Tuberculosis (TB) Outbreak In The Kansas City Metro Area Largest In Modern US History

     An ongoing tuberculosis (TB) outbreak in the Kansas City metro area has become one of the largest in modern U.S. history, with health officials confirming 67 active cases and 79 latent infections across Wyandotte and Johnson counties as of January 2025. Linked to two deaths in 2024, the outbreak highlights broader concerns about TB resurgence and systemic public health challenges.

     The Kansas Department of Health and Environment (KDHE) initially called it the "largest documented outbreak in U.S. history" since federal tracking began in the 1950s. However, the CDC later clarified that while significant, it does not surpass past outbreaks, including a 2008–2017 Atlanta homeless shelter outbreak (170+ active cases) and a 2021 bone graft-linked incident (113 cases). Despite this, the Kansas outbreak’s rapid spread—70+ active cases since January 2024—alarms experts.

The outbreak coincides with a 15% increase in U.S. TB cases in 2023 (9,615 cases), the highest since 2013. Factors driving this rise include:

• Global migration: 70% of U.S. TB cases occur in non-U.S.-born individuals.
• Healthcare disruptions: Pandemic-related delays in diagnosis and treatment.
• Drug resistance: A 2021 Kansas City outbreak involved multidrug-resistant TB (MDR-TB), complicating treatment.

     TB disproportionately impacts marginalized communities, with racial and ethnic disparities projected to account for 45% of U.S. TB cases and 44% of deaths from 2023–2035, costing $914 million in economic losses. Nationwide, TB’s societal burden—including healthcare expenses and lost productivity—could exceed $1.4 billion annually.

• Federal communication freeze: A Trump administration policy has halted CDC, NIH, and HHS public health updates, complicating outbreak response.
• Latent TB risks: 5–10% of latent cases (like the 79 in Kansas) can reactivate, especially among immunocompromised individuals.
• Resource strain: Kansas’s TB cases surged from 37–43 annually pre-2020 to 52 in 2022, straining local systems.

     While TB remains rare in the U.S. (2.9 cases per 100,000 people), experts warn that underfunded public health infrastructure and global TB prevalence (8.2 million cases worldwide in 2023) threaten progress. Dr. Dana Hawkinson of the University of Kansas Health System called the outbreak a “serious alert,” emphasizing the need for vigilance in testing and treatment.The Kansas outbreak underscores the fragility of TB control efforts and the urgent need for sustained investment in public health to prevent future crises.