Two dead, dozens sickened in Kansas tuberculosis outbreak

A wave of tuberculosis cases hitting the Kansas City, Kansas, metro area has caused dozens of illnesses and at least two deaths, according to the state health department.

Cases related to the outbreak were first reported in January 2024, and there were two reported TB deaths last year associated with this outbreak, Jill Bronaugh, a spokesperson for the Kansas Department of Health and Environment, said Tuesday.

“This outbreak is still ongoing, which means that there could be more cases,” Bronaugh said in an email. “We are working with and following the guidance of the CDC.”

As of Friday, there have been at least 67 people treated for confirmed active TB infections in the outbreak, and there have been 79 confirmed latent cases, in which TB is detected in the body but it’s not causing disease and making people sick.

TB germs are spread from person to person through prolonged contact with someone who has an active infection. People with latent infections cannot spread TB bacteria to others, but if the bacteria becomes active, latent infection can develop into TB disease.

“TB is an infectious disease that most often affects the lungs and is caused by a type of bacteria. It spreads through the air when infected people cough, speak, or sing,” Bronaugh said. “While there is a very low risk of infection to the general public in these communities, KDHE is working to ensure that patients are receiving appropriate treatment, which will limit the ability to spread this disease and prevent additional cases from occurring.”

The state health department has not said what caused the outbreak. Affected local health departments are working with each patient to identify possible close contacts and conduct TB testing at no cost, according to the state agency’s website.

The US Centers for Disease Control and Prevention said Tuesday that four of its staffers are on-site to help with the response to the outbreak, including contact tracing, testing and screening.

People who test positive will be further screened to determine whether they have active TB disease or a latent TB infection, “which will help determine the best treatment,” according to the state health department. The disease is curable and often treated with a standardized course of drugs that usually includes antibiotics.

“Treatment will be provided through the patient’s local health department, and it will be provided for free if the person is uninsured or the treatment isn’t covered by health insurance,” according to the state health department’s website. “Health department staff will remain in touch with patients throughout treatment to help them stay on course and address any questions or concerns they may have.”

The National Association of County and City Health Officials has been closely monitoring news about the tuberculosis outbreak in Kansas, but concern remains that there is little information being shared at the national level while federal health agencies have been ordered to pause communications.

“Information exchange really matters and helps to shape and guide these outbreaks, and we’re having a lull in that right now, which makes it concerning if we’re missing out on any important updates or things that could impact how people are addressing disease, the spread of it, what to look for and how to stop it,” Lori Tremmel Freeman, the association’s CEO, said Tuesday.

Nationally, tuberculosis case counts in the United States increased in 2023 among all age groups and in most reporting jurisdictions, according to a report released last year by the CDC. The numbers of reported cases rose slightly from 8,320 in 2022 to 9,615 in 2023, and the rate of TB rose from 2.5 cases per 100,000 people in 2022 to 2.9 in 2023. But the report emphasizes that the United States has “one of the lowest TB rates in the world” and that most US residents are at “minimal risk” for TB.

Anyone can get tuberculosis, but people have a higher risk of being exposed to TB germs if they were born in or frequently travel to countries where the disease is common; if they live in large group settings where TB may be more common, such as homeless shelters, prisons or jails; or if they work in places where TB may be more likely to spread, such as hospitals, homeless shelters, correctional facilities and nursing homes.

Each year, about 10 million people around the world fall ill with the disease, even though it is preventable and curable, and about 1.5 million people die, making it “the world’s top infectious killer,” according to the World Health Organization.

Along with screening, TB can be prevented with protocols such as vaccination and making sure people who are infected finish their course of treatment. The vaccine is not generally used in the United States because of its low TB incidence rate.

People infected with TB bacteria have up to a 10% lifetime risk of becoming sick with the disease, according to WHO, and those with compromised immune systems – such as people living with HIV or diabetes or those who use tobacco – have a higher risk of falling ill.

Correction: In a previous version of this report, Kansas health officials said the ongoing TB outbreak is the largest in the United States since the 1950s. The CDC said Tuesday that there have been at least two US outbreaks that were larger.