why no one mentioned the vaccine.

        There is also speculation that the lack of that vaccine is one reason the US has such higher levels of allergies.

  2. mrsyk

    Edit note, pretty sure From ID Doc on Saturday, should read “IM Doc”.
    Allowing tb to regain a solid foothold during COVID seems like an adventure not worth going on.

  3. JBird4049

    >>>I always thought you could not hire illegals. Guess I am wrong.

    For decades there have been employment agencies that supply undocumented workers for the national networks that ship workers to order across the United States. A contractor or a corporation just calls the current iteration of an agency and orders the workers needed. A car, van, or bus ships the order to the designated location and time. It is illegal of course, and occasionally the feds bust an employment agency, which is immediately replaced by another one. It is a good way to drive down wages and suppress unions. Completely illegal, but so what?

    We don’t have a healthcare system, we a grift masquerading as one. I still remember the grotesque sight of Los Angeles’ Skid Row and I can drive around the Bay, but especially in San Francisco with the mass of homeless and the lack of public sanitation. Or I can see more of it in pictures and videos online although they lack the punch of being there. Really, having just two freaking porta-potties mounted on a wooden flatbed trailer for the whole of the Tenderloin is nuts. Hundred of thousands of dollars paid for it. Then there is the rest of San Francisco.

    But hell, those locations are merely the most obvious. The epidemics of lice, typhus, and other diseases, while often overhyped, is real enough. Not to mention the suffering of all involved. It would not take that much money to put the homeless in hotels or to build public sanitation.

    Somehow having fifteen thousand San Franciscans living in their car, or a tent, or on cardboard is just fine. We still have great wealth in California despite its great decline, and it is in real decline, but those who suffer in this land of plenty never get any of its milk and honey. And if wages threaten to increase or housing costs not rise, they will bus in more workers.

    As IM Doc has said, this is not a serious country.

    1. vao

      All the practices and conditions imposed upon the Third World fatally end up being applied in developed Western countries, turning them into the Third World.

    2. Acacia

      This is all bang on. I’ll just add that for small jobs it’s not even necessary to contact an agency. Idk what they are called, but I can think of many places in the S.F. Bay Area alone where Jornaleros are there every day, waiting for a contractor to pick them up in a truck. I’ve even seen signs put up by the city to designate the pick-up area. Saw a statistic that roughly 60% of them don’t have health insurance… imagine doing day labor in construction with no insurance.

    3. Eclair

      “For decades there have been employment agencies that supply undocumented workers for the national networks that ship workers to order across the United States.”

      Thank you, JBird4049. I remember reading an investigative piece in the Los Angeles Times, back in the ’90’s when we lived in Southern California. I was horrified as it detailed stories of workers, recruited in Mexico and Central America, and transported to work, essentially as slave-labor, in the chicken processing facilities across the US south. Perdue, Tyson and Colonel Sanders were left with clean hands and spotless conscience, in a classic ‘don’t ask, don’t tell’ operation, regarding the workers’ ‘documentation.’

      Friends and neighbors at that time would complain about ‘Mexicans’ and ‘illegals’ and I would ask them who would disinfect their swimming pools, cut their grass (and what were they doing with grass in a Mediterranean semi-arid climate anyway, but I digress), clean their houses, watch their children, put up the dry wall and install the roofs in the new housing developments spreading over Orange County like a rash, and wash the dishes in their favorites trendy restaurants, if we sent all the ‘Mexicans’ back over the border.

      1. Eclair

        Found an article about the LA Times investigative piece. It was published on November 10-12, 1996. Hudson Foods, the chicken processing company targeted by the Times, was purchased by Tyson in 1998. Such a profitable business model!

      2. flora

        “who would do” that work for next to no pay?
        Because US union carpenters and roofers and slaughterhouse and meat packinghouse workers used to do that work for good wages and benefits.

        Reagan gave “Amnesty” to illegals in 1986. Clinton went one better (or worse) in 1996. Biden’s plan goes even farther. It’s bipartisan!

      3. Carolinian

        Don’t forget the beef and hog processing plants which are often not in the South. They too have depended on immigrant labor and of course the classic book on the subject, Upton Sinclair’s The Jungle, was set in Chicago.

