Tuberculosis exposure warning issued for transit riders in CA county. Who’s at risk?
Public officials in California are warning some transit riders they may have been exposed to tuberculosis in San Diego County from February to August.
The warning is specifically for trolley and bus riders, according to an Oct. 11 joint statement from the Tuberculosis Program in County Public Health Services and the Metropolitan Transit System.
Officials advised of possible exposure on two trolley lines Feb. 16-Aug. 15, as well as on one bus route April 22-July 15. Specifically, county officials said the warning impacts:
“Trolley Blue Line between Balboa Ave Transit Center and Old Town Transit Center, and on the Green Line between Fashion Valley and Old Town roughly between the hours 6 a.m. to 12 p.m. Monday to Sunday
Bus Route 901 from Iris Avenue Transit Center to Palm Ave., and 8th Street between the hours 10 a.m. to 11 a.m. and 6 p.m. to 8 p.m.”
“Trolley exposures did not occur on a specific schedule,” the county said. “As such, large numbers of people may have had exposures, but the likelihood that any particular rider had long cumulative exposure times is low.”
TB cases have been decreasing in the U.S. for decades, data from the Centers for Disease Control and Prevention shows, but the disease can still be fatal.
Prolonged indoor exposure to someone with tuberculosis carries the highest risk of transmitting infection, but shorter exposures may be of concern for immunocompromised individuals, the county said.
Health officials said they are issuing this warning so immunocompromised riders in particular can make informed decisions about their health.
The county encourages anyone with symptoms of active TB to get tested. Skin and blood tests can detect the illness, according to Wilma Wooten, County Public Health Officer, but someone might be contagious for months before realizing they have active TB.
Symptoms of active TB include persistent cough lasting at least three weeks, fever, night sweats, tiredness and fatigue and weight loss, the CDC says. It is also possible to have TB and not have any symptoms, which is called latent TB, health officials say.
People with latent TB can’t spread TB to others, according to the CDC. But county health officials said they could develop symptoms later, even years after infection, if their latent TB is not treated.
Health officials estimate 175,000 people in San Diego County have latent TB infection and could develop active TB without preventive treatment.
Who’s at risk for TB
Tuberculosis is an airborne bacterial disease that mostly affects the lungs. Without treatment, TB can be fatal, but treatments are available for those with both active and latent TB, according to the CDC.
Tuberculosis rates vary across the U.S. due to health and demographic factors. In the U.S., tuberculosis cases occur at higher rates among Asian and Hispanic or Latino populations, the CDC reports. Individuals with medical conditions that weaken their immune system are also more at risk of TB if they’re infected.
California had the third-highest rate of tuberculosis infections in 2021.
San Diego County had a higher rate of tuberculosis than California at large, with the rate of infection reaching 6.1 cases per 100,000 people in 2021, compared to the statewide rate of 4.5 per 100,000.
Tuberculosis cases among transit riders had also been reported to the county in August and September 2022 as well as in February 2023, San Diego officials said.
“At this time the County of San Diego Health and Human Services Agency does not have any evidence directly linking the rider(s) most recently diagnosed with TB to the other MTS riders. Additional lab tests will be conducted to determine if there may be linkages between any of these riders,” officials said.
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