127-552: Neponsit Beach Hospital , also known as Neponsit Beach Hospital for Children , Neponsit Hospital , Neponsit Children's Hospital , and various other names, was a former municipal tuberculosis sanatorium located adjacent to Jacob Riis Park and the Neponsit community on the western end of the Rockaway peninsula in Queens, New York City. Originally oriented towards the treatment of children,
254-415: A Rasmussen aneurysm , resulting in massive bleeding. Tuberculosis may become a chronic illness and cause extensive scarring in the upper lobes of the lungs. The upper lung lobes are more frequently affected by tuberculosis than the lower ones. The reason for this difference is not clear. It may be due to either better air flow, or poor lymph drainage within the upper lungs. In 15–20% of active cases,
381-468: A 10-foot (3.0 m) high, 1,000-foot (300 m) sea wall. The power plant was completed in 1939, and work on the nurses' residence began shortly afterwards. The nurses' residence was completed in February 1941. The hospital was closed temporarily on January 7, 1943, to conserve fuel during World War II . Also during the war, the fence separating Riis Park from the hospital grounds was erected. The hospital
508-560: A common ancestor, remains unclear. A comparison of the genes of M. tuberculosis complex (MTBC) in humans to MTBC in animals suggests humans did not acquire MTBC from animals during animal domestication, as researchers previously believed. Both strains of the tuberculosis bacteria share a common ancestor, which could have infected humans even before the Neolithic Revolution . Skeletal remains show some prehistoric humans (4000 BC ) had TB, and researchers have found tubercular decay in
635-400: A lack of available materials. Therefore, the railroad asked Green Bus Lines to provide service for passengers stranded at Broad Channel and The Raunt . Another took place at The Raunt on December 15, 1948, delaying trains between nine and nineteen minutes during the morning rush hour. 300 feet (91 m) of the trestle was destroyed during a July 4, 1949, fire, and morning rush hour service
762-680: A microscope. Since MTB retains certain stains even after being treated with acidic solution, it is classified as an acid-fast bacillus . The most common acid-fast staining techniques are the Ziehl–Neelsen stain and the Kinyoun stain , which dye acid-fast bacilli a bright red that stands out against a blue background. Auramine-rhodamine staining and fluorescence microscopy are also used. The M. tuberculosis complex (MTBC) includes four other TB-causing mycobacteria : M. bovis , M. africanum , M. canettii , and M. microti . M. africanum
889-551: A parking lot and a lifeguard station. In its abandonment, the former Neponsit Hospital buildings had become the site of LGBT-affirming public art with messages such as "Black Trans Lives Matter", "Queer Trans Power", and a pride flag foregrounded by watchful eyes, much of the art done by Hugo Gyrl. When plans for the demolition were announced, a school of fish was found living in the Neponsit Hospital site's flooded basement. After advocacy efforts by LGBTQ activists and fish rescuers,
1016-407: A small decrease in case numbers. Some countries have legislation to involuntarily detain or examine those suspected to have tuberculosis, or involuntarily treat them if infected. The only available vaccine as of 2021 is bacillus Calmette-Guérin (BCG). In children it decreases the risk of getting the infection by 20% and the risk of infection turning into active disease by nearly 60%. It
1143-472: A train every 24 minutes. The line was built to handle 100,000 daily passengers but was only carrying 6,000. A new station at Far Rockaway–Mott Avenue opened on January 16, 1958, completing the Rockaway Line. The completion of the new terminal was delayed due to the slow delivery of steel. The line charged a double fare south of Howard Beach which entailed the deposit of two tokens for those entering along
1270-401: A tuberculosis infection does become active, it most commonly involves the lungs (in about 90% of cases). Symptoms may include chest pain and a prolonged cough producing sputum. About 25% of people may not have any symptoms (i.e., they remain asymptomatic). Occasionally, people may cough up blood in small amounts, and in very rare cases, the infection may erode into the pulmonary artery or
1397-459: A year on the maintenance and security of the property. The beach directly in front of the hospital (Neponsit Bay 1), now part of Riis Park, is popular among the gay community as well as nudists . A fence, which had originally been erected to separate the hospital from the park, later isolated this section from the rest of the beach until it was taken down by Hurricane Irene in 2011. A second fence just west of Beach 149th Street separates Bay 1 from
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#17330852307261524-398: Is Mycobacterium tuberculosis (MTB), a small, aerobic , nonmotile bacillus . The high lipid content of this pathogen accounts for many of its unique clinical characteristics. It divides every 16 to 20 hours, which is an extremely slow rate compared with other bacteria, which usually divide in less than an hour. Mycobacteria have an outer membrane lipid bilayer. If a Gram stain
1651-432: Is spread from one person to the next through the air when people who have active TB in their lungs cough, spit, speak, or sneeze . People with latent TB do not spread the disease. Active infection occurs more often in people with HIV/AIDS and in those who smoke . Diagnosis of active TB is based on chest X-rays , as well as microscopic examination and culture of bodily fluids. Diagnosis of latent TB relies on
1778-491: Is a growing problem, with increasing rates of multiple drug-resistant tuberculosis (MDR-TB). In 2018, one quarter of the world's population was thought to have a latent infection of TB. New infections occur in about 1% of the population each year. In 2022, an estimated 10.6 million people developed active TB, resulting in 1.3 million deaths, making it the second leading cause of death from an infectious disease after COVID-19 . As of 2018, most TB cases occurred in
1905-445: Is able to reproduce inside the macrophage and will eventually kill the immune cell. The primary site of infection in the lungs, known as the Ghon focus , is generally located in either the upper part of the lower lobe, or the lower part of the upper lobe . Tuberculosis of the lungs may also occur via infection from the blood stream. This is known as a Simon focus and is typically found in
2032-653: Is also rare and is seen almost only in immunodeficient people, although its prevalence may be significantly underestimated. Other known pathogenic mycobacteria include M. leprae , M. avium , and M. kansasii . The latter two species are classified as " nontuberculous mycobacteria " (NTM) or atypical mycobacteria. NTM cause neither TB nor leprosy , but they do cause lung diseases that resemble TB. When people with active pulmonary TB cough, sneeze, speak, sing, or spit, they expel infectious aerosol droplets 0.5 to 5.0 μm in diameter. A single sneeze can release up to 40,000 droplets. Each one of these droplets may transmit