        So health is being neglected and degraded for the sake of business interests but also political interests since practically everything Biden does seems related to his own political needs. His open border policy is a club to use against Trump and the Republicans just as draw downs of the Strategic Petroleum Reserve take place before elections and the Justice Department has been weaponized to try to skew the upcoming vote.

        I think one could go even further and suggest that the anti Trump hysteria is merely a tool being used to create an authoritarian US that TPTB have craved ever since the Powell memo declared that too much freedom for the proles and critics had become a problem. As Alfred Hitchcock would say Trump is the McGuffin–the bomb on the bus or whatnot that is the mainspring of the movie’s action and suspense. Hitch saw himself as the great audience manipulator and so do they.

        Our elites live in a dream world and leave it to others to bury the many many dead.

  4. WillyBgood

    What puzzles me is how San Francisco comes up in these discussions all the time. LA is far more affected by illegal immigration and has as much or more of shanty towns and car campers. Southern CA has WAY more Home Despots parking lots full of would be braceros and you would think would be ground zero for incoming pathogens.

    1. JBird4049

      That is true, but San Francisco is a much more compact and beautiful city, Baghdad by the Bay, which makes the homeless more apparent. It is inescapable. It’s right across city hall and surrounds the main library. Also, I have lived within an hour of the city of my birth all my life, which means that I am much more familiar with it. Also, Los Angeles is such a sprawling city it is easier to miss or just ignore the squalor unlike San Francisco.

    2. JonnyJames

      Most immigrants work, most folks on the street are US citizens. Let’s not get it twisted. Also, SF has more affluent immigrants, on average. The SF Bay Area has plenty of shanty-towns, just not downtown SF – you just have to drive over the bridge to Berkeley, Oakland, Richmond, Vallejo etc.

      1. JBird4049

        >>Most immigrants work, most folks on the street are US citizens.

        And many of the people who are homeless also work. It is not just about work. It is the mismatch between income and the cost of living especially housing. Deliberately ignoring the law to import underpaid workers helps to create this situation.

          1. JBird4049

            My apologies. I just don’t see a different point. Please restate it.

            Thank you.

  5. flora

    45 cities.

    Homeland data on Biden parole program reveals illegal aliens flown to more than 45 cities

    Florida received the bulk of the newcomers, with 80% of the migrants flown into airports in four Florida cities. New York, California, Georgia, Texas, and Nevada also received migrant flights.

    “If approved, the migrants are given work permits and a two-year authorization to live in the country. But the program is only open to those who are considered “inadmissible” to the country otherwise.”

    https://justthenews.com/government/federal-agencies/dhs-report-reveals-45-cities-paroled-migrants-were-flown

    1. Rod

      Okay
      Steve Inskeep and NPR is all over this today:
      https://www.npr.org/2024/05/06/1248670734/immigration-us-mexico-border
      but they didn’t mention disease because–I don’t know. Maybe they will in tomorrow’s installment.
      Mentioned they had to Pay what sounded like a lot. Neglected to ask how they got the money of course–nobody likes to talk about money.
      But this fact got through:
      Everyone in the group said they had family living in the U.S. already — in Carla’s case, an adult daughter in Florida. Her family hoped to go there next,after their appointment with Customs and Border Protection, which was scheduled for 2:30 p.m. the following day.
      They got a work permit and an asylum hearing for Nov 18, 2027, in Orlando
      They could be sick with latent disease but at least they won’t be working illegally.
      It’s a real mess and repeated millions of times.
      But i shouldn’t complain because there are ‘old laws’ that don’t get enforced and no new laws because that is not a Political priority. I don’t think Trump is espousing the Solution either, but Inskeep did include this in his Report:
      Many who cross the border tell agents that President Donald Trump’s departure from office encouraged them to think the U.S. would be more open, Modlin said.
      FWIW, (having visited many ‘Undeveloped Countries’) I think Health Screening at the Border before Migrant entrance is a really prudent idea to protect American Public Health however, like IM Doc, I wonder how we are going to deal with what we find out.

    2. Gregorio

      The U.S. already has a labor shortage, aging population, birthrates and fertility are declining, and considering that the economic system is based on perpetual growth, it seems to me like it would probably be a really good idea to revamp immigration quotas drastically higher, for anyone who doesn’t have a criminal record and wants to work, instead of trying to make their lives miserable. Then the CBP can concentrate on identifying and deporting the undesirables. Otherwise, we’ll soon end up in the same boat as Eastern Europe and Japan.

