An outbreak of tuberculosis, commonly referred to as TB, emerged in January 2024 in Kansas City, Kansas, along with two nearby counties. As of early March 2025, this alarming situation persists, with a total of 147 individuals diagnosed with TB during the outbreak. Out of these cases, 67 have developed symptoms of the disease, while the remaining 80 individuals are experiencing a latent infection, meaning they carry the bacteria without showing any symptoms. TB remains a significant global health concern, being the leading infectious cause of death worldwide, second only to COVID-19 during the early years of the pandemic.
The bacterium responsible for tuberculosis, Mycobacterium tuberculosis, has affected humans for thousands of years. Evidence suggests that TB existed as far back as 9,000 years ago, discovered in the remains of individuals from the Eastern Mediterranean region. The first recorded mentions of TB date back to approximately 410-400 B.C.E., when Hippocrates referred to the disease as "phthisis," a term denoting a progressive "wasting away," reflecting the severe emaciation of those afflicted. Over the centuries, TB has been known by various names, including consumption and the "white plague," referencing the pallid appearance of those suffering from the disease.
Untreated active TB is highly lethal, with nearly 50% of those infected dying if left untreated. However, with appropriate treatment, the mortality rate drops dramatically to around 12%. The disease was also historically referred to as the "king's evil," due to the belief that royal touch could cure scrofula, a form of TB causing neck swelling. It was ominously dubbed the "robber of youth" for its tendency to strike individuals aged 15 to 30. In 1865, Jean Antoine Villemin demonstrated the transmission of TB from infected animals to healthy ones, dispelling earlier beliefs about its causes. The definitive discovery of the Mycobacterium tuberculosis bacterium was made by German physician Robert Koch in 1882, a milestone commemorated annually on World TB Day.
Tuberculosis is primarily spread through small infectious droplets released into the air when a person with TB coughs, sings, or even breathes. While transmission through unpasteurized dairy products is possible, it is quite rare. Additionally, there have been isolated cases of TB transmission via bone grafts. As of early March 2025, the precise origin of the TB outbreak in Kansas remains unclear. The impact of this outbreak has been severe, particularly affecting low-income communities, with two reported deaths. Alarmingly, an untreated TB patient can potentially infect 10 to 15 people.
The COVID-19 pandemic has significantly contributed to the resurgence of TB cases globally. From 2020 to 2023, TB cases increased by 4.6%, reversing years of declining rates. In the United States, there was a more than 15% rise in TB cases from 2022 to 2023. During pandemic-related shutdowns, individuals faced challenges in accessing healthcare for early TB diagnosis or medication refills, often due to fears of COVID-19 exposure. Consequently, nearly 700,000 additional deaths from TB were reported as a result of these healthcare disruptions. Furthermore, medical supply shortages, particularly of essential TB medications between 2021 and 2023, have exacerbated the situation.
The only effective method to cure TB and halt its spread is through multidrug treatment. Prior to the introduction of antibiotics in the late 1930s, TB treatment options included bloodletting and the consumption of cod liver oil, along with isolation in sanatoriums located in high-altitude areas, believed to provide healing benefits. The first antibiotic for TB, streptomycin, became available in the 1940s, but the bacterium quickly developed drug resistance. Over the years, additional antibiotics, notably isoniazid, were introduced, yet drug resistance remains a significant issue. Today, both latent infections and active cases are treated with two- and four-drug combinations, requiring a minimum of six months of uninterrupted therapy. Disruptions in treatment can lead to increased transmission of TB and the emergence of multidrug-resistant strains, necessitating prolonged and more complex treatment regimens.
It is essential for people to recognize that TB continues to be a major public health issue globally. Education regarding the transmission, treatment, and eradication efforts for TB is crucial in combating the disease. Awareness initiatives can help prevent further outbreaks and ultimately save lives.
