The following is an edited transcript of a recent interview between Dr. Houman David Hemmati and Morning Wire host Georgia Howe on the rise in cases of tuberculosis and measles. Catch the full interview on Morning Wire.
Georgia Howe: Dr. Hemmati, thanks so much for coming on.
Dr. Hemmati: It’s a pleasure.
Georgia: Now, the California Department of Public Health recently sent out an alert to all doctors about a “Substantial Increase in Tuberculosis.” What did that letter say?
Dr. Hemmati: That letter, which was sent to all doctors, said that the state is experiencing a surge in tuberculosis cases. That’s number one. Number two, those tuberculosis cases are largely originating from people who have come here from outside the country. And number three, and what is particularly alarming, is that this type of tuberculosis coming into California, and presumably the rest of the United States, has about a 13% or higher death rate.
Georgia: Is there any way to screen people? What’s the normal procedure for checking people for tuberculosis?
Dr. Hemmati: That’s a great question. Anytime someone wants to come into the U.S. on a visa or green card a standard part of the process, among other medical assessments, is to perform a tuberculosis blood test and, in many cases, in addition to that, a chest x-ray to simply rule it out. However, when someone doesn’t have those — and especially if they’re coming from endemic nations, which we’re surrounded by, especially to the south — then there’s a high chance that they could be bringing it in undetected.
Georgia: Now, why is TB such a threat? Can you describe a little bit about how it progresses and why it becomes so intractable?
Dr. Hemmati: Yes. So tuberculosis is caused by a bacteria, not caused by a virus like COVID. It’s a particularly unusual type of bacteria that can reside in the lungs, sometimes asymptomatically and at other times with no symptoms at all. It can stay like that, even with no symptoms, for years or decades, and at any point basically pop up and cause a horrific infection that chews up the lungs and causes the infected person to spew large amounts of bacteria every time they cough. This is why it has a high death rate, because it literally chews through the lung tissue and leaves nothing behind other than a gaping hole.
The problem with tuberculosis is that we only have a few medications in our arsenal to try to defeat it. And those medications, even when they do work, can take many months to years of therapy in order to kill the bacteria. The problem now is that we’re seeing a lot of multidrug resistant tuberculosis — bacteria for which none of the drugs we have available work or work well enough. This is why I think we’re suddenly seeing such high death rates — death rates we have never been seen before in this country.
LISTEN: Hear the full interview with Dr. Hemmati on Morning Wire.
Georgia: How easily is it transmitted?
Dr. Hemmati: That’s a great question. You generally have to be in relatively close proximity with a person who’s actively coughing in order to get tuberculosis, which is pretty rare. It is transmitted in the air from relatively close contacts, but it doesn’t mean less than six feet. You can be in the same room, in the same general vicinity. It’s not necessarily easy to get, but once you get it, you have it and you have it for good. Incidentally, the predominant use of the N95 mask is really for prevention of tuberculosis. Whenever we would see someone who had tuberculosis or who was presumed to have a case of tuberculosis in the hospital, we would have to wear the N95 mask simply to be around them. Without a mask like that, being in close proximity puts you at risk.
Georgia: The CDC is also investigating a measles outbreak at a migrant center in Chicago. Can you give us some insight into what’s happening there?
Dr. Hemmati: It is very likely related to immigration. And the reason why I say that is that we’ve seen measles outbreaks in migrant housing centers, including one just this last week in Chicago. So when you have people coming in the country who are not being screened for having been infected with measles, all of a sudden you are bringing in people who could be carrying this disease and could be spreading it within their community of people who have zero vaccination rates. This can pose a major public health threat.
Georgia: Should the CDC be testing people at the border as they coming across? What would be the solution for this?
Dr. Hemmati: Well, the solution we’ve already had for decades is to test anyone coming into the country for measles. Without getting that testing done and getting a lot of different vaccinations checked as well, you simply couldn’t get a green card to immigrate to the U.S. Problems occur when that process is circumvented and the system is simply overwhelmed by people who are doing a runaround, then you get people coming in who are not tested. And, at this point, with the large numbers who are streaming through our borders, it’s basically impossible to test every single person, especially since so many are considered “gotaways” and are never even processed through the system.
Georgia: Dr. Hemmati, thank you so much for coming on.
Dr. Hemmati: Thank you. It’s a pleasure.