The tuberculosis outbreak in Kansas is alarming. It's not the biggest in US history though, CDC says
A yearlong outbreak of tuberculosis in the Kansas City, Kansas area has taken local experts aback, even if it does not appear to be the largest outbreak of the disease in U.S. history as a state health official claimed last week.
'We would expect to see a handful of cases every year,' said Dr. Dana Hawkinson, an infectious disease doctor at the University of Kansas Health System. But the high case counts in this outbreak were a 'stark warning,' he said.
The outbreak has killed two people since it started in January 2024, Kansas state health department spokeswoman Jill Bronaugh said. Health officials in Kansas say there is no threat to the general public.
What is tuberculosis?
TB is caused by bacteria that lives in the people's lungs and spreads through the air when they talk, cough or sing. It is very infectious, but only spreads when a person has symptoms.
Once it infects a person, TB can take two forms. In 'active' TB, the person has a long-standing cough and sometimes bloody phlegm, night sweats, fever, weight loss and swollen glands. In 'latent' TB, the bacteria hibernates in the person's lungs or elsewhere in the body. It does not cause symptoms and does not spread to others.
Roughly a quarter of the global population is estimated to have TB, but only about 5% to 10% of those develop symptoms.
How big is the tuberculosis outbreak in Kansas?
As of Jan. 24, 67 people are being treated for active TB, most of them in Wyandotte County, Bronaugh said. Another 79 have latent TB.
The state's provisional 2024 count shows 79 active TB cases and 213 latent cases in the two counties where the outbreak is happening, Wyandotte and Johnson. Not all of those are linked to the outbreak and Bronaugh did not respond to requests for clarification.
The situation is improving, though: 'We are trending in the right direction right now,' Ashley Goss, deputy secretary at the Kansas Department of Health and Environment, told the state Senate's Committee on Public Health and Welfare Jan. 21.
Is the Kansas tuberculosis outbreak the largest in U.S. history?
Kansas health officials called the outbreak 'the largest documented outbreak in U.S. history' since the U.S. Centers for Disease Control and Prevention began counting cases in the 1950s.
But a spokesperson for the CDC on Tuesday refuted that claim, noting at least two larger TB outbreaks in recent history. In one, the disease spread through Georgia homeless shelters. Public health workers identified more than 170 active TB cases and more than 400 latent cases from 2015 to 2017. And in 2021, a nationwide outbreak linked to contaminated tissue used in bone transplants sickened 113 patients.
How is tuberculosis treated?
TB is treated with antibiotics over the course of several months. A vaccine is available, but generally not recommended in the U.S. because the risk of infection is low and getting the vaccine can interfere with the test doctors use to diagnose the disease.
TB is a much bigger problem outside of the U.S.
TB is a leading cause of infectious disease death worldwide, and has been on the rise.
In 2023, the bacteria killed 1.25 million people globally and infected 8 million, the highest count since the World Health Organization started keeping track.
While tuberculosis was a much bigger danger in the U.S. in earlier generations, it has been trending back up in recent years. In 2023 there were more than 9,600 cases nationwide, the highest in a decade, according to the CDC.
___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
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Atlantic
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‘We're Just Becoming a Weapon of the State'
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More than 300 officials, from across all of the NIH's 27 institutes and centers, have signed and sent a letter to Bhattacharya that condemns the changes that have thrown the agency into chaos in recent months—and calls on their director to reverse some of the most damaging shifts. Since January, the agency has been forced by Trump officials to fire thousands of its workers and rescind or withhold funding from thousands of research projects. Tomorrow, Bhattacharya is set to appear before a Senate appropriations subcommittee to discuss a proposed $18 billion slash to the NIH budget—about 40 percent of the agency's current allocation. The letter, titled the Bethesda Declaration (a reference to the NIH's location in Bethesda, Maryland), is modeled after the Great Barrington Declaration, an open letter published by Bhattacharya and two of his colleagues in October 2020 that criticized 'the prevailing COVID-19 policies' and argued that it was safe—even beneficial—for most people to resume life as normal. The approach that the Great Barrington Declaration laid out was, at the time, widely denounced by public-health experts, including the World Health Organization and then–NIH director Francis Collins, as dangerous and scientifically unsound. The allusion in the NIH letter, officials told me, isn't meant glibly: 'We hoped he might see himself in us as we were putting those concerns forward,' Jenna Norton, a program director at the National Institute of Diabetes and Digestive and Kidney Diseases, and one of the letter's organizers, told me. None of the NIH officials I spoke with for this story could recall another time in their agency's history when staff have spoken out so publicly against a director. But none of them could recall, either, ever seeing the NIH so aggressively jolted away from its core mission. 'It was time enough for us to speak out,' Sarah Kobrin, a branch chief at the National Cancer Institute, who has signed her name to the letter, told me. To preserve American research, government scientists—typically focused on scrutinizing and funding the projects most likely to advance the public's health—are now instead trying to persuade their agency's director to help them win a political fight with the White House. Bhattacharya, the NIH, and the Department of Health and Human Services did not respond immediately to a request for comment. The agency spends most of its nearly $48 billion budget powering science: It is the world's single-largest public funder of biomedical research. But since January, the NIH has canceled thousands of grants —originally awarded on the basis of merit—for political reasons: supporting DEI programming, having ties to universities that the administration has accused of anti-Semitism, sending resources to research initiatives in other countries, advancing scientific fields that Trump officials have deemed wasteful. Prior to 2025, grant cancellations were virtually unheard-of. But one official at the agency, who asked to remain anonymous out of fear of professional repercussions, told me that staff there now spend nearly as much time terminating grants as awarding them. And the few prominent projects that the agency has since been directed to fund appear either to be geared toward confirming the administration's biases on specific health conditions, or to benefit NIH leaders. 