Q&A
Tuberculosis control and recent increase in cases
0:52:08
ยท
4 min
Dr. Michelle Morse discusses the current state of tuberculosis control in New York City, addressing the recent increase in cases and the department's response strategies.
- The 2024 Bureau of Tuberculosis Control annual summary will be published around World TB Day in March
- NYC saw a 28% increase in TB cases from 2022 to 2023
- DOHMH is hiring more case managers to support TB patients and ensure treatment completion
- The department offers low or no-cost TB treatment regardless of documentation or insurance status
- There's concern about an increase in drug-resistant TB strains, which require longer treatment and more medications
Lynn Schulman
0:52:08
So when will the, I'm gonna go into tuberculosis now, when will the 2024 Bureau of Tuberculosis Control annual summary be published?
Dr. Michelle Morse
0:52:17
Thanks for that question.
0:52:19
Yes, we will be publishing the annual report around the time of World TB Day which is March.
Lynn Schulman
0:52:26
Okay.
0:52:28
And you'll share that with us?
0:52:29
Absolutely.
0:52:29
With the council?
0:52:30
Okay.
0:52:30
What is DOHMH's current policy regarding tuberculosis and for containing the spread of tuberculosis and how does the recent outbreak in Kansas impact this work?
Dr. Michelle Morse
0:52:41
Well I will say interestingly as a physician tuberculosis is one of the diseases that we often struggle with because it grows slowly, it can be hard to diagnose, and it's one of those things that can mimic a lot of other diseases.
0:52:55
So sometimes it can take a while to get the diagnosis.
0:52:58
However, the New York City Health Department has a long history of successfully responding to tuberculosis.
0:53:05
We have seen an increase in tuberculosis cases.
0:53:09
Our 2023 report did show that cases were up, and again we'll be releasing our newest data in March of this year.
0:53:17
We have a number of different policies and programs that are focused on diagnosing tuberculosis and getting people into treatment immediately.
0:53:27
And we offer that treatment at low or no cost to anyone in New York City regardless of documentation status and regardless of insurance status at our tuberculosis clinics across New York City.
0:53:41
So we offer, contact tracing as well.
0:53:45
The contact tracing is important to make sure we understand, who might have been exposed, if someone does develop active tuberculosis.
0:53:53
And again, we work with our partners at health and hospitals and many hospitals across the city to make sure that anyone who is diagnosed with tuberculosis gets started on treatment as quickly as possible and has a case manager who actually helps to make sure that they take their medications every day.
0:54:10
All of that data, of course, is part of our extensive surveillance system across New York City and that allows us to create the annual reports, but it also guides our programmatic activities to make sure we get the rates of tuberculosis lower.
Lynn Schulman
0:54:25
In the 2023 Bureau of Tuberculosis Control Annual Survey, DOHMH noted a twenty eight percent increase in TB cases from 2022 and 2023.
0:54:35
How are you responding to this increase?
Dr. Michelle Morse
0:54:38
Thank you for question.
0:54:39
We are very concerned about the increase in tuberculosis cases.
0:54:44
The things that we've done to respond, number one, we are doing our best to hire more case managers.
0:54:50
We want to make sure that every case manager has a reasonable number of tuberculosis patients so that they can ensure that they're cared for, that they get the treatment they need, and that they're supported to complete their treatment, which can be six to nine months or longer depending on the type of tuberculosis they have.
0:55:09
So we have ramped up our hiring activities to make sure that we have enough case managers and contact tracers to make sure that we can trace anywhere that tuberculosis is happening and get people treated.
0:55:24
I would also ask my colleague, Suda, Ready to share a little bit more about our tuberculosis program.
Sudha Reddy
0:55:31
Actually I work in the Bureau of Communicable Disease and TB is managed by a different bureau.
0:55:39
Investigated and there's a case manager that does contact tracing and follows up with cases and contacts to make sure that they're following their treatment plan.
Lynn Schulman
0:55:49
So one of the things I want to ask about is in the survey there was a talk about a strain that was resistant to the drug rifampin.
0:55:57
It doubled from 2022 to 2023.
0:56:00
So what what are you doing about that and what's the level of threat to the city around that strain?
Dr. Michelle Morse
0:56:07
Part of our surveillance system is to monitor and make sure we know if this is a routine kind of tuberculosis strain or a drug resistant strain.
0:56:17
Over time there has been more and more drug resistance unfortunately for tuberculosis.
0:56:22
However, we do have treatment regimens that for even patients who have evidence of drug resistance, there are regimens that are still effectively able to completely treat their tuberculosis.
0:56:36
Unfortunately, it's just usually a longer treatment and more medications.
0:56:42
So the appropriate response, which our colleagues in the tuberculosis program are doing, is making sure that those people who do have a strain of tuberculosis that has some resistance are on a regimen that is still going to cure them of tuberculosis and that they have the support they need to tolerate the higher, the number of medications and the length of treatment that they need because of that resistance.