2159-444: Is difficult, as is diagnosing the disease in those who have a weakened immune system. A diagnosis of TB should, however, be considered in those with signs of lung disease or constitutional symptoms lasting longer than two weeks. A chest X-ray and multiple sputum cultures for acid-fast bacilli are typically part of the initial evaluation. Interferon-γ release assays (IGRA) and tuberculin skin tests are of little use in most of
2286-500: Is not widespread, but it is a significant cause of tuberculosis in parts of Africa. M. bovis was once a common cause of tuberculosis, but the introduction of pasteurized milk has almost eliminated this as a public health problem in developed countries. M. canettii is rare and seems to be limited to the Horn of Africa , although a few cases have been seen in African emigrants. M. microti
2413-479: Is often used to screen people at high risk for TB. Those who have been previously immunized with the Bacille Calmette-Guerin vaccine may have a false-positive test result. The test may be falsely negative in those with sarcoidosis , Hodgkin's lymphoma , malnutrition , and most notably, active tuberculosis. Interferon gamma release assays , on a blood sample, are recommended in those who are positive to
2540-501: Is performed, MTB either stains very weakly "Gram-positive" or does not retain dye as a result of the high lipid and mycolic acid content of its cell wall. MTB can withstand weak disinfectants and survive in a dry state for weeks. In nature, the bacterium can grow only within the cells of a host organism, but M. tuberculosis can be cultured in the laboratory . Using histological stains on expectorated samples from phlegm (also called sputum), scientists can identify MTB under
2667-423: Is poor as of 2019 . The Centers for Disease Control and Prevention (CDC) stopped recommending yearly testing of health care workers without known exposure in 2019. Tuberculosis prevention and control efforts rely primarily on the vaccination of infants and the detection and appropriate treatment of active cases. The World Health Organization (WHO) has achieved some success with improved treatment regimens, and
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#17330852307262794-588: Is provided by a limited number of A trains). The segment of the line between Howard Beach and the Rockaway Peninsula suffered serious damage during Hurricane Sandy and was out of service for several months. On November 20, 2012, a free shuttle designated as H replaced the Rockaway portion of the A service between Far Rockaway–Mott Avenue and Beach 90th Street via the Hammels Wye. On May 30, 2013, full service
2921-464: Is termed caseous necrosis . If TB bacteria gain entry to the blood stream from an area of damaged tissue, they can spread throughout the body and set up many foci of infection, all appearing as tiny, white tubercles in the tissues. This severe form of TB disease, most common in young children and those with HIV, is called miliary tuberculosis. People with this disseminated TB have a high fatality rate even with treatment (about 30%). In many people,
3048-476: Is the most widely used vaccine worldwide, with more than 90% of all children being vaccinated. The immunity it induces decreases after about ten years. As tuberculosis is uncommon in most of Canada, Western Europe, and the United States, BCG is administered to only those people at high risk. Part of the reasoning against the use of the vaccine is that it makes the tuberculin skin test falsely positive, reducing
3175-470: The IND Fulton Street Line . On June 28, 1956, service on the line began between Euclid Avenue and Rockaway Park at 6:38 PM and between Euclid Avenue and Wavecrest at 6:48 PM. Once the slow order was removed, the travel time from Euclid Avenue to Rockaway Park decreased from 40 to 28 minutes, and the travel time from Euclid Avenue to Wavecrest decreased from 44 to 32 minutes. In September 1956,
3302-621: The IND Rockaway Line north of the hospital's former site, connected by the Q22 and Q35. Around the turn of the 20th century, social journalist Jacob Riis (the namesake for the future Jacob Riis Park ) advocated for a children's hospital to be built in the Rockaways, in order treat the increasing cases of tuberculosis in the city. In 1904, the city planned to build an oceanside park in the western Rockaways, supported by Riis' Association for Improving
3429-618: The Jamaica Bay , into the Rockaways . At its southern end in the Rockaways, the line has two branches: one traveling east to Far Rockaway–Mott Avenue and one traveling west to Rockaway Park–Beach 116th Street . The A train serves the line on the Far Rockaway branch, as well as on the section north of Hammels Wye (where the two branches merge). The Rockaway Park Shuttle runs between Broad Channel and Rockaway Park. Five rush hour A trains provide service between Rockaway Park and Manhattan in
3556-586: The Marine Parkway–Gil Hodges Memorial Bridge and Cross Bay Veterans Memorial Bridge to the Rockaways. In 1986, the New York City Transit Authority launched a study to determine whether to close 79 stations on 11 routes, including the segment of the Rockaway Line south of Howard Beach, due to low ridership and high repair costs. Numerous figures, including New York City Council member Carol Greitzer , criticized
3683-454: The lymphatic system (in scrofula of the neck), the genitourinary system (in urogenital tuberculosis ), and the bones and joints (in Pott disease of the spine), among others. A potentially more serious, widespread form of TB is called "disseminated tuberculosis"; it is also known as miliary tuberculosis . Miliary TB currently makes up about 10% of extrapulmonary cases. The main cause of TB
3810-420: The tuberculin skin test (TST) or blood tests. Prevention of TB involves screening those at high risk, early detection and treatment of cases, and vaccination with the bacillus Calmette-Guérin (BCG) vaccine. Those at high risk include household, workplace, and social contacts of people with active TB. Treatment requires the use of multiple antibiotics over a long period of time. Antibiotic resistance
3937-512: The 1930s and early 1940s, the hospital was expanded as a Works Progress Administration (WPA) project, adding the nurses' residence and power plant. The expansion was first announced in November 1929 by city hospitals commissioner Dr. William Schroeder, Jr. The project was intended to double the patient capacity of the facility. In June 1931, an appropriation of $ 300,000 was made by the Board of Estimate for
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4064-610: The 1956 summer season, but the power supply was inadequate. Because of a strike, the delivery of substation equipment was delayed. Trains operated slowly across Jamaica Bay in order to conserve power. The newer R10s were intended to operate over the line, but because they required more power than the R1–9 fleet , the R1–9 fleet operated on the line instead. The line was incorporated into the Independent Subway System (IND) and connected to
