Arnhem hit by tuberculosis outbreak among drug users

Public health authorities are investigating a small outbreak of contagious tuberculosis (TB) in Arnhem, primarily among people in the city’s drug circuit, according to AD.

The first cases were reportedly detected in visitors to local drug facilities, and further infections have been identified through ongoing contact tracing. The exact number of patients has not been disclosed by the municipality due to privacy concerns.

Following the initial cases, the Municipal Health Service (GGD) immediately began source and contact tracing to determine who else might be at risk. “Because the outbreak was discovered early, we hope to keep tuberculosis manageable,” the GGD said. Patients are receiving treatment from GGD physicians or in hospitals.

The GGD has organized mobile testing sessions for people in the Arnhem drug circuit, visiting recognized drug locations throughout the city. Many users are reportedly homeless or precariously housed, so upcoming test rounds will also include shelters and methadone clinics.

Tuberculosis is treatable, but requires patients to take medication daily for at least six months. For homeless people and drug users, maintaining this strict regimen can be challenging, the city notes. The GGD said it will closely monitor adherence to treatment to ensure effectiveness.

Arnhem expects additional TB cases in the coming weeks. Crowded living conditions and poverty increase the risk of transmission, factors prevalent among the current patients.

Although TB is now rare in the Netherlands, the disease is gradually reemerging. In 2023, 768 cases were reported nationwide, a rebound to pre-pandemic levels, according to the National Institute for Public Health and the Environment (RIVM). Globally, TB remains deadly, causing 1.25 million deaths in 2023.

“The situation in the Netherlands is far less severe than in countries like Nigeria, where nearly 600,000 people are infected each year and almost half die,” the city said.

The current outbreak involves pulmonary, or open, TB — the contagious form of the disease. Transmission occurs through airborne particles, not by touch, similar to COVID-19. Not all infected individuals develop active TB; onset can occur months or even years after infection, with the first two years posing the highest risk.

Common symptoms include persistent cough (sometimes with blood if untreated), weight loss, fatigue, night sweats, and fever.