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Increased tuberculosis cases reported in Santa Clara County

Public Health Department recommends testing and treatment for people at increased risk

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SANTA CLARA COUNTY, Calif. – The County of Santa Clara Public Health Department today released new data showing a 19 percent increase in new tuberculosis (TB) diagnoses in the county in 2023, compared to the previous year. This follows a six percent increase in new TB diagnoses in the county for calendar year 2022, compared to the previous year. These data do not reflect an outbreak, but rather a widely dispersed and increasing community health risk for a contagious illness. The health risks are especially high for small children who live with untreated adults with the TB disease. In 2021, the most recent year for which comparisons are available, the San Jose area had the second highest rate of TB of any metropolitan statistical area in the nation, second only to Honolulu.

The County of Santa Clara Public Health Department is urging people at increased risk to seek TB testing and treatment. A simple skin test or blood test can identify someone with TB infection.

Ask yourself the following questions:

  1. Were you born in, or have you lived in, a country where TB is common?
  2. Have you lived with, or spent time with, someone who has had TB?
  3. Do you have any of the following health conditions: diabetes, kidney failure, cancer, or HIV?   
  4. Do you take medications that suppress your immune system, such as: steroids; treatment after organ transplantation; treatment for cancer; or immunosuppressive medicines for arthritis, inflammatory bowel disease, or other autoimmune diseases?

If you or a loved one has one of these risk factors, talk to your doctor about testing and treatment. For information about TB prevention and treatment, and to find a list of TB testing sites in the County of Santa Clara, visit sccphd.org/TBinfo.

What is TB?

Worldwide, TB is the second leading infectious cause of death after COVID, according to 2022 data.  An estimated 1 in 4 people are infected worldwide.

Transmission occurs when people breathe in the bacteria while in close and prolonged contact with someone with infectious TB disease. TB is not nearly as contagious as COVID and flu, and it can take months or years for people to develop symptoms. Most people with TB infection have latent tuberculosis infection (LTBI), meaning they have no symptoms and are not contagious. These people need testing and treatment to prevent developing contagious, and potentially life-threatening disease.

Researchers estimate that 170,000 people in the County of Santa Clara, and as many as 13 million people in the US, have LTBI. If not diagnosed or treated, these individuals are at risk of becoming sick with TB disease in the future. Five to ten percent of individuals with LTBI develop TB disease over their lifetime.

“For the majority of people getting diagnosed with TB in County of Santa Clara, it’s likely they had the bacteria that causes TB for many years and didn’t know it,” said Dr. Ann Loeffler, Assistant Health Officer and TB Controller for the County of Santa Clara Public Health Department. “Early detection and treatment can keep you healthy and protects the people you live with from getting sick.”

“We are seeing a rise in Tuberculosis cases, but once we can identify a case, we can quickly begin treatment to cure the patient,” said Dr. Harleen Sahni with Santa Clara Valley Healthcare. “With our recently opened VHC Lundy Tuberculosis Clinic, it is easy for the public to get tested and receive treatment in County of Santa Clara. This is the only such TB clinic in our County and it provides a wide range of comprehensive health assessments and medical treatments. It even includes a cutting-edge airborne isolation facility to prevent the spread of airborne diseases.”

Although TB commonly affects the lungs, it can affect any part of the body. Symptoms of TB can include an unexplained persistent cough that lasts more than several weeks, coughing up blood, chest pain, fever, and weight loss. Young children are more likely than adults to develop TB disease after exposure and can become very sick with TB.

Who is most at risk?

While anyone can become infected with TB, individuals who were born or lived in a country where TB is most common are at highest risk of infection. Data from 2023 show that in County of Santa Clara, about 97 percent of diagnosed TB cases occurred among people born outside of the U.S., though many (64 percent) had lived in the U.S. for more than ten years. People at highest risk of progressing from LTBI to TB disease include individuals with recent exposure to TB disease, young children under five years old, people who have a weakened immune system from diseases like HIV and diabetes, people who take medications that suppress your immune system, and people who smoke.

Public Health’s role

Across the state of California, local TB Prevention and Control programs follow up on all reports of persons with confirmed or suspected TB disease and provide personalized care to each patient. This ensures the completion of lifesaving treatment and helps identify close contacts that may need treatment to prevent further TB transmission. The TB program also works with local healthcare professionals to increase TB screenings and treatment as part of routine preventive care.