4191-488: The Association, as well as in newspapers and magazines across the country. "Smiling Joe" also received visits from then-President Theodore Roosevelt and John D. Rockefeller . Rockefeller would pledge $ 125,000 to the project. Construction on the hospital began on January 28, 1914. It was provisionally known as Seaside Hospital . The hospital, which cost $ 250,000 to construct, was completed by March 1, 1915, and relinquished to
4318-486: The Association, before being turned over to the city. The money had been raised by the Association by 1906 and held in a trust. As part of their campaign, the Association distributed pictures of a boy suffering spinal tuberculosis at Sea Breeze Hospital in Coney Island, Brooklyn , who was strapped to a board as part of his treatment. This boy was later called "Smiling Joe". The pictures were included in letters sent out by
4445-583: The Board of Estimate voted 10–6 to block Moses' park plans. Those opposed included the five borough presidents, as well as Gerosa who cast multiple votes. The two members in favor of park expansion were Mayor Robert F. Wagner Jr. and city councilman Abe Stark , who each cast three votes. This led to a back-and-forth exchange of letters between Moses and Gerosa. After a lawsuit by the Park Association of New York City, on October 14, 1955, New York Attorney General Jacob K. Javits stated in an advisory ruling that
4572-600: The College Point Outpatient Department, and the Ozone Park ambulance station were also absorbed into the new medical center. Around this time, the city planned to renovate and expand Neponsit Hospital so it could be used in a general hospital capacity in the event of an emergency. Plans were drawn up by the York and Sawyer firm in 1952. In July 1953, the Board of Estimate approved fireproofing and electrical work for
4699-576: The Condition of the Poor . The Association as well as New York City Mayor George B. McClellan Jr. also lobbied for a hospital and " convalescent home " to be established. On May 15, 1906, an act was passed in the New York State Legislature allowing for the purchase of beach property in or outside of the city for a maximum of $ 2.5 million. The act also allowed a portion of the property to be leased for
4826-454: The LIRR in 1887, and trains using the branch began serving Far Rockaway via a new connection to the old Far Rockaway Branch. The line south of Woodhaven Junction was electrified in 1905. The wooden trestle through Jamaica Bay was subjected to numerous fires, which damaged it. A fire on May 7, 1950, cut service on the middle of the line, but as the LIRR was bankrupt, it did not seek to restore service on
4953-693: The Mantoux test. These are not affected by immunization or most environmental mycobacteria , so they generate fewer false-positive results. However, they are affected by M. szulgai , M. marinum , and M. kansasii . IGRAs may increase sensitivity when used in addition to the skin test, but may be less sensitive than the skin test when used alone. The US Preventive Services Task Force (USPSTF) has recommended screening people who are at high risk for latent tuberculosis with either tuberculin skin tests or interferon-gamma release assays . While some have recommend testing health care workers, evidence of benefit for this
5080-533: The Neponsit Home. The plan received opposition from the local community, due to fears about the transmission of the disease at the time. On July 31, a Queens judge blocked the move. Koch proceeded to drop the plans on September 3. Between September 10 and 12, 1998, the nursing home was evacuated and closed after bricks fell from the roof of the building due to damage from the Labor Day storm of that year. Residents of
5207-594: The Neponsit portion of Rockaway Beach . The Q22 and Q35 local buses directly serve the hospital's former site on Rockaway Beach Boulevard. The Q22 runs east-to-west across the Rockaway Peninsula, and the Q35 travels between Rockaway Park and Brooklyn. The QM16 express route to Manhattan also operates on Rockaway Beach Boulevard. The closest New York City Subway station is the Rockaway Park–Beach 116th Street station on
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5334-530: The New York City Transit Authority announced that the Rockaway revenues were disappointing, as $ 15,000 was expected to be made every day during the summer, while only $ 7,000 was made. As a result, there was a $ 750,000 deficit. On January 27, 1957, as a result of low ridership, service was reduced from running on eight minute headways to Broad Channel to twelve minute headways. Since service alternated between Rockaway Park and Wavecrest, stations had
5461-602: The Rockaway Park Shuttle was extended from Broad Channel to Rockaway Boulevard to allow passengers on both Lefferts Boulevard and Far Rockaway-bound A trains to transfer to the shuttle and shuttle passengers to transfer to more frequent Manhattan-bound A service at Rockaway Boulevard. Since then, the seasonal extension has occurred on an annual basis. In 2022, the Metropolitan Transportation Authority (MTA) hired Schiavone to conduct repairs to
5588-766: The South Side Railroad of Long Island. In 1892, the line first saw service by the Long Island Rail Road from its Atlantic Branch . In the late 1890s, the Brooklyn Elevated Railway (later the Brooklyn Rapid Transit Company ) received permission to operate elevated trains from Brooklyn on the line for beach access. The city soon began eyeing the line as popularity soared. Additionally, the Ocean Electric Railway used part of
5715-672: The US , up to 35% of those affected by TB were also infected by HIV. Handling of TB-infected patients in US hospitals was known to create airborne TB that could infect others, especially in unventilated spaces. IND Rockaway Line The IND Rockaway Line is a rapid transit line of the IND Division of the New York City Subway , operating in Queens . It branches from the IND Fulton Street Line at Rockaway Boulevard , extending over
5842-511: The United States test positive via the tuberculin test. Tuberculosis has been present in humans since ancient times . Tuberculosis has existed since antiquity . The oldest unambiguously detected M. tuberculosis gives evidence of the disease in the remains of bison in Wyoming dated to around 17,000 years ago. However, whether tuberculosis originated in bovines, then transferred to humans, or whether both bovine and human tuberculosis diverged from
5969-601: The WHO regions of South-East Asia (44%), Africa (24%), and the Western Pacific (18%), with more than 50% of cases being diagnosed in seven countries: India (27%), China (9%), Indonesia (8%), the Philippines (6%), Pakistan (6%), Nigeria (4%), and Bangladesh (4%). By 2021, the number of new cases each year was decreasing by around 2% annually. About 80% of people in many Asian and African countries test positive, while 5–10% of people in
6096-688: The active disease. Use of certain medications, such as corticosteroids and infliximab (an anti-αTNF monoclonal antibody), is another important risk factor, especially in the developed world . Other risk factors include: alcoholism , diabetes mellitus (3-fold increased risk), silicosis (30-fold increased risk), tobacco smoking (2-fold increased risk), indoor air pollution , malnutrition, young age, recently acquired TB infection, recreational drug use, severe kidney disease, low body weight, organ transplant, head and neck cancer, and genetic susceptibility (the overall importance of genetic risk factors remains undefined ). Tobacco smoking increases
