Tuberculosis (TB) probably isn't at the top of your worry list like the flu, COVID, and norovirus are. After all, many people believe the disease has been all but eradicated in the U.S. As it turns out, though, the Centers for Disease Control and Prevention estimates that 13 million Americans have latent TB infections, and as the American Lung Association explains, "without treatment, 1 in 10 of them will become sick with active TB disease, which is then highly contagious."
In 2022, this resulted in more than 8,000 active TB cases in the U.S., making it the second-most deadly infectious disease after COVID. In 2023, this number jumped 15 percent to 9,633 cases.
That's why the current TB outbreak in Kansas is so alarming. This month alone, the Kansas Department of Health and Environment (KDHE) has reported 67 active TB infections—"the largest documented outbreak in U.S. history, presently," said KDHE spokesperson Jill Bronaugh.
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What is tuberculosis?
Tuberculosis is an airborne bacterium most commonly caused by the bacteria Mycobacterium tuberculosis, which can remain in the air for several hours. It typically attacks the lungs, but can also affect the brain, kidneys, spine, or lymph nodes, notes the CDC.
One of the distinguishing aspects of TB is that a person can have a latent or inactive TB infection, or they can have TB disease.
"Latent TB infection cannot be spread to others, and individuals with latent TB do not have symptoms, while TB disease can be spread to others through the air when a person with active TB disease coughs or talks and others breathe in the bacteria," explains the American Lung Association.
Tuberculosis reached epidemic proportions in the U.S. in the 18th and 19th centuries, but the "discovery of streptomycin in 1944 and isoniazid in 1952" got the disease largely under control, reports a historical review published in the journal Respiratory Medicine.
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How did the Kansas TB outbreak start?
The current outbreak in Kansas likely began last year, as the KDHE reported the following latent infections since 2024:
- 77 in Wyandotte County (home to Kansas City)
- 2 in Johnson County (bordering Kansas City)
- 60 in Wyandotte County
- 7 in Johnson County
The exact nature of the spread hasn't been reported, but it's likely due to infected persons being in close proximity with others.
"The current KCK Metro TB outbreak is the largest documented outbreak in U.S. history, presently," Bronaugh said in a statement to The Topeka Capital-Journal. "This is mainly due to the rapid number of cases in the short amount of time. This outbreak is still ongoing, which means that there could be more cases."
"We still have a couple of fairly large employers that are involved that we're working with on this," added Ashley Goss, a deputy secretary at the KDHE, at a Senate Public Health and Welfare Committee last week. "So we do expect to find more, but we're hoping the more that we find is latent TB not active, so that their lives are not disrupted and having to stay home from work. Because it is highly contagious."
However, the KDHE says it is working with the CDC on the outbreak and is assuring people that there is "very low risk to the general public."
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What are the symptoms of TB?
According to the American Lung Association, the most common symptoms of active TB are:
- A cough that lasts more than three weeks
- Loss of appetite and unintentional weight loss
- Fever
- Chills
- Night sweats
If you believe you may have TB or know you came in contact with someone with the disease, seek medical attention immediately. A doctor can order a skin test or blood test to determine if a TB infection is present.
Latent TB is typically treated with the antibiotic isoniazid (INH) "taken as a single daily pill for six to nine months," notes the American Lung Association.
"If you have an active TB disease you will probably be treated with a combination of antibacterial medications for a period of six to 12 months," they add. However, after 10 days those with active TB are usually no longer contagious.
