New York City is recording a ‘dramatic’ rise in tuberculosis cases, reports suggest – fueling fears the disease could reemerge in the US.
Preliminary data shows that 500 cases of tuberculosis (TB) have been diagnosed in the city so far this year – a 20 percent increase from this time last year.
The number of infections in the city is also at the highest level in more than a decade for this time of year, raising concerns that the disease could spread to other parts of the country.
Some health officials say the increase is driven by fatigue from the Covid pandemic – with some people avoiding clinics and treatments – and funding cuts – with Manhattan’s only TB clinic recently closing.
There are also fears that New York City’s migrant crisis, which has seen more than 100,000 migrants arrive in the city since the spring, could drive infection rates as this group is at increased risk of infection due to cramped housing conditions.
The above graph shows tuberculosis cases in New York City by year. Data shows that the number of tuberculosis infections this year is already about 20 percent higher than last year
Preliminary 2022 data from the Centers for Disease Control and Prevention on Thursday shows tuberculosis cases increased 5 percent in 2022 to 8,300 cases
TB was once one of the deadliest infections in the world and a death sentence for half of those who became infected with it.
But with the arrival of vaccines – which are up to 80 percent effective against severe disease – and other treatments, the death rate in developed countries has now fallen below four percent.
Patients contract the disease by inhaling droplets laced with the bacteria, with infections starting with coughing up mucus or blood and a persistent cough that doesn’t clear up within three weeks.
The US stopped routinely distributing the TB vaccine – called Bacillus Calmetter-Guerin – in the 1970s after the number of cases and deaths in the country plummeted.
But the vaccine can still be offered to patients and healthcare workers who have had close contact with a TB patient.
People exposed to tuberculosis patients will also be monitored and offered medicines to curb the infection.
Doctors treat tuberculosis by administering a cocktail of drugs over eight months to eliminate the bacteria.
However, people who have previously been infected or exposed are at risk of “latent” infections, when the bacteria lie dormant in the lungs and are ready to emerge if the immune system weakens again.
Commenting on rising tuberculosis cases in New York, Elizabeth Lovinger of the advocacy group Treatment Action Group said: Politics: ‘This is definitely a more dramatic resurgence than we probably expected.
“When there are particularly high spikes in tuberculosis and other infectious diseases in New York City, it often acts as a kind of alarm bell for the rest of the country.”
In the US, tuberculosis cases are rising after a decline in 2020 – likely due to a reduction in testing as most stayed at home during the Covid pandemic.
8,300 cases were detected in 2022 and almost 9,000 in 2019.
Before the pandemic, tuberculosis cases were steadily declining, having fallen below 20,000 per year in 1997 and below 10,000 in 2012.
In New York City, the increase is likely to be exacerbated by the closure of one of the four clinics that care for tuberculosis patients – and the only one in Manhattan.
The TB clinic in Washington Heights was shifted to treating Covid patients during the pandemic and later closed. Local health officials insist there are still plans to renovate or reopen the clinic.
The reduction in capacity means patients with active infections now have to wait two to three days for treatment, increasing the risk of infecting others.
There are also concerns that tuberculosis could enter the city’s already cramped and overcrowded migrant centers and quickly cause a wave of infections.
A spokesperson for the New York City Department of Health emphasized that the city remains a “leader in TB care.”
He said, “We have pioneered treatments and therapies in New York City.
“We have also launched a new latent tuberculosis infection provider campaign to increase screening, diagnosis and treatment among at-risk New Yorkers.
“In addition, we have a contract with a local provider worth up to $500,000 to ensure New Yorkers receive care and that we have additional capacity if anyone needs services.”