6223-458: The arrival of streptomycin and other antibiotics, although the disease remained a significant threat. In 1946, the development of the antibiotic streptomycin made effective treatment and cure of TB a reality. Prior to the introduction of this medication, the only treatment was surgical intervention, including the " pneumothorax technique", which involved collapsing an infected lung to "rest" it and to allow tuberculous lesions to heal. Because of
6350-423: The bacterium is enveloped by the macrophage and stored temporarily in a membrane-bound vesicle called a phagosome. The phagosome then combines with a lysosome to create a phagolysosome. In the phagolysosome, the cell attempts to use reactive oxygen species and acid to kill the bacterium. However, M. tuberculosis has a thick, waxy mycolic acid capsule that protects it from these toxic substances. M. tuberculosis
6477-449: The beach. The original building, built in 1915, was designed by the McKim, Mead & White firm. It was four stories high with a red-brick outer facade. It was designed in a "U" shape, with eastern and western wings opening towards the beach. Open-aired balconies and enclosed porches were located on the building facing the beach. It was built with a 122-patient capacity. Renovations were made to
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#17330852307266604-425: The body. Most infections show no symptoms, in which case it is known as latent tuberculosis . Around 10% of latent infections progress to active disease that, if left untreated, kill about half of those affected. Typical symptoms of active TB are chronic cough with blood-containing mucus , fever , night sweats , and weight loss . Infection of other organs can cause a wide range of symptoms. Tuberculosis
6731-437: The building in 1938 and 1958. Adjacent to the original building was the nurses' residence completed in 1941. It was the easternmost of the two buildings and was also four stories high. It was designed by Dodge & Morrison architects, and built as a Works Progress Administration (WPA) project. Fronting Rockaway Beach Boulevard was the hospital's power plant, built at the same time as the nurses' home. The building also contained
6858-425: The cattle and human tuberculosis diseases were similar, which delayed the recognition of infected milk as a source of infection. During the first half of the 1900s, the risk of transmission from this source was dramatically reduced after the application of the pasteurization process. Koch announced a glycerine extract of the tubercle bacilli as a "remedy" for tuberculosis in 1890, calling it "tuberculin". Although it
6985-480: The cause of pulmonary tuberculosis. J. L. Schönlein first published the name "tuberculosis" (German: Tuberkulose ) in 1832. Between 1838 and 1845, John Croghan, the owner of Mammoth Cave in Kentucky from 1839 onwards, brought a number of people with tuberculosis into the cave in the hope of curing the disease with the constant temperature and purity of the cave air; each died within a year. Hermann Brehmer opened
7112-542: The city did not have the jurisdiction to sell the hospital as it was still parkland. The ruling had been requested by Moses. On October 27, New York Supreme Court Justice Peter M. Daly ruled in favor of the Park Association, preventing the sale. The ruling was upheld by the Appellate Court in Brooklyn on July 9, 1956. On October 15, 1958, a compromise plan was proposed by councilman Stark and Mayor Wagner. The plan entailed
7239-611: The city the next day. Neponsit Beach Hospital for Children opened on April 16, 1915. Neponsit Hospital was operated by the Bellevue and Allied Hospitals organization, a city agency which also operated Bellevue Hospital in Manhattan. It replaced Sea Breeze Hospital, also operated by the Association, with children from Sea Breeze transferred to Neponsit. Upon opening, the hospital was subject to odors and fumes from waste disposal operations on nearby Barren Island (now Floyd Bennett Field ). In
7366-530: The city. Meanwhile, 10 acres (4.0 ha) of the property were turned over to the Parks Department to expand Riis Park, adding 1,000 feet (300 m) of beach. In July 1985 under Mayor Ed Koch , the New York City Health and Hospitals Corporation (HHC), which operates city-owned health facilities, planned to transfer 10 patients diagnosed with HIV/AIDS from Bellevue Hospital to an isolated wing of
7493-503: The complex was cancelled; the plans were approved in 1956 solely in order for the York and Sawyer firm to be compensated. Following the closure of the hospital, the site was considered a "hot property", located on the beach in the fairly exclusive Neponsit neighborhood. The site of the hospital was valued at $ 1 million. Numerous groups had conflicting interests in the future of the site. New York City Parks Commissioner Robert Moses desired to use
7620-515: The conversion of the hospital into the nursing home proposed by the Welfare Department. The surrounding undeveloped land would be absorbed into Jacob Riis Park. The plan was approved by New York City Board of Estimate in February 1959. Renovations were made to the main building and the nurses' residence. The Neponsit Home for the Aged was dedicated and opened August 31, 1961. Among those in attendance
7747-478: The creation of hospitals. On March 15, 1907, the New York City Board of Estimate accepted $ 250,000 from the Association to construct a hospital for people with "non-pulmonary tuberculosis". Efforts to develop the park (then called Seaside Park) and the hospital were suspended on November 1, 1907, due to the panic of 1907 , but resurrected in 1909. The agreement between the Association and the Board of Estimate
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#17330852307267874-700: The declaration of a global health emergency by the World Health Organization (WHO) in 1993. There is a popular misconception that tuberculosis is purely a disease of the lungs that manifests as coughing . Tuberculosis may infect many organs, even though it most commonly occurs in the lungs (known as pulmonary tuberculosis). Extrapulmonary TB occurs when tuberculosis develops outside of the lungs, although extrapulmonary TB may coexist with pulmonary TB. General signs and symptoms include fever, chills , night sweats, loss of appetite , weight loss, and fatigue . Significant nail clubbing may also occur. If
8001-640: The developing world. IGRA have similar limitations in those with HIV. A definitive diagnosis of TB is made by identifying M. tuberculosis in a clinical sample (e.g., sputum, pus , or a tissue biopsy ). However, the difficult culture process for this slow-growing organism can take two to six weeks for blood or sputum culture. Thus, treatment is often begun before cultures are confirmed. Nucleic acid amplification tests and adenosine deaminase testing may allow rapid diagnosis of TB. Blood tests to detect antibodies are not specific or sensitive , so they are not recommended. The Mantoux tuberculin skin test
