HealthDay speaks with Dr. Dana Hawkinson, Director of Infection Control and Prevention at the University of Kansas Health System.
Hi, I’m Dr. Robin Miller for HealthDay. Is tuberculosis making a comeback in the U.S.? After three decades on the decline, TB rates in the U.S. have been steadily increasing since 2020.
The state of Kansas is now experiencing one of the largest TB outbreaks ever recorded in the country.
While the threat to the general public remains low, many experts are blaming the resurgence of this ancient disease on a major crack in our public health infrastructure.
Joining me now is Dr. Dana Hawkinson, an infectious disease doctor at the University of Kansas health system. Hello, and thank you for speaking with us today, Dr. Hawkinson.
Thank you for having me.
Robin Miller, MD, MHS, HealthDay
So, what is the current status of the outbreak happening in Kansas with TB?
So just to set this up a little bit, we know that in 2022, we had an outbreak around here. This is not in any way related to that. That was investigated and all the proper measures were taken. We now have this newest one that was present really throughout 2024. And the most recent update was 67 active cases plus all of the contacts
Over the past couple of months there has been a decrease in the number of active cases that have been diagnosed. I think it continues to be extremely low risk to the general public. And overall, the outbreak is being contained.
Robin Miller, MD, MHS, HealthDay
So, for people watching who may not know a lot about TB, can you tell us what it is, how it spreads and who's most at risk?
Dana Hawkinson, MD, Medical Director of Infection Prevention and Control, The University of Kansas Health System
TB is an ancient disease that has been infecting humans for centuries. It is mycobacterium tuberculosis. The organism is a bacteria. So that's different than, say, measles or SARS-CoV-2, which are viruses.
There are really two forms of tuberculosis. For people with TB infection or latent TB, that means your body has come into contact or been exposed to the bacteria. 90% of people with latent TB or TB infection are never, ever symptomatic. They are not ill. They cannot spread it to people.
It is that 10% or less that can go on to develop TB disease or active tuberculosis. And again, in this case, we're really focusing on the lung infection, pulmonary TB. When you have that, you can cough into the air and you can spread the bacteria through that way. So, it is similar to other organisms. I mentioned measles and SARS-CoV-2 before, but it is not as easy to get tuberculosis. You need to have much more prolonged contact with somebody who is actively expressing the bacteria into the air.
Robin Miller, MD, MHS, HealthDay
Now, there is a treatment, correct?
Dana Hawkinson, MD, Medical Director of Infection Prevention and Control, The University of Kansas Health System
For active TB or TB disease, typically treatment is four drugs that you take for six months or more. Now, the first couple of months, you're taking four drugs. But after that first two months, it goes down to just two drugs. So, there is a decrease once we know and understand that you are no longer contagious.
For latent tuberculosis or TB infection, we also have a treatment for that, as well. And you say, why do I need a treatment for that? I'm not sick. I'm not spreading to anybody. Well, with tuberculosis, if your body has had exposure and you come into contact with it, your body can control it for a long period of time. But there is always that risk that tuberculosis can become active a year later, two years later, five years later, even a couple of decades later.
Robin Miller, MD, MHS, HealthDay
Now, there is vaccine. Who gets that?
Dana Hawkinson, MD, Medical Director of Infection Prevention and Control, The University of Kansas Health System
There is a vaccine available. We do not use that here in the United States. It is mostly given to babies who are at high risk of TB disease in those high risk and endemic areas. You say, why don't we give the vaccine to two people in the United States? Well, number one, it typically used to interfere with our testing modality, which used to be a skin test.
In addition, there is really variable or not very good evidence that the BCG vaccine helps protect people against lung disease, especially adults.
Robin Miller, MD, MHS, HealthDay
How are the current restrictions put on the US health agencies by the new administration affecting this TB outbreak and your concerns about future outbreaks?
Dana Hawkinson, MD, Medical Director of Infection Prevention and Control, The University of Kansas Health System
You know, I think it's too early to tell at this point in time. What I can tell you, though, is that really for a lot of many years in many communities, we know that public health funding has gone down and that's has certainly played a role.
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