CHICAGO — A worried father kept vigil all night Monday as his 5-year-old son suffered from a high fever. He tried to calm her down by putting a rag on her forehead and forcing her to take a sip of water.
The Venezuelan man said he sought help from staff at the city-run migrant shelter on Ogden Street where he was staying that night, but was told he would have to pay for the ambulance himself.
“I had no work permit and no money, so I had no way to pay,” said the man, who did not want to give his name for fear of being kicked out of the shelter. he is talking to a reporter.
On Tuesday afternoon, he said his daughter had tested positive for tuberculosis, which he said appears to be one of a “small number” of confirmed cases of tuberculosis among migrants in city-run shelters. The Chicago Department of Public Health declined to answer questions about the exact number of immigrants with active tuberculosis infection or which shelters were affected.
The father told the Tribune that medical authorities sent the man's daughter to the hospital several hours after the girl's fever peaked. She remained there for several days, he said, after which she was given medication and returned to the West Loop shelter.
“My daughter shouldn't be in a shelter right now,” he said. “Her hospital told us she needed advanced medical care with a low risk of infection.”
Nearly all cases of tuberculosis have been found in shelters since migrants first arrived in the city by bus in 2022, said Jacob Martin, a CDPH spokesman. At the shelter, migrants with a history of tuberculosis are assigned a nurse case manager who conducts contact tracing. Martin said the city has not yet confirmed any cases in Chicago resulting from contact with the new arrivals.
Martin stressed that there is no outbreak of tuberculosis and there is no cause for public concern. It is still unclear how many cases have been detected in evacuation centers in recent days.
“This is by no means an outbreak,” Martin said. “To characterize something as an outbreak, you need evidence of human-to-human transmission, and we don't have that.”
It's the latest infectious disease confirmed to have entered the shelter after last month's measles outbreak, raising questions about the health and safety of about 9,700 migrants living closely together in 21 city- and state-run shelters. being watched.
Since March 7, there have been 56 measles cases in Chicago, including 33 children under the age of 4, according to CDPH.
Tuberculosis is a serious bacterial infection that usually attacks the lungs but can spread to other parts of the body. Although rare, 100 to 150 cases are detected in Chicago each year. The disease usually requires prolonged contact, several hours, to become airborne and is treatable with antibiotics.
According to CDPH, latent TB is when a person is infected but remains asymptomatic and non-contagious. In about 5% of these cases, the bacteria reactivates and causes symptoms later in life.
“It is important to note that an estimated 10-20% of Latin American residents have latent TB infection, which is asymptomatic and cannot be transmitted to others, but “The test will come back positive,” he said.
More than 38,500 migrants have arrived in Chicago since Texas Gov. Greg Abbott began busing new arrivals from the southern border in August 2022.
Emily Landon, an infectious disease physician at the University of Chicago Medicine and the hospital's executive medical director of infection prevention and control, said that given how many people are exposed to tuberculosis in certain developing countries, , says it's not surprising that people get infected in evacuation centers, and it's not a cause for concern. .
“I'm actually surprised at how few cases we're seeing,” Landon said. “[Tuberculosis]doesn't pose a huge risk to the public, certainly not as much as measles.”
The disease is usually diagnosed by blood tests and chest x-rays, and patients are considered not infectious after taking antibiotics for two weeks.
“The majority of cases we see are people who were infected with this virus many years ago, and the virus reactivates in their bodies, making them sick, but it's not because they got it from someone else. No,” Martin said.
Although it is thought to be less contagious than measles, primary infections are still possible in crowded shelters, said Bessie Guivarghese, a pediatric infectious disease specialist at Northwestern Medicine Central DuPage Hospital.
“The risk is definitely highest in close encounters,” Guivarghese said. “So the risk is a little bit higher, especially in shelters because there are a lot of people and they may already have latent TB.”
On Thursday afternoon, few migrants at the Pilsen shelter had heard of tuberculosis cases. However, some people became wary after watching the news and learning that another infectious disease was spreading in densely populated areas.
“We don't want what happened with measles to happen again,” said Alejandra Hernandez, a mother of three young children. She said, “They (the city) should let us know as soon as possible so we can find a way to protect our children.”
Although all of her children are vaccinated against tuberculosis, Hernandez said she still worries about how, or if, the infectious bacterial disease will affect other immigrant children. He said he was doing it.
What also makes tuberculosis difficult to deal with is the long incubation period, which can make contact tracing difficult, experts say. Even if infected, symptoms may not appear for up to a month.
“We hope that the health department will do a very good job of contact tracing to make sure that they identify those who have been infected and that they test those people sooner rather than later,” Guivarghese said.
When immigrants first arrive at the Chicago landing zone, they will be screened for acute medical problems, including symptoms of tuberculosis, Martin said. Those who develop symptoms will be sent to a local hospital for further testing.
New arrivals will also be screened to see if they are eligible for vaccinations such as measles, influenza and COVID-19. Although a tuberculosis vaccine exists, it is primarily used in countries where tuberculosis is endemic. It also does not guarantee immunity.
Still, Landon said he is confident in the city's ability to detect and prevent active tuberculosis cases.
“There are a lot of concerns about shelters, but I don't think everyone is going to get tuberculosis,” Landon said. “That probably wouldn’t be high on my list of concerns.”
Meanwhile, the father of the five-year-old said his daughter is recovering. She was given medication to take for the next four months.
But he's still worried. He said almost all the children at the shelter have coughs and colds. All three of his children are sick, and he hopes shelter staff will provide more care.
On Thursday, a friend gave him $10 to buy soup for his daughter.