8128-596: The disease became common among the urban poor. In 1815, one in four deaths in England was due to "consumption". By 1918, TB still caused one in six deaths in France. After TB was determined to be contagious, in the 1880s, it was put on a notifiable-disease list in Britain. Campaigns started to stop people from spitting in public places, and the infected poor were "encouraged" to enter sanatoria that resembled prisons. The sanatoria for
8255-620: The disease, since the infectious dose of tuberculosis is very small (the inhalation of fewer than 10 bacteria may cause an infection). People with prolonged, frequent, or close contact with people with TB are at particularly high risk of becoming infected, with an estimated 22% infection rate. A person with active but untreated tuberculosis may infect 10–15 (or more) other people per year. Transmission should occur from only people with active TB – those with latent infection are not thought to be contagious. The probability of transmission from one person to another depends upon several factors, including
8382-501: The east of Cross Bay Boulevard, on its own private right-of-way. Then the line passes over the North Channel Swing Bridge. The crossing across Jamaica Bay between Howard Beach and Broad Channel is the longest distance between any two adjacent stations in the entire New York City Subway system. In 1997 to 1999, outer tracks were installed to the north of Broad Channel for between $ 5 million and $ 10 million. The track to
8509-463: The emergence of multidrug-resistant tuberculosis (MDR-TB), surgery has been re-introduced for certain cases of TB infections. It involves the removal of infected chest cavities ("bullae") in the lungs to reduce the number of bacteria and to increase exposure of the remaining bacteria to antibiotics in the bloodstream. Hopes of eliminating TB ended with the rise of drug-resistant strains in the 1980s. The subsequent resurgence of tuberculosis resulted in
8636-570: The facility reopened as a general hospital, as an annex or relocation of Rockaway Beach Hospital , or converted into a school. These residents were opposed to the Riis Park plans, in part out of fear that extending the park would lead Riis Park visitors to "invade" the adjacent beaches in Neponsit. On June 29, 1955, the New York City Planning Commission unanimously approved Moses' plans to extend Riis Park. On July 21, 1955, however,
8763-429: The facility; following the closure, that figure rose to $ 50 million. After closing the home, the city initially planned to sell the site, to "get it back on the tax rolls" according to deputy mayor Joe Lhota . The site was worth an estimated $ 15 to $ 20 million. By late October, however, Lhota stated that the sale of the site was blocked by the deed restrictions on the property, based on the 1955 court ruling which prevented
8890-541: The first TB sanatorium in 1859 in Görbersdorf (now Sokołowsko ) in Silesia . In 1865, Jean Antoine Villemin demonstrated that tuberculosis could be transmitted, via inoculation, from humans to animals and among animals. (Villemin's findings were confirmed in 1867 and 1868 by John Burdon-Sanderson . ) Robert Koch identified and described the bacillus causing tuberculosis, M. tuberculosis , on 24 March 1882. In 1905, he
9017-570: The first genuine success in immunization against tuberculosis in 1906, using attenuated bovine-strain tuberculosis. It was called bacille Calmette–Guérin (BCG). The BCG vaccine was first used on humans in 1921 in France, but achieved widespread acceptance in the US, Great Britain, and Germany only after World War II. By the 1950s mortality in Europe had decreased about 90%. Improvements in sanitation, vaccination, and other public-health measures began significantly reducing rates of tuberculosis even before
9144-404: The fish were rehomed prior to demolition. The hospital building was demolished in early 2023. Tuberculosis Tuberculosis ( TB ), also known colloquially as the " white death ", or historically as consumption , is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria . Tuberculosis generally affects the lungs , but it can also affect other parts of
9271-406: The four walls of the dining room. They consisted of eleven panels depicting clowns and other circus characters. The second series of murals, called "Children at Work and Play", were created by Helen West Heller . The 23 panels portrayed children taking part in games and activities, and include disabled children. Both artists utilized tempera painting. By 2014, NYC Health + Hospitals spent $ 266,000
9398-625: The future if it intends to transfer 100 or more nursing home patients. Redevelopment or use of the site, meanwhile, was limited due to its deed restrictions. On March 9, 2004, the Neponsit Adult Day Health Care moved to a permanent location in the Sands Point Professional Building at Beach 102nd Street in nearby Rockaway Park . In 2006, the HHC considered plans to turn over facility to the city, and develop luxury homes on
9525-584: The home were forced to leave the facility in the middle of the night. Patients were transferred to Bellevue Hospital in Lower Manhattan, and the Coler and Goldwater Hospitals on Roosevelt Island . City officials under Mayor Rudy Giuliani stated that the buildings were in danger of collapsing, and that renovations were required to make the facility structurally sound. An estimate made by an engineering firm on June 19, 1998, stated it would take $ 1 million to renovate
9652-453: The hospital and develop a waterfront park on the site. The plan was announced October 28, 1998 by Giuliani and the HHC. It was opposed by the local community. On October 30, 1998, District Court Judge Deborah Batts blocked the demolition of the buildings. On November 2, 1998, the federal government released a report on the relocation, finding that the Health and Hospitals Corporation endangered
9779-558: The hospital be converted into a nursing home. Local businessmen such as the Rockaway Park Businessmen's Association, supported by the Rockaways' Chamber of Commerce, desired to build homes on the property. New York City Comptroller Lawrence E. Gerosa desired for the property to be turned over to a private owner, in order to get it "back on the tax rolls". Gerosa may have been influenced by the Rockaway developers, an assertion put forth by Moses. Local residents, meanwhile, wanted
9906-427: The hospital land to expand the adjacent Jacob Riis Park. Moses planned to raze the hospital buildings in order to construct sports fields, a swimming pool, and a comfort station, and to extend the beach. Moses also pointed out the clause in the 1906 act which provided the land for the hospital, in which it must be returned to the Parks Department when no long used for a hospital. The U.S. Welfare Department proposed that
10033-674: The hospital treated military veterans during and after World War II , but closed in 1955 due to a declining need for tuberculosis hospitals. Afterwards, it operated as the Neponsit Home for the Aged , later the Neponsit Health Care Center , a city-run nursing home until its controversial closure in 1998. The hospital was demolished in 2023. Neponsit Beach Hospital was located on the south side of Rockaway Beach Boulevard just west of 149th Street (originally Mohawk Street), with Rockaway Beach at its southern edge. The hospital sat at
