The United States is facing one of the largest recorded outbreaks in U.S. history, according to local health officials and the Centers for Disease Control and Prevention.
As of Jan. 24, there have been 67 confirmed cases of active tuberculosis (TB) including 60 in the state of Kansas (Wyandotte County and Johnson County), according to the Kansas Department of Health and Environment.
Now, I know what you’re thinking: tuberculosis? Yes, that was that disease that you used to get a shot for when you were younger and we really didn’t have to think about it. Well, times have changed.
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In addition to the confirmed cases, there are also 79 confirmed latent TB cases, including 77 in Wyandotte County and two in Johnson County. Wyandotte County contains part of Kansas City and Johnson County is just southwest of Kansas City.
Cases linked to the outbreak were first reported in January 2024, according to KDHE. So far, there have been two deaths related to the outbreak, both of which occurred last year.
The Disease is Spreading
The disease is also spreading outside of Kansas. The Michigan Department of Agriculture and Rural Development reports a beef herd in eastern Michigan has tested positive for bovine tuberculosis.
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The positive herd is in Alcona County, one of the four counties where the disease is most active. All four counties are in a cluster together in northeastern Michigan: Alcona, Alpena, Montmorency and Oscoda.
It is the first detection within a herd since January 2022. However, the Michigan Department of Natural Resources found at least 13 cases in wild deer last year, all within that four-county area.
Bovine tuberculosis is a bacterial disease that can affect all mammals, including humans. It is spread primarily through “respiratory secretions,” whether through nose-to-nose contact or contaminated shared feed or water.
Most deer infected with bovine TB won’t show symptoms for a long time, which is why the DNR recommends having all harvested deer tested. Infection usually starts in the lymph nodes and can take years before lesions become noticeable in the lungs.
“Bovine TB is a persistent and challenging disease to address,” State Veterinarian Nora Wineland said in a statement. “Hunters, producers, academics, industry stakeholders, animal-health professionals, and state and federal agencies all have a vital role to play in combatting this disease and protecting animal and human health.”
The outbreaks in 2015 in a homeless shelter and 2021 related to contaminated bone graft surgery were larger, according to the CDC, which has dispatched a team to help with the ongoing outbreak.
TB is a disease caused by a type of bacteria called Mycobacterium tuberculosis, that primarily affects the lungs, according to the CDC. The federal health agency says it is one of the world’s leading infectious disease killers.
TB is spread in the air from one person to another. When a person with TB coughs, speaks or sings, germs are expelled into the air — where they can linger for several hours — before another person breathes in the air and becomes infected.
Symptoms
People with TB don’t always feel sick, but there are symptoms that can give us more insight to find out if someone may be infected.
- Swollen glands
- Body aches and pains
- Swollen joints or ankles
- Tummy or pelvic pain
- Constipation
- Dark or cloudy urine
- Headache
- Feeling sick
- Feeling confused
- Stiff neck
Stages of TB
Exposure: A person has been in contact with someone who has TB.
Latent TB infection: A person has TB bacteria in their body but no symptoms.
TB disease: A person has signs and symptoms of an active infection.
Some people become infected with TB germs that live in the body for years without causing illness. This is known as inactive TB or latent TB.
People with inactive TB do not feel ill, do not have symptoms and cannot spread germs to other people, the CDC says. However, without receiving treatment, people with inactive TB can develop active TB.
Who’s Most at Risk?
The risk of a TB infection becoming an active TB disease changes with age.
- Under 5 years of age: Until children reach age 5, they have high risk of a TB infection becoming active TB disease. The risk is greater for children under age 2. Tuberculosis in this age group often leads to serious disease in the fluid surrounding the brain and spinal column, called meningitis.
- Age 15 to 25: People in this age group have an increased risk of developing more-severe active TB disease in the lungs.
- Age 65 and older: The immune system weakens during older age. Older adults have a greater risk of active TB disease. Also, the disease may be more difficult to treat.
Last year, the U.S. saw more than 8,700 cases of TB, according to CDC data. Although TB cases have been steadily declining since the mid 1990s, rates increased in 2021, 2022 and 2023, with 2023 matching pre-pandemic levels.
How Can You Protect Yourself?
If you have active TB disease, you’ll need to take steps to prevent other people from getting an infection. You will take drugs for four, six or nine months. Take all of the drugs as directed during the entire time.
During the first 2 to 3 weeks, you will be able to pass TB bacteria to others. Protect others with these steps:
- Stay home: Don’t go to work or school.
- Isolate at home: Spend as little time as possible among members of your household. Sleep in a separate room.
- Ventilate the room: Tuberculosis germs spread more easily in small, closed spaces. If it’s not too cold outdoors, open the windows. Use a fan to blow air out. If you have more than one window, use one fan to blow air out and another to blow air in.
- Wear face masks: Wear a mask when you have to be around other people. Ask other members of the household to wear masks to protect themselves.
- Cover your mouth: Use a tissue to cover your mouth anytime you sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.
- Vaccinations: In countries where tuberculosis is common, infants often are vaccinated with the bacille Calmette-Guerin (BCG) vaccine. This protects infants and toddlers who are more likely to have active TB disease in the fluid surrounding the brain and spinal cord.
The vaccine may not protect against disease in the lungs, which is more likely in the United States. Dozens of new TB vaccines are in various stages of development and testing.
How can this Disease be Treated?
There are several treatment regimens for TB disease that may last anywhere from four months to nine months depending on the course of treatment. Health care providers may consider specific regimens for patients with co-existing medical conditions such as diabetes or HIV.
A vaccine, known as Bacille Calmette-Guérin (BCG), is commonly given to children in countries where TB is common, although it is generally not recommended in the U.S. due to the low risk of infection with the bacteria, variable vaccine effectiveness among adults, and the vaccine’s potential interference with TB tests, the CDC notes. The BCG vaccine often leaves a scar where the recipient was given the shot.
Long-term effects
Even after treatment, some people may experience chest infections and shortness of breath for the rest of their life.
In some cases, the TB bacteria can become resistant to the antibiotics used to treat it.
