4 Things You Should Know About Tuberculosis
A TB outbreak in Kansas has people around the country worried. These facts will help you put the risk in perspective.
You may have seen reports of an outbreak of tuberculosis in Kansas City and thought: Oh, no! Is this the start of something bigger? Do you need to worry?
First, the facts: The tuberculosis outbreak has been going on for more than a year, but it’s been in the news because it’s one of the largest TB outbreaks in U.S. history. As of Feb. 7, there have been 67 confirmed cases and two deaths. In addition, despite the U.S. having one of the lowest rates of tuberculosis in the world, the disease may be experiencing a resurgence here.
Tuberculosis Can Be Deadly, But It’s Not Easy to Catch
Tuberculosis is an infectious bacterial disease that mainly affects the lungs. It spreads through the air when people cough, sneeze, or spit.
Ninety percent of people who get tuberculosis don’t have symptoms—they have what’s known as latent or inactive TB. Latent tuberculosis isn’t contagious. The immune system fights the bacteria just enough to keep the disease dormant.
But without treatment at this stage, it can develop into active tuberculosis, with symptoms such as a cough that lasts more than two weeks, chest pain, fatigue, weight loss, and fever. The active stage can be treated, too, but if it’s not, the disease can be fatal.
That sounds scary, but you generally have to be around someone with an active case of tuberculosis for long periods to get infected. “Unlike respiratory viruses like flu, COVID, and RSV, which are transmitted rather readily, TB usually requires prolonged exposure in an indoor setting to be transmitted from someone who has active tuberculosis to someone else,” says William Schaffner, a professor of medicine in the division of infectious diseases at the Vanderbilt University School of Medicine.
Your Risk of Getting TB Is Probably Low
Although anyone can get tuberculosis, for that to happen you first need to come into contact with someone who has it, and not just casually. Tuberculosis doesn’t spread by shaking hands, touching something an infected person has touched, or even sharing food or kissing, according to the CDC.
To catch tuberculosis, you typically have to live or work in close quarters with someone who is infected or where TB often occurs and is easily transmitted, such as in hospitals, nursing homes, correctional facilities, or homeless shelters. People who frequently travel to countries where tuberculosis is common, such as India, Indonesia, and China, are also at greater risk of exposure.
If you do become infected, you’re more likely to develop an active case of tuberculosis if you have a weakened immune system because of a health condition, such as diabetes, HIV/AIDS, or an organ transplant, or if you take certain medications, like corticosteroids, or specialized medications for rheumatoid arthritis or Crohn’s disease.
Children under age 5 and older adults are also more vulnerable once infected. People who were born in a country with higher rates of tuberculosis are also at greater risk even if they haven’t been there in many years. That’s because they may have a latent infection, which can develop into an active one at any time.
Tuberculosis Can Be Detected, Treated, and Cured
If you’re concerned that you may have been infected with tuberculosis, check with your doctor or local health department about getting a blood or skin test. The healthcare provider will determine which one is best for you.
For the blood test, blood is drawn from an arm and sent to a lab for evaluation. For the skin test, a small amount of tuberculosis proteins is injected under the skin. Two or three days later the doctor will check for a raised bump that indicates infection. With either option, further tests may be needed to see whether the infection is latent or active.
Treatment (for both latent and active TB) consists of combinations of antibiotics that you take for several months without interruption. Although there’s a vaccine against tuberculosis, it’s not used in the U.S. “because it has not been proven to protect people, particularly adults, from getting active TB in the lung,” Hawkinson says.
This Tuberculosis Outbreak Is Unlikely to Spread
While the cases in Kansas are concerning, they don’t pose a threat of spreading in the same way that, say, the COVID-19 pandemic did. Hawkinson and his colleagues, the Kansas Department of Health and Environment, and the CDC have been screening, testing, and treating people infected in the current outbreak. Although more cases could arise in the coming days, he says, “we feel that it is being addressed correctly and really getting resolved.”
“Just to put things in perspective, we’re approaching 10,000 flu-related and 600 COVID-related deaths this season,” says Thomas Russo, a SUNY distinguished professor and chief of the Division of Infectious Diseases in the Department of Medicine at the University at Buffalo. “So even though this outbreak has gotten some buzz, TB is quantitatively significantly less important than a variety of other infections, including those respiratory viruses.”
