Tuberculosis has been on the rise in the Midwest states with over 67 active cases in Kansas alone, with an additional 79 cases of latent TB and 384 people undergoing testing and treatment. This rise in cases is one of the largest outbreaks in recent history.
In the U.S., the overall risk from tuberculosis is low. TB is a very serious and sometimes deadly disease, but it is not the most infectious of all diseases, and officials are doing everything possible to keep the current outbreak contained.
However, states have had little power in controlling the outbreak. The governor of Kansas was banned from closing down businesses during public health emergencies and legislation has forbidden state and county public health officials to mandate tests, isolation and closures. Most of these laws are in reaction to the COVID-19 pandemic. All of this has made a perfect storm that makes it hard to help people and communities most impacted by the outbreak.
TB is a very contagious airborne pathogen, with the ability to linger in the air for several hours. Those with poor air circulation and in crowded conditions like prisons, jails and homeless shelters may be at higher risk.
“You can think of TB outbreaks like a canary in the coalmine of our public health infrastructure,” said David Dowdy, professor of epidemiology at Johns Hopkins Bloomberg School of Public Health. An outbreak of TB usually shows problems in the underlying public health infrastructure because outbreaks occur when cases are unable to be identified and treated.
Kansas is a great example of what can happen when the first tools used to help limit the spread of illness have been severely limited. “The people in Kansas are doing a good job with this. They just don’t have the resources they need,” Dowdy said. Adding to this, the Trump administration limited what the CDC and other federal health agencies can do, with the most impactful one being a freeze on communications until a political appointee has approved it. It isn’t fully uncommon however with the outbreak actively going it does hurt and impact what can be done, especially with Robert F. Kennedy Jr. stepping in as Secretary of Health and Human Services, who has identified himself as highly anti-vaccination.