'We're just becoming a weapon of the state,' another official, who signed their name anonymously to the letter, told me. 'They're using grants as a lever to punish institutions and academia, and to censor and stifle science.' NIH officials have tried to voice their concerns in other ways. At internal meetings, leaders of the agency's institutes and centers have questioned major grant-making policy shifts. Some prominent officials have resigned. Current and former NIH staffers have been holding weekly vigils in Bethesda, commemorating, in the words of the organizers, ' the lives and knowledge lost through NIH cuts.' (Attendees are encouraged to wear black.) But these efforts have done little to slow the torrent of changes at the agency. Ian Morgan, a postdoctoral fellow at the NIH and one of the letter's signers, told me that the NIH fellows union, which he is part of, has sent Bhattacharya repeated requests to engage in discussion since his first week at the NIH. 'All of those have been ignored,' Morgan said. By formalizing their objections and signing their names to them, officials told me, they hope that Bhattacharya will finally feel compelled to respond. (To add to the public pressure, Jeremy Berg, who led the NIH's National Institute of General Medical Sciences until 2011, is also organizing a public letter of support for the Bethesda Declaration, in partnership with Stand Up for Science, which has organized rallies in support of research.) Scientists elsewhere at HHS, which oversees the NIH, have become unusually public in defying political leadership, too. Last month, after Health Secretary Robert F. Kennedy Jr.—in a bizarre departure from precedent—announced on social media that he was sidestepping his own agency, the CDC, and purging COVID shots from the childhood-immunization schedule, CDC officials chose to retain the vaccines in their recommendations, under the condition of shared decision making with a health-care provider. 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'It's important for us to provide a nudge to some Americans to remember that they have agency over their future,' Mehmet Oz, the administration's Medicare and Medicaid chief, told reporters on Wednesday, following a closed-door meeting with GOP senators. Later Wednesday in an interview on Fox Business, Oz elaborated. 'Go out there, do entry-level jobs, get into the workforce, prove that you matter. Get agency into your own life,' he said. Republicans are wary about being attacked over health care cuts, and they're eager to reframe the debate and try to go on offense. Voter backlash over the 2017 ObamaCare repeal effort led to widespread GOP losses and cost them control of the House in the 2018 midterms. 'Give me a break, This is just fear-mongering from Democrats,' Sen. Bill Cassidy (R-La.) said in a post on the social platform X. 'No one's losing health care—unless you count the 1.4 million illegal immigrants getting Medicaid on your dime.' 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A bloc of Republican senators has been raising concerns about some of the Medicaid provisions, and some have said they do not like the idea of anything that could be interpreted as a cut. But by and large, they've signaled the coverage losses aren't what's troubling. '[We need to] protect the program for the people that really deserve and need the help and need the program, you know, and that's children, disabled, seniors, on and on and on,' said Sen. Jim Justice ( 'That's what we got to do. You know, at the end of the day, we shouldn't be protecting the program for people that are abusing or people that shouldn't be eligible, or whatever.' Sen. Josh Hawley (R-Mo.) has said he worries about the bill's potential impact on rural hospitals and pledged to withhold support from any bill that cuts Medicaid benefits. But what is a benefit cut? 'If my state tells me that, because of legislative changes in the House bill, the Senate bill, we're going to have to cut benefits. That's a benefit cut,' Hawley told The Hill. Missouri has 1.3 million Medicaid beneficiaries, but Hawley said he thinks there would only be a small number impacted by the work requirements. 'I'm fine with people who are able-bodied and not working … I'm all for that. So you know what, cut benefits from illegal aliens. Yeah, I'm fine with that, but I'm concerned about people who are here legally, residents of my state, citizens of my state, who are working and would lose health care coverage,' he said. Hawley has said that President Trump reiterated his opposition against any Medicaid cuts during recent conversations about the 'big, beautiful bill,' though the president supported the House version. Health experts say the impact of the cuts will go far beyond the small slice of the population Republicans claim. Work requirements will likely add layers of red tape for people to prove they meet the threshold. 'The people losing coverage aren't people who aren't working … but they're actually people who should satisfy the work reporting or should qualify for an exemption, but they can't navigate the complex systems for either reporting one's hours for work or other activities,' said Edwin Park, a research professor at the Georgetown University McCourt School of Public Policy. The legislation includes some exemptions, like for caregiving, but it doesn't specify what would qualify or how beneficiaries would prove they qualify. There's no requirement that states exempt people automatically, Park said, so many people who would be eligible likely wouldn't be enrolled. No matter how Republicans spin it, Park said, 'these are huge Medicaid cuts. They're going to take away coverage from millions of low-income people.' 'And those cuts are going to affect everyone throughout the Medicaid program, not just the expansion group, but also kids, seniors and people with disabilities,' he added. 'And it's going to have big ripple effects throughout the health care system.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.