  6. The Rev Kev

    Let’s see. Take a very large population. Discourage physical fitness from a young age. Flood the place with cheap junk food that encourages people to be obese. Have that population be flooded with a virus that plays havoc with their immune systems and degrades it so that they are vulnerable to getting sick or infected by other diseases. Bring in untold numbers of immigrants without so much as a medical check – people from places that fight to keep diseases down. Degrade even the idea of public health. Make the medical health system unaffordable to the most vulnerable people. Introduce diseases like measles, TB, the Plague, etc. Shak’n’bake.

  7. reify99

    14 cases, 9 of which have been hospitalized, 1 of which died. This has been cooking a while.

    I had a TB patient in 2004, with active disease in all four lobes. He and five brothers came to the US, rented a house with a window air conditioner, (thereby removing the need to open the windows), got bicycles, and proceeded to look for work. My patient had worked in a large restaurant as a dishwasher. Clouds of steam. He was infectious, so I went daily to watch him swallow 11 pills. (4 different antibiotics.)

    Some of the brothers had girlfriends. Some of the girlfriends had kids. Once, when I was sitting across the sofa from him and he had taken his pills, (Daily Observed Treatment. Monday through Friday. “Honors system” on the week end), I heard snoring. Neither of us. So I leaned to the side to look behind, and saw feet. A friend from Mexico who had come in the night before. I had to do a TB skin test on each of these new contacts in two steps: giving it to them today and then having to find them again in 48 hours to get results. The brothers all needed xrays, which meant I drove them to the hospital.

    I had to remain diligent with each contact and to convey to them that I did not care if they were sin papeles. “The germ is whom I am at war with.” I only said this once. More often I’d mention that my great-grand parents had come over from Ireland in the hold of a ship and caught TB on the way to the US. Sometimes the pregnant ladies in the access clinic prenatal program would know the person who did not come back for me to check TB skin test results. They would get him in. Now and then there were McDonald’s coupons…

    “Public health is 90% trust.” (Source?)
    IMO public health should be a steel hand in a velvet glove. I used to carry a paragraph of state law that where the risk to the public health is concerned privacy rights are superseded. I used it.

  8. Screwball

    From the last paragraph;

    Of course this problem could be handled if the US wanted to, but that would take bureaucratic competence and a willingness to spend money, neither of which is much in evidence.

    Bold mine. We don’t have any trouble finding money for proxy wars, bombs, and military budgets. Simply, the people running our country don’t give one good **** about our health, safety, or lives. Their priorities are obvious, and it ain’t we the people.

    Vote blue no matter who.

    1. chris

      Yes, at this point single payer health care would be cheaper than hoping the current health disasters don’t merge into combined pandemics.

      One of my kids has a HS class where he has to listen to NPR and they said on a recent show that Biden has made healthcare affordability a centerpiece of his administration. The tone of the report was clear… Joe is doing great. Everything is getting better. You apparently just haven’t realized that. Healthcare – It’s a centerpiece. It’s going to be affordable. Stop asking questions.

  9. JTMcPhee

    Did not mark it, but saw Biden quote saying that the reason US economy is growing compared to the rest of the West is because “we” invite and admit essentially anyone who can get to the border.

    This asshat and the people around him, it boggles the mind that they may actually believe this sh!t.

    “Sometime a great country.” We mopes are, so many of us, stupid enough to believe that this geographic accident is a “country.” Not how the carrion eaters think about it, and they obviously have the better grip on all the parts that matter.

    1. chris

      Yeah, but because the Red team has decided to implode over abortion, the old fool has decent odds of being re-elected. Doesn’t matter what damage he does to our country for the remainder of this term or his next. Doesn’t matter if he has to abdicate his position in our serial dictatorship. The illegals and capital must flow across borders. It won’t be good for people on either side of the border, but no one cares about them. Or anyone one of us really.

      It is amazing to see the US essentailly fund and reward settlers in the West Bank, in what is actually replacement theory in action, while also support Ukraine viciously attempting to defend its borders, while completely ignoring our own.

