Kansas has experienced one of the largest tuberculosis (TB) outbreaks ever recorded in the United States, as public health forces at the state and federal levels have been significantly reduced.
Experts say such outbreaks can be more common and dangerous as officials’ efforts become more intense and limited communication between them.
“We’ve seen a lot of people who have had a lot of trouble with their health,” said David Dowdy, professor of epidemiology at Johns Hopkins Bloomberg School of Public Health.
“What makes them happen is the weakening of public health infrastructure.”
Since January 2024, there have been 67 active cases of tuberculosis identified in two Kansas counties. This exceeds the normal statewide case count for a year, despite the combined counties representing less than 3% of the state’s population. 2023 Census data.
“It’s definitely more than a bit of a blip,” Dowdy said. “This is one of the biggest outbreaks of tuberculosis we have seen in the country over the last 30, 40, 50 years.”
The state also detected at least 79 potential tuberculosis cases. In this case, the patient does not show active symptoms but may develop and spread later with an active disease.
The state is currently monitoring 384 people being tested and treated, Kansas officials said.
Kansas Public Health Officials and the US Centers for Disease Control and Prevention (CDC) are the Kansas Communications Director “to work together to reduce the risk of tuberculosis in our communities and ensure the safety of all individuals.” One Jill Bronnow said in a statement: Health and the Environment.
But the risk to the general public remains low, she said.
“We will also help prevent spread of tuberculosis by working with schools and businesses to support efforts to monitor symptoms and provide education,” Bronau said.
It’s a difficult battle in the midst of seeing the sudden decline in public health power caused by the pandemic.
The governor of Kansas was banned from closing businesses during the 2021 public health emergency. Legislatures were barred from requiring state and county civil servants to test, isolate or close for infections in 2023.
Tuberculosis tends to spread when you spend a lot of time in crowded conditions such as prisons, prisons, and homeless shelters. These are places where people often lack access to proper health care and may make infection more possible.
Other factors such as malnutrition, HIV/AIDS, and other immunosuppressive conditions make people at increased risk of getting sick.
But what really causes the outbreak of tuberculosis is something public health experts can’t handle, Dowdy said.
“It’s not that I don’t know how to do that,” Dowdy said of treating TB patients and preventing the spread of bacteria. “It’s about this underlying condition that will allow these occurrences to be deployed.”
If there is a way to detect the first case, and you have enough healthcare workers to track and test contacts and support patients testing positive, you can stop the outbreak before you start.
But the system is incomplete or dismantled and “it’s easy for this kind of thing to be undetected for a long period of time,” Doudy said.
“The people in Kansas do a good job with this. They just don’t have the resources they need,” he said.
At the national level, the Trump administration has restricted what the CDC and other federal health agencies can do by enacting a blackout of communications in the first few weeks.
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The ban on external communications includes withholding the release of the Morbidity and Mortality Weekly Report (MMWR). This is a highly anticipated epidemiological digestion that renews public and practitioners regarding new and ongoing outbreaks amidst other crises.
On Friday, hundreds of pages were removed from the Health Agency’s website, and in compliance with Donald Trump’s executive order, it removed mentions of race, gender, sexual identity, disability and other identity. Some of these pages are currently being restored and sometimes omitted due to occasional editing and omissions.
Outbreaks like Kansas speak to the importance of coordination between states and national companies like the CDC, Dowdy said.
“You can only see this kind of event when you can see it from a big picture perspective. That’s why our national institutions are there, but we only respond at the local level. You can. There’s an agency there,” he said.
“The importance of being able to maintain strength at both national and state and local levels cannot be truly exaggerated,” Dowdy added. “The disruption in these systems certainly increases the risk of such an outbreak.”
Internationally, effectively, the dissolution of the United States Organization for International Development (USAID) means increasing the global outbreak of preventable diseases such as tuberculosis.
Author YouTube star and tuberculosis advocate John Greene said he was involved in private donors with the Philippines and USAID on a $85 million project to end tuberculosis in two regions of the Philippines. He said he worked for months in the partnership.
“It can provide a blueprint to eliminate tuberculosis around the world, except that it’s not happening,” he wrote in a Bluesky post.
The global outbreak is a major driver of US tuberculosis cases.
The outbreak in Kansas is large, but last year it accounted for less than 1% of all US TB cases. Approximately two-thirds of cases have been detected among people born outside the United States, pointing to greater transmission abroad.
The current outbreak in Kansas occurs in the same location as the different outbreaks detected in 2021-22. Trouble, diseased strains in their outbreaks are resistant to several tuberculosis treatments known as multidrug resistance (MDR) TB, making outbreaks more difficult.
There are no indications that this cluster of cases shows resistance to treatment, but once MDR-TB spreads, it may be difficult to see right now.
MDR-TB outbreaks are often detected by prominent spikes in CDC monitoring reports that may be affected by US health agencies’ GAG orders.
For example, a report on the 2021-22 outbreak in Kansas has appeared in the now quiet MMWR.