10160-579: The hospital's laundry facilities, a men's dormitory, and an administrative center. A fourth building, a parking garage later converted into an office, was demolished before the rest of the hospital. The hospital's location on the sea provided patients with exposure to sunlight and beach recreation. The hospital originally contained two sets of murals, commissioned by the Works Progress Administration in 1938. The first set of murals called "The Circus" were painted by Louis Schanker and located on
10287-450: The hospital, including fire stairs to replace the original wooden staircases. However, in January 1955 the city decided to close Neponsit Beach Hospital due to a declining need for tuberculosis treatment. The hospital was vacated on February 1, 1955, with patients transferred to Sea View Hospital or Triboro Hospital. It was officially closed on April 21, 1955. The planned $ 1 million addition to
10414-431: The host's immune system. Macrophages and dendritic cells in the granulomas are unable to present antigen to lymphocytes; thus the immune response is suppressed. Bacteria inside the granuloma can become dormant, resulting in latent infection. Another feature of the granulomas is the development of abnormal cell death ( necrosis ) in the center of tubercles . To the naked eye, this has the texture of soft, white cheese and
10541-400: The infected macrophages. When other macrophages attack the infected macrophage, they fuse together to form a giant multinucleated cell in the alveolar lumen. The granuloma may prevent dissemination of the mycobacteria and provide a local environment for interaction of cells of the immune system. However, more recent evidence suggests that the bacteria use the granulomas to avoid destruction by
10668-439: The infection spreads outside the lungs, causing other kinds of TB. These are collectively denoted as extrapulmonary tuberculosis. Extrapulmonary TB occurs more commonly in people with a weakened immune system and young children. In those with HIV, this occurs in more than 50% of cases. Notable extrapulmonary infection sites include the pleura (in tuberculous pleurisy), the central nervous system (in tuberculous meningitis ),
10795-613: The infection waxes and wanes. Tissue destruction and necrosis are often balanced by healing and fibrosis . Affected tissue is replaced by scarring and cavities filled with caseous necrotic material. During active disease, some of these cavities are joined to the air passages ( bronchi ) and this material can be coughed up. It contains living bacteria and thus can spread the infection. Treatment with appropriate antibiotics kills bacteria and allows healing to take place. Upon cure, affected areas are eventually replaced by scar tissue. Diagnosing active tuberculosis based only on signs and symptoms
10922-487: The life from the other family members. Although Richard Morton established the pulmonary form associated with tubercles as a pathology in 1689, due to the variety of its symptoms, TB was not identified as a single disease until the 1820s. Benjamin Marten conjectured in 1720 that consumptions were caused by microbes which were spread by people living close to each other. In 1819, René Laennec claimed that tubercles were
11049-561: The line as a connection between the Far Rockaway and Rockaway Beach Branches . Plans for the New York City Subway to take over the Long Island Rail Road (LIRR)'s Rockaway branches were put forth as early as 1932. The Long Island Rail Road's wooden trestle over Jamaica Bay often caught fire. A fire that started at 3:30 on a December night damaged 1,300 feet of the trestle. Service could not be resumed for several days because of
11176-408: The line or one token on exit for those arriving from other parts of the system. Passengers traveling only within the double-fare zone would request a special "refund ticket", entitling them to a refund upon exiting the system, either in cash or a token. The unpopular double fare was abolished on September 1, 1975, though it coincided with a system-wide fare increase, as well as an increase in tolls on
11303-550: The line. The next year, the MTA announced plans to reconstruct much of the Rockaway Line on the Rockaway peninsula. The first phase would entail repairing the South Channel Bridge and Hammels Wye structure. The project entailed demolishing and completely reconstructing about 1,600 feet (490 m) of viaduct. As a result, service between Howard Beach and the peninsula will be suspended for 17 weeks beginning on January 17, 2025, and
11430-600: The line. Service to Far Rockaway and Rockaway Park ran through Valley Stream, while service on the Rockaway Beach Branch terminated at Hamilton Beach. The line was then purchased by the New York City Board of Transportation in 1952, and the line south of Ozone Park was taken out of service in June 1955 to allow for the line's conversion to subway service. On June 26, 1956, the line opened for subway service. A connection
11557-533: The lives of the 300 residents, and deceived them about plans to later return to the Neponsit Home. It also found that the hasty evacuation was unnecessary. Based on the report, the Health Care Financing Administration fined the HHC $ 3,050 per day for every day the former residents remained in sub-par housing, totaling $ 450,000. In December 1998, a portion of the complex, the Neponsit Adult Day Health Care which provided outpatient physical therapy,
11684-525: The middle and upper classes offered excellent care and constant medical attention. What later became known as the Alexandra Hospital for Children with Hip Disease (tuberculous arthritis) was opened in London in 1867. Whatever the benefits of the "fresh air" and labor in the sanatoria, even under the best conditions, 50% of those who entered died within five years ( c. 1916). Robert Koch did not believe
11811-596: The newly infected person becomes infectious enough to transmit the disease to others. A number of factors make individuals more susceptible to TB infection and/or disease. The most important risk factor globally for developing active TB is concurrent HIV infection; 13% of those with TB are also infected with HIV. This is a particular problem in sub-Saharan Africa , where HIV infection rates are high. Of those without HIV infection who are infected with tuberculosis, about 5–10% develop active disease during their lifetimes; in contrast, 30% of those co-infected with HIV develop
11938-599: The number of infectious droplets expelled by the carrier, the effectiveness of ventilation, the duration of exposure, the virulence of the M. tuberculosis strain , the level of immunity in the uninfected person, and others. The cascade of person-to-person spread can be circumvented by segregating those with active ("overt") TB and putting them on anti-TB drug regimens. After about two weeks of effective treatment, subjects with nonresistant active infections generally do not remain contagious to others. If someone does become infected, it typically takes three to four weeks before