    2. Acacia

      Maybe this: https://www.bbc.com/news/world-us-canada-68947042

      Actually, Biden went even better, saying that US allies Japan and India are “xenophobic” w.r.t. immigrants.

      Maybe Genocide Joe thinks he’s pretty clever, spinning his policy of inviting in undocumented workers as a way to bash China. Seems he got a bit carried away.

  10. Paul Art

    There is a variation of TB called Glandular TB. Only symptoms are high fever, night sweats and extreme fatigue. No respiratory issues or symptoms. Treatment is same as TB. 3 month course of tablets. I got this in Bangalore in 2008. Was hard to diagnose. Went through several tests until one clever Doctor caught it. They thought it was Cancer initially. The clever Doctor physically felt me all over and caught a limp in my neck region. They biopsies it and it came out positive for Glandular TB.

  11. JonnyJames

    Sadly, this sort of thing is used for fear-mongering, distractions, scapegoating, and creating the illusion of choice in an election year. The likelihood of getting a disease from an “illegal”, as pointed out, is extremely low. One is much more likely to die in a road accident, fall off a roof, or get a disease from a US citizen.

    The US, no matter which puppet sits in the WH, doesn’t give a toss about the health of its own citizens. The handling of the pandemic, the influence of BigPharma monopolies, the perverse costs of privatized, so-called health care, the dismal health outcomes. Health care in the US is tantamount to institutional extortion.

    And the US will continue to drive migration and refugees by economic siege warfare, bombing campaigns, debt-trap diplomacy, etc. The largest refugee crises since WWII have been caused by US policy, but we don’t want to hear all that, let’s blame the victims – it’s part of our culture and it’s good for business.

    1. Raymond Sim

      If the “Leonardi Effect” is in play, and I think the evidence indicates it is, then we won’t have to worry about importing TB for long. Domestic production will ramp up fast.

  12. Ignacio

    FWIW in Spain there were nearly 2000 cases of respiratory TB in 2023 and 1600 in 2022. 4th position among infections caused by pathogenic bacteria which are under continuous epidemiological vigilance. Syphilis is first. Bordetella pertussis second, Legionella third.

  13. kareninca

    Thank you so much to IM Doc for informing us, and to NC for reporting on this.

    The following is not exactly on topic, but maybe it is really. People in Chicago and elsewhere are showing up with the problems of later stage syphillis. But they are getting it early; the later term symptoms are showing up much, much earlier in the course of the disease than is typical:

    “Disease detectives in Chicago say they have been seeing a worrisome trend: Patients complaining of unusual symptoms like vision and eye problems, headaches and hearing loss or dizziness caused by the sexually transmitted infection syphilis.

    Doctors have long known that syphilis can permanently damage a person’s vision and hearing and can even lead to psychiatric changes, but these symptoms are usually associated with infections that have gone undiagnosed and untreated for years.

    In a new study presented on Wednesday at the 2024 Epidemic Intelligence Service Conference in Atlanta, researchers say there were more than two dozen cases with these kinds of symptoms in Chicago last year, and nearly a third of the cases were in the early stages of their infections.

    More than two-thirds of these patients (68%) lacked typical syphilis symptoms, like a rash or chancre sore, that might tip doctors off to the infection.”
    https://www.cnn.com/2024/04/26/health/doctors-warn-theyre-seeing-syphilis-patients-with-unusual-and-severe-symptoms/index.html

    A worldwide population of people with deteriorating immune systems (see Daniel Brittain Dugger) could be behind this and a factor in the case of TB, too.

  14. old ghost

    IM Doc can add a couple of diseases to his list to be on the look out for along with TB. Aspergellis, and MAC Lung Disease (mac is short for Mycobacterium avium Complex). I suspect the 4 antibiotics given for TB are azrithromycin, rifabutin, ethambutol, and cresemba ? Sputum tests failed to detect anything wrong, until the Infectious Disease MD used a Bronchoscopy with a follow up culture to diagnose MAC and Aspergellis.

    I am an elderly WASP male, 4th generation US citizen, not Hispanic, nor do I have much exposure to immigrants up here in America’s Siberia (aka Wisconsin). I do have a lifetime of asthma, and now COPD. Living conditions have never been crowded, except for a period in the early 1970’s when I lived in a dorm. After a year of dorm life, my health got a whole lot worse.

