Largest Tuberculosis Outbreak in U.S. History Now in Kansas

The Kansas City metro area is facing the largest documented tuberculosis (TB) outbreak in U.S. history, with at least 67 confirmed active cases reported in two Kansas counties.

The outbreak, which began in January 2024, has already resulted in two deaths, both occurring last year. While health officials emphasize that the risk to the general public remains low, the outbreak has raised concerns about TB’s persistence and spread.

Scope of the Outbreak

According to the Kansas Department of Health and Environment (KDHE), the 67 active TB cases have been identified in Wyandotte County (60 cases) and Johnson County (7 cases). Additionally, 79 latent TB infections have been confirmed, meaning those individuals carry the bacteria but are not currently ill or contagious.

The Centers for Disease Control and Prevention (CDC) has confirmed that this outbreak, while significant, is not the largest in U.S. history. The agency noted that previous outbreaks, including a 2015 incident at a homeless shelter and a 2021 outbreak linked to contaminated bone graft surgeries, were larger.

However, KDHE communications director Jill Bronaugh stated that this outbreak is the largest documented TB outbreak since the CDC began tracking cases in the 1950s.

“This outbreak is still ongoing, which means that there could be more cases,” Bronaugh said in a statement. “We are working with and following the guidance of the CDC to manage and contain its spread.”

What is Tuberculosis?

Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. It primarily affects the lungs but can spread to other parts of the body, including the brain, kidneys, and spine.

TB spreads through airborne transmission when an infected person coughs, speaks, or even sings, releasing bacteria into the air. These bacteria can remain suspended in the air for several hours, making prolonged close contact with an infected person the most common means of transmission.

Symptoms and Risk Factors

Symptoms of active TB disease include:

• A persistent cough lasting more than three weeks
• Coughing up blood or phlegm
• Chest pain
• Fatigue and weakness
• Unintentional weight loss
• Loss of appetite
• Fever and chills
• Night sweats

Some individuals who contract TB develop latent TB infection (LTBI), meaning the bacteria remain in the body without causing illness. While individuals with LTBI are not contagious, they are at risk of developing active TB disease later in life, particularly if they have weakened immune systems.

Who is at Risk?

While TB can affect anyone, certain groups are at higher risk, including:

• People living in or traveling frequently to areas where TB is common
• Individuals residing in large group settings such as homeless shelters, correctional facilities, or nursing homes
• Healthcare workers who are regularly exposed to TB patients
• People with compromised immune systems, such as those with HIV, diabetes, or individuals who smoke

Response and Public Health Measures

State and local health officials are actively working to contain the outbreak and prevent further spread. The CDC has deployed a team to assist with the response. Officials are conducting TB testing for individuals who may have been exposed, and testing is being provided at no cost.

“Health departments are identifying possible close contacts of infected individuals and offering TB testing,” KDHE stated. “People who test positive will be further screened to determine whether they have active TB disease or latent TB infection, which will help determine the best treatment.”

For those diagnosed with active TB, treatment is available and highly effective. Patients receive antibiotics for a period ranging from four to nine months, depending on the severity of the infection and the treatment regimen.

Note: Health departments are providing medication for free to uninsured individuals or those whose insurance does not cover TB treatment.

Concerns Over Communication Gaps

Despite the ongoing public health efforts, concerns have been raised about communication gaps at the federal level. The National Association of County and City Health Officials (NACCHO) has expressed frustration over the lack of national-level updates on the outbreak.

“Information exchange really matters and helps guide these outbreaks,” NACCHO CEO Lori Tremmel Freeman said. “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 the disease, the spread of it, and how to stop it.”

CNN has reached out to the CDC for additional comments regarding national communication efforts related to the outbreak.

National TB Trends

According to CDC data, tuberculosis cases in the U.S. have fluctuated in recent years. In 2023, there were 9,633 reported TB cases, an increase from 8,320 in 2022. The incidence rate rose from 2.5 cases per 100,000 people in 2022 to 2.9 per 100,000 in 2023.

While TB cases in the U.S. have declined since the mid-1990s due to improved public health measures, rates increased in 2021, 2022, and 2023, with last year’s numbers reaching pre-pandemic levels. Experts attribute this increase to delayed testing and treatment during the COVID-19 pandemic, which may have allowed undiagnosed infections to persist and spread.

Globally, tuberculosis remains a major public health threat. The World Health Organization (WHO) estimates that about 10 million people worldwide contract TB each year, with 1.5 million deaths annually, making it the world’s deadliest infectious disease.

Prevention and Control Measures

TB prevention efforts focus on early detection, screening, and treatment. Health officials emphasize the following steps to minimize the risk of TB transmission:

• Regular Testing – Individuals at high risk, including healthcare workers, residents of shelters or correctional facilities, and people with weakened immune systems, should undergo routine TB screening.
• Prompt Treatment – Those diagnosed with TB should complete their prescribed course of antibiotics to prevent the development of drug-resistant strains.
• Vaccination – The Bacille Calmette-Guérin (BCG) vaccine is commonly administered in countries where TB is prevalent. However, it is not widely used in the U.S. due to variable effectiveness in adults and potential interference with TB skin tests.
• Public Awareness – Educating communities about TB symptoms, transmission, and treatment options can help reduce stigma and encourage early detection.

Looking Ahead

While the Kansas TB outbreak is the largest in recorded U.S. history, public health officials remain optimistic about containment efforts. The key to managing the outbreak lies in rapid testing, early treatment, and effective communication between local, state, and federal agencies.

For now, the risk to the general public remains low, but vigilance is crucial. Health officials continue to urge individuals with prolonged coughs or TB symptoms to seek medical evaluation promptly.

With coordinated efforts from public health agencies, healthcare providers, and community leaders, the goal remains to prevent further spread and ensure that those affected receive the care they need.