12065-621: The nurses' home. In December 1933, the city applied for a loan to fund the project. Sketches for the murals were approved as part of the Federal Art Project in October 1935. The first contract was awarded in December 1935, for the power plant. The contract for the nurses' residence was awarded in 1938. In addition, the WPA planned to plant 800 trees and create gardens on the grounds of the hospital, and add
12192-456: The peak direction. The line was built in 1880 as the New York, Woodhaven and Rockaway Railroad. Incorporated in 1877, the line was built to better serve the beach resorts in the Rockaways, cutting travel times by 30 minutes over the existing South Side Railroad route. Long Island Rail Road (LIRR) trains began using the branch that year by operating over its Montauk Division. The railroad was sold to
12319-507: The plans. A significant service improvement on the Rockaway Line took effect in 1993, when direct late-night service between Far Rockaway (but not Rockaway Park) and Brooklyn and Manhattan began; previously, only shuttle or Round Robin service was provided during these hours, with a transfer at Euclid Avenue (the Rockaway Park branch remains a shuttle at all times, with a transfer at Broad Channel, although additional direct rush hour service
12446-534: The property, and repair fences and windows. At this time, the site was appraised at $ 40 million. In April 2022, the New York City government announced plans to demolish the remains of the Neponsit Beach Hospital. These plans prompted opposition from LGBTQ community. As of September 2022, city officials had not finalized plans for the site, although they tentatively planned to convert the hospital site into
12573-410: The railroad made it clear that it was not planning to rebuild the line, the city bought the line on June 11, 1952, for $ 8.5 million. The LIRR needed the money for its big safety program, which cost $ 6 million. The New York City Board of Transportation , operators of the subway system, started preparing contracts for the reconstruction of the line right after the sale went through. In total, $ 47.5 million
12700-435: The risk of developing active TB increases to nearly 10% a year. If effective treatment is not given, the death rate for active TB cases is up to 66%. TB infection begins when the mycobacteria reach the alveolar air sacs of the lungs, where they invade and replicate within endosomes of alveolar macrophages . Macrophages identify the bacterium as foreign and attempt to eliminate it by phagocytosis . During this process,
12827-414: The risk of infections (in addition to increasing the risk of active disease and death). Additional factors increasing infection susceptibility include young age. About 90% of those infected with M. tuberculosis have asymptomatic , latent TB infections (sometimes called LTBI), with only a 10% lifetime chance that the latent infection will progress to overt, active tuberculous disease. In those with HIV,
12954-412: The sale of the hospital at that time. Meanwhile, accusations were made against Giuliani of using new tactics to justify closing health facilities, after attempts to privatize Coney Island Hospital , Elmhurst Hospital Center , and Queens Hospital Center . There were also rumors of a plan to develop a hotel on the site. After the plans to sell the site fell through, Giuliani and the city decided to demolish
13081-400: The shuttle will run between Rockaway Park and Far Rockaway. In addition, there will be shuttle bus service between Howard Beach and the Rockaways. During the closure, fares on the Rockaway Park Shuttle are planned to be waived, and all trips from the LIRR's Far Rockaway station to City Terminal Zone stations are planned to be discounted to $ 2.75. In 2024, as part of a program to upgrade
13208-414: The site. These plans were opposed by local residents and politicians. Alternate plans from the community called for a veteran's rehabilitation center, or a children's hospital. Local politician Lew Simon, in opposition to the city plans, stated it would take "seven years" to rezone the land for other purposes. None of these plans came to fruition. In 2008, the HHC spent $ 1 million in order to cleanup debris on
13335-467: The southeast corner of the Jacob Riis Park property, adjacent to the residential portion of Neponsit . It occupied a 5.6-acre (2.3 ha) site. The grounds were originally 14.3 acres (5.8 ha) in size, extending west to the end of the roundabout in front of the park, and included the beaches on the coast of Neponsit Bays 1 and 2. The hospital consisted of three buildings, two of which fronted
13462-535: The spines of Egyptian mummies dating from 3000 to 2400 BC. Genetic studies suggest the presence of TB in the Americas from about AD 100. Before the Industrial Revolution , folklore often associated tuberculosis with vampires . When one member of a family died from the disease, the other infected members would lose their health slowly. People believed this was caused by the original person with TB draining
13589-467: The station is a single storage track. The Far Rockaway Branch, tracks F3A and F4A, goes east via an elevated structure over the Rockaway Freeway and terminates at a two-track terminal of Far Rockaway–Mott Avenue. Most of the Rockaway Line dates back to the 1880s when it was operated as the New York, Woodhaven and Rockaway Railroad; the Far Rockaway station had been in operation since 1869 as part of
13716-475: The surface. Then the right-of-way widens to be four tracks wide. Trains in service going south then diverge from F3, and go onto F1. Trains coming from the Rockaways merge from track F2 onto track F4. South of this point, track F4 is out of service, and track F3 can only be used by work trains as it is de-energized. The line then continues as a four track line, and south of Howard Beach , the tracks merge into two tracks. The line then passes over Jamaica Bay just to
13843-465: The test's usefulness as a screening tool. Several vaccines are being developed. Intradermal MVA85A vaccine in addition to BCG injection is not effective in preventing tuberculosis. Public health campaigns which have focused on overcrowding, public spitting and regular sanitation (including hand washing) during the 1800s helped to either interrupt or slow spread which when combined with contact tracing, isolation and treatment helped to dramatically curb
13970-483: The three Neponsit buildings to be in good condition, with repairs estimated at $ 600,000. Following a lawsuit over the closure of the facility by former residents and the Legal Aid Society , on June 2, 2003, under the administration of Michael Bloomberg , the HHC agreed to pay $ 5 million out of court, with $ 18,000 going to each patient or their estate if they had passed away. In addition, the city must give notice in
