Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis. Mycobacteria are transmitted by airborne particles that are generated when a person with TB coughs, speaks, or sings. These airborne particles can remain suspended in the air for several hours. TB is more likely to spread in indoor spaces with poor air circulation than outdoors.
Transmission occurs when a person inhales airborne particles containing mycobacteria and the particles are able to traverse the mouth or nasal passages and reach the alveoli of the lungs. Not everyone infected with mycobacteria becomes ill. As a result, two forms of TB exist: latent and active. Latent TB infection begins when extracellular bacilli in the alveoli lungs are ingested by macrophages, leading to the formation of granulomas. Without treatment, approximately 5% of persons with latent TB will develop active TB disease in the first two years after infection, and another 5% will develop active TB disease sometime later in life. The classic clinical features of active tuberculosis include chronic cough, sputum production, appetite loss, weight loss, fever, night sweats, and hemoptysis.
Despite the availability of inexpensive and effective medications, tuberculosis still accounts for millions of cases of active disease and deaths worldwide. The disease disproportionately affects the poorest persons in both high-income and developing countries. CDC estimates that up to 13 million people in the United States live with latent TB infection. In 2023, there were 9,633 cases of active TB, which was a 16% increase from 2022.
On January 21, 2025, Ashley Goss of the Kansas Department of Health and Environment informed the Senate Public Health and Welfare Committee that the state was experiencing the largest tuberculosis outbreak in the history of the United States. As of January 17, public health officials had documented 67 active and 79 latent infections in Kansas City, Kansas. Sixty of the active cases were located in Wyandotte County and seven in Johnson County. Of the latent cases, 77 occurred in Wyandotte county and 2 in Johnson County.
References
Jason Alatidd, Topeka Capital-Journal, January 25, 2025
Zumla A, et al. Tuberculosis, New Engl J Med 2013;368:745-55.
CDC, Tuberculosis, January 6, 2025. https://www.cdc.gov/tb/hcp/clinical-overview/index.html
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