When I started my PHAP assignment in October 2014, Los Angeles County was in the midst of a tuberculosis (TB) outbreak that had been going strong in the homeless population there since 2007. Most of my work in the Los Angeles County Public Health Department’s TB Control Program has focused on different methods of combatting the outbreak (e.g., active case finding, contact tracing, prevention strategies).
One of my most exciting projects was helping design and implement a contact investigation in a homeless shelter where many people with the outbreak strain of TB had stayed. I managed screening data for nearly 2,000 contacts from that shelter. Initially, only about 100 of these contacts could be found for screening because the homeless population is so mobile. I worked continually with data collected by the Los Angeles Homeless Services Authority to locate more of these individuals for TB testing. I also interviewed homeless TB patients around the county and helped start a weekly TB screening at the shelter, which has tested more than 1,000 shelter residents to date. Those who test positive for TB infection are referred for treatment, and we just started an exciting new project to offer housing to people for the duration of their treatment. I was even able to help administer the TB blood tests at the screening myself because my host site arranged for me to be certified in phlebotomy.
TB is a fascinating disease and it has been an incredibly motivating time to be involved in TB prevention—the World Health Organization recently designated it the number one cause of infectious disease-related death globally, and the annual number of TB cases in the United States increased (although slightly) in 2015 for the first time in decades. The global fight against TB has not received as much attention as the fights against diseases like HIV and malaria in recent years, so I’m hoping to see TB enter the public dialogue a bit more! I’ve loved learning about how TB affects my community by working directly with patients. I know my PHAP experience has given me a great foundation for a career dedicated to reducing disparities in infectious diseases, healthcare access, and health education.