The worried father stood watch throughout the night Monday as his 5-year-old suffered through a strong fever. He put rags on her forehead, forced her to drink sips of water and tried to calm her down.
The Venezuelan man said he had pleaded for help from staff that night at the city-run migrant shelter on Ogden Avenue where they are staying, but he was told he’d have to pay for the ambulance himself.
“Because I don’t have a work permit or any money, I didn’t have any way to pay for it,” said the man who didn’t want to share his name out of fear of being kicked out of the shelter for talking to reporters.
On Tuesday afternoon, he said his daughter tested positive for tuberculosis, apparently one out of a “small number” of confirmed tuberculosis cases in migrants at city-run shelters. The Chicago Department of Public Health declined to answer questions on the exact number of migrants with active cases of tuberculosis and which shelters were affected.
The father told the Tribune that hours after the girl’s fever was at its peak, health care officials sent the man’s daughter to the hospital. She stayed there for days, he said, and then was given medication and released back to the West Loop shelter.
“My daughter should not be in a shelter right now,” he said. “The hospital told me she needs to have a high level of medical care — an area where there is a low risk of infection.”
According to Jacob Martin, a spokesperson for CDPH, there have been tuberculosis cases detected in shelters since migrants first were bused to the city in 2022, but almost all are latent cases. In shelters, migrants who have active cases of tuberculosis are assigned a nurse case manager who conducts a contact tracing investigation. The city has yet to confirm any cases in Chicago which resulted from exposure to new arrivals, Martin said.
Martin emphasized that there is no tuberculosis outbreak, and no cause for public concern. It’s still unclear how many active cases have been detected in shelters in recent days.
“It is absolutely not an outbreak,” Martin said. “In order for us to characterize something as an outbreak, we need to have evidence of person-to-person transmission, which we do not have.”
It’s the latest infectious disease confirmed to reach shelters after a measles outbreak last month leading to questions about the health and safety of the nearly 9,700 migrants who live in close quarters in 21 shelters run by the city and state.
The Ogden Ave. migrant shelter on Thursday, April 4, 2024, in Chicago. (Vincent Alban/Chicago Tribune)
Since March 7, there have been 56 cases of measles in Chicago, including 33 children under the age of 4, according to the CDPH.
Tuberculosis is a serious bacterial infection that usually attacks the lungs, but can spread to other parts of the body. It’s rare, but 100 to 150 cases are detected in Chicago each year. The disease usually requires several hours of prolonged contact for airborne transmission and is treatable with antibiotics.
Latent tuberculosis is when a person is infected but remains asymptomatic and non-contagious, according to the CDPH. In around 5% of those cases, the bacteria will reactivate, causing symptoms later in life.
Martin said it was “important to note that an estimated 10% to 20% of residents of Central and South America have latent TB infection, which is asymptomatic and not transmissible to others, but does result in a positive TB test.”
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.
Given how many people are exposed to tuberculosis in certain developing countries, it’s not surprising or concerning to see cases in shelters, according to Emily Landon, an infectious disease doctor at the University of Chicago Medicine and the hospital’s executive medical director of infection prevention and control.
“I’m surprised by how few cases that we’ve seen, actually,” Landon said. “(Tuberculosis) doesn’t pose a huge risk to the public, certainly not as much as measles does.”
The disease is usually diagnosed with a blood test and chest X-ray, and a patient is considered noncontagious after two weeks of taking an antibiotic.
“The vast majority of cases that we do see are people who contracted it years and years ago, and it reactivates in their body and they get sick, but it’s not because they got it from somebody else,” Martin said.
Though it’s considered less infectious than measles, there’s still a chance for primary cases to develop in crowded shelters, according to Bessey Geevarghese, a pediatric infectious disease specialist at Northwestern Medicine Central DuPage Hospital.
“The risk is definitely highest with close encounters,” Geevarghese said. “So, you know, especially in the shelters, where there’s a lot of people and people may already have latent tuberculosis, they’re slightly at higher risk.”
At a shelter in Pilsen Thursday afternoon, few migrants had heard of tuberculosis cases. But some had grown alarmed after watching the news and finding out of another contagious disease spreading in the heavily populated spaces, they said.
“We don’t want the same thing that happened with measles to happen again,” said Alejandra Hernandez, a mother of three young children. “They (the city) should let us know as soon as possible for us to find ways to protect our children.”
Hernandez said that her children were all vaccinated against tuberculosis but that nonetheless she is worried about how or if the infectious bacterial disease could affect other migrant children.
What also makes tuberculosis difficult to navigate is its longer incubation period, which can make contact tracing difficult, experts said. People can be infected but not have any symptoms for up to a month.
“I’m hoping that the health department is doing a really good contact tracing to make sure that they identify anybody that’s exposed, and make sure that they’re screening those people sooner than later,” Geevarghese said.
When migrants first arrive in Chicago at landing zones, they’re screened for acute medical issues, including symptoms of tuberculosis, according to Martin. Those who exhibit symptoms are sent to local hospitals and receive further evaluation.
New arrivals are also screened for vaccine eligibility, including measles, the flu and COVID-19. While there is a tuberculosis vaccine, it’s mainly used in countries where the disease is more common. It also doesn’t guarantee immunity.
Still, Landon said she felt confident in the city’s ability to detect and prevent active tuberculosis cases.
“There’s a lot of concerns with shelters, but I don’t think everybody getting TB is one of them,” Landon said. “That’s probably not high on my list of things that are concerning.”
Meanwhile, the father of the 5-year-old said his daughter is recovering. She was given medicine to take for the next four months, he said.
But he remains worried. He said almost all of the children at the shelter have a cough or a cold. All three of his children are sick, and he wishes the shelter staff provided more care.
On Thursday, a friend gave him $10 so he could buy soup for his daughter.