14097-565: The top of the lung. This hematogenous transmission can also spread infection to more distant sites, such as peripheral lymph nodes, the kidneys, the brain, and the bones. All parts of the body can be affected by the disease, though for unknown reasons it rarely affects the heart , skeletal muscles , pancreas , or thyroid . Tuberculosis is classified as one of the granulomatous inflammatory diseases. Macrophages , epithelioid cells , T lymphocytes , B lymphocytes , and fibroblasts aggregate to form granulomas, with lymphocytes surrounding
14224-533: The tracks north of the wye with flying junctions. The Rockaway Park Branch turns to the west and the Far Rockaway Branch turns to the east. The third leg of the wye is a single track that connects the two branches together. This single track, track F6, is not currently used in revenue service. However, it was used as part of the Round Robin service that operated mostly during late nights between 1958 and 1988. It
14351-462: The transmission of both tuberculosis and other airborne diseases which led to the elimination of tuberculosis as a major public health issue in most developed economies. Other risk factors which worsened TB spread such as malnutrition were also ameliorated, but since the emergence of HIV a new population of immunocompromised individuals was available for TB to infect. During the HIV/AIDS epidemic in
14478-442: The west of the original tracks, track F5, extends slightly less than two miles, or 10,300 feet (3,100 m), and is used for testing of equipment. The track to the east of the original tracks, track F6, is used for reversing trains on the Rockaway Park shuttle, and is approximately as long as a standard full length train. This track allows the shuttle to turn around significantly faster than it had been able to do before, when it
14605-468: Was also used for the temporary H service after Hurricane Sandy . The Rockaway Park Branch, tracks F3 and F4, goes west via an elevated structure over the Rockaway Freeway before terminating at Rockaway Park–Beach 116th Street . Directly to the north of the station is a seven-track storage yard named Rockaway Park Yard. This yard stores the trains for the Rockaway Park Shuttle . To the south of
14732-514: Was awarded the Nobel Prize in Physiology or Medicine for this discovery. In Europe, rates of tuberculosis began to rise in the early 1600s to a peak level in the 1800s, when it caused nearly 25% of all deaths. In the 18th and 19th century, tuberculosis had become epidemic in Europe , showing a seasonal pattern. Tuberculosis caused widespread public concern in the 19th and early 20th centuries as
14859-653: Was built between to the IND Fulton Street Line at Liberty Avenue using the old Fulton Street Elevated line to allow for its use by the subway, and the line then became the IND Rockaway Line. The following services use part or all of the IND Rockaway Line: The north end of the Rockaway Line is a junction with the IND Fulton Street Line just east of Rockaway Boulevard . The line starts out as tracks F3 and F4 and descend from an elevated structure to
14986-401: Was city councilman Stark, who urged the construction of more facilities like the Neponsit Home, due to the increasing elderly population in the city. This included the conversion of the former Manhattan Beach Hospital (now the site of Kingsborough Community College ) in Brooklyn into a nursing home. Costing $ 2.4 million, the Neponsit Home was the first municipally-operated geriatric facility in
15113-554: Was delayed the following day. The worst fire, the one that sealed the fate of the line, took place on May 7, 1950. The fire burned all night and destroyed 1,800 feet (550 m) of the trestle between The Raunt and Broad Channel stations, and the estimated cost to repair it was $ 1 million. As a result, the LIRR deemed the line useless, and instead of repairing it, the LIRR decided to abandon the line in favor of their "land route" to Far Rockaway via Valley Stream in Nassau County. When
15240-582: Was forced to relay at Howard Beach–JFK Airport or Euclid Avenue . South of the Broad Channel station is a fixed span leading to the small Subway Island, followed by the Beach Channel Drawbridge, which does open regularly and can cause delays to service when it is open for marine traffic. South of the drawbridge is Hammels Wye, a three-legged junction with the respective Rockaway Park and Far Rockaway branches. The tracks from each branch connect to
15367-468: Was not effective, it was later successfully adapted as a screening test for the presence of pre-symptomatic tuberculosis. World Tuberculosis Day is marked on 24 March each year, the anniversary of Koch's original scientific announcement. When the Medical Research Council formed in Britain in 1913, it initially focused on tuberculosis research. Albert Calmette and Camille Guérin achieved
15494-449: Was now associated with Queens General Hospital in Jamaica. In July 1950 Neponsit Beach Hospital began operating as an annex of Triboro Hospital for Tuberculosis (adjacent to Queens General), with 24 patients transferred from Triboro to Neponsit. On June 19, 1952, Queens Hospital Center was formed with the merger of the adjacent Queens General and Triboro Hospitals. Neponsit Beach Hospital,
15621-589: Was relocated to the gymnasium of the Young Israel of Far Rockaway synagogue in Far Rockaway . A second court ruling on October 29, 1999, stated that the HHC overextended its authority when evacuating the facility, and blocked demolition. Despite this, the Giuliani administration continued to try and demolitish the building. In March 2000, a structural evaluation was conducted by the New York City Council , finding
15748-544: Was renewed in 1912. The land for what would become Riis Park, 250 acres (100 ha) extending 1 mile (1.6 km) east-to-west, was sold to the city in 1913 by the Neponsit Realty Company, which was developing the Neponsit neighborhood. The site for the hospital was then transferred from the New York City Parks Department on April 24, 1913. The hospital was funded by private sources and built by
15875-551: Was reopened on March 1, 1945, after the United States Public Health Service began leasing it to treat servicemen with tuberculosis. Following the war, the Public Health Service continued to use the hospital for veterans of the war. After short extensions of the lease, it was returned to the city in 1950. Neponsit Beach Hospital returned to city operations in summer 1950 following minor renovations, and
16002-475: Was restored. In 2018, a two-phase program of flood mitigation work along the Hammels Wye required further service disruptions. The first phase, from April 9 to May 18, suspended rush-hour A trips to Rockaway Park. The second phase, from July 2 to September 3, diverted all Far Rockaway A trips to Rockaway Park. In both phases, the shuttle ran from Rockaway Park to Far Rockaway. During weekends between Memorial Day and Labor Day in 2016 and 2017, weekend service on
16129-471: Was spent to rebuild the line and to convert it for subway use, something they were planning to do as far back as the late 1920s . As part of the construction to convert the line to subway use, two new steel swing bridges were built to cross the North and South Channels, and two artificial islands were built using sand from Jamaica Bay to provide a roadbed for the subway trestle. Work was completed right before
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