The biggest TB crisis since the 1950s vs a federal health communications freeze: What’s the worst we can expect?

By MDLinx staff | Fact-checked by Davi Sherman
Published January 29, 2025

Key Takeaways

Industry Buzz

  • “An outbreak like this normally would be alerted to the general public and physicians through the CDC’s Health Alert Network, which is not happening right now because there is still a pause that’s been issued by the executive branch of the government to federal health agencies. This pause needs to stop as quickly as possible, because to tackle public health problems, communications is key.” — Zachary Rubin, MD @rubin_allergy

Kansas is currently grappling with a significant tuberculosis (TB) outbreak, marking one of the largest recorded outbreaks in the United States since the 1950s.[] As of January 24, 2025, health officials have reported 67 active TB cases and 79 latent infections, primarily concentrated in Wyandotte and Johnson Counties.

While the Kansas Department of Health and Environment (KDHE) has labeled this as the largest documented TB outbreak in US history, the CDC notes that previous outbreaks, such as those in Georgia (2015–2017), and a nationwide surge in 2021, have seen higher case numbers.[]

Docs worry about related impacts of federal spending freeze

Allergist and immunologist Zachary Rubin, MD, shared a video on Instagram that noted an important issue about the outbreak as it relates to the Trump administration’s freeze on federal spending, encompassing grants and loans to local governments, hospitals, schools, and businesses.[] While the spending freeze was rescinded Wednesday morning, it is still unknown if communication between the government and its health agencies has also resumed.[]

“An outbreak like this normally would be alerted to the general public and physicians through the CDC’s Health Alert Network, which is not happening right now because there is still a pause that’s been issued by the executive branch of the government to federal health agencies,” Dr. Rubin shared in his video. “This pause needs to stop as quickly as possible, because to tackle public health problems, communications is key.”[]

The freeze has created significant communication breakdowns between health agencies and the government.[] Public health officials have reported delays in critical guidance, as agencies like the CDC and state health departments struggle to get clear directives or approvals for outbreak response measures. In Kansas, health officials working to contain the tuberculosis outbreak have faced bureaucratic roadblocks, with routine data-sharing and funding requests caught in limbo. 

This lack of coordination could make it harder for local health departments to scale up testing, secure medications, and deploy public health interventions in a timely manner. Without a clear communication pipeline, healthcare professionals are left navigating uncertainty, potentially hindering outbreak containment efforts.

2 fatalities so far

The outbreak has been linked to two fatalities since it began in January 2024,[] and the ongoing surge is part of a broader national trend. After a significant decline in TB cases over 27 years, the US experienced a notable decrease in 2020, coinciding with the COVID-19 pandemic.[] However, subsequent years have seen an uptick in cases, with 9,615 reported in 2023.

TB, caused by Mycobacterium tuberculosis, primarily affects the lungs and is transmitted through airborne particles. While latent TB infections are asymptomatic and non-transmissible, they can progress to active disease if not adequately treated.[] Treatment involves prolonged antibiotic regimens, often lasting several months.

What’s behind the outbreak?

The current outbreak in Kansas has been traced to a close-knit community, where prolonged interpersonal contact has likely contributed to the rapid spread. Health officials have not disclosed specific details about the affected group but emphasize that TB thrives in environments with frequent, sustained exposure. 

While no definitive index case has been identified, the outbreak underscores the importance of screening high-risk populations, including those in congregate living settings or with limited access to healthcare.

Healthcare professionals should remain vigilant, especially when treating patients from high-risk groups or those presenting with persistent respiratory symptoms. Early detection through appropriate testing and prompt initiation of treatment are crucial in controlling the spread of TB.

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