    My father’s parents both died of TB in the early 1920’s, and he spent 9 years in a TB Preventorium. I did receive the BCG vaccine for TB as an infant. But all my life I have set off the TB skin test that the school nurses would administer whenever a student changed schools. Follow up tests never found TB. Now I suspect the TST detected the mycobacterium for MAC, which is a “kissing cousin” of the mycobacterium for TB.

    Covid was very mild. But about 2 weeks later, I woke up with the most incredible pain. The MD diagnosed Rheumatoid Arthritis and gave me a pain Med that suppressed my immune system. Big mistake. I went from 219 to 132 pounds without dieting. So I was finally sent over to Infectious Diseases (after everything else was checked first).

    I am only 3 months into the 6-18 month antibiotic regime, and am feeling a whole lot better. I now think that instead of asthma, I was suffering from MAC all along. Even the RA has subsided to a wee bit of stiffness in the AM.

    FWIW, don’t blame Biden for the border woes. The D team conceded everything the R’s were asking for. But that career criminal, Trump, nixed the deal because he wanted an issue to campaign on.

    1. JonnyJames

      Yes, Biden, despite the cheap rhetoric is just toeing the bipartisan line. At times he can’t even read a teleprompter, and has to be led out of the room. Yet they are running him again. And also the other cognitively-challenged freak is running a repeat ticket – scraping the bottom of the kakistocracy barrel. Is this real, or just a simulation?

  15. Rip Van Winkle

    In Chicago an 80 year old abandoned factory adjacent to 130 year old freight railroad south of White Sox Park had been identified as potential migrant housing. Prob should check if it belongs on superfund list first.

  16. MFB

    A good friend of mine died of TB (he’d actually contracted it when he was in an Indian township in the 1960s in Johannesburg, but it remained latent in the scar tissue in his lungs for fifty years). It’s a poverty disease, after all. There should be no poverty in San Francisco.

    Or, as Randy Newman put it back when his first proposition was actually true,

    “Living in the richest country in the world
    Wouldn’t you think you’d have a better life?”

  17. Cakeeater

    I volunteered for a woman’s auxiliary in the late 1990s in Orlando. We dropped off food at a small multifamily project which housed men who were being treated for the new type of TB which requires months of drug therapy. The virus is airborne and we were instructed to walk in the unit quickly and drop off the food parcel. This was after the cleaners disinfected the units. https://pubmed.ncbi.nlm.nih.gov/1918197/ Around the same time, hospitals were getting patients with TB and grappling with hvac issues – basically how to not spread the virus throughout the campus. This is a similar situation and has to be carefully dealt with or TB spreads to the population at large. My mother was an Army nurse in WWII and tested positive but not active for the virus.

  18. LAS

    Along with other public health programs, those addressing TB were put on hold/hiatus during the COVID pandemic. Most public health resources were then activated and diverted to COVID. The outcome of that shift on TB cases is an uptick in cases among persons who have always been the prime TB carriers in the USA, immigrants and homeless populations. Biden has nothing to do with it per say. It’s an effect occurring within the underresourced public health system itself. Rob Peter to pay Paul and this is what you get.

  19. DG

    “I always thought you could not hire illegals. Guess I am wrong.”

    I always thought that was why we had immigrants. Furthermore life has to be terrible for people to emigrate. Northern cities once had solid ethnic neighborhoods. And they all came over when American industry needed bodies to run the system. Immigrants are only illegal when it is convenient for political rhetoric. The USA has certainly created a wasteland in Central America as well as many other places.

    In Pittsburgh the Mon Valley was a transplantation of Serbia, Croatia etc. Small terraced houses lined smokey streets in the shadows of the great mills. All social ills and diseases were welcome. Meanwhile the technocratic WASPS needed to keep industry running lived in places with accurate descriptive names: Pleasant Hills, Point Breeze, Shadyside, Highland Park. The owners of industry moved to New York City.

    I am currently brushing up on my ‘Downton Abbey’, ‘To the Manor Born’, ‘The Jewel in the Crown’ and ‘Gone with the Wind’ to perfect my social skills for living in a colony. Isn’t flyover America viewed as a colony to have all value extracted from it. Similar to Haiti in my opinion.

    Disease in the colonies is not a problem as long as you live in a place like Highland Park.

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