It sounds like something out of a 19th-century medical journal—a disease long thought controlled, if not entirely forgotten. But in a modern twist that’s raising eyebrows and concerns alike, this ancient illness is quietly making a comeback in parts of the United States.
It’s not a new virus, nor a mysterious condition emerging from an unfamiliar corner of the globe. In fact, it’s something humans have battled for thousands of years. Yet despite advances in medicine, public health systems are once again facing outbreaks that are difficult to trace, harder to contain, and easier than expected to miss.
So what exactly is going on—and why now? The story behind this resurgence is part history lesson, part public health puzzle, and a reminder that some threats don’t stay buried forever.
The Kansas Outbreak: A Wake-Up Call
In early 2024, Kansas became the unexpected epicenter of a tuberculosis (TB) outbreak that has since grown into the largest of its kind in the United States in recent decades. As of early 2025, health officials have confirmed 67 active TB cases—60 in Wyandotte County and seven in Johnson County—alongside 79 latent infections.
While TB is often associated with the past, this outbreak serves as a stark reminder that the disease remains a present threat. The outbreak has resulted in two deaths, and although the general public’s risk remains low, the situation underscores vulnerabilities in public health infrastructure.
Efforts to contain the outbreak have involved extensive contact tracing, testing, and treatment initiatives. Health authorities emphasize the importance of early detection and adherence to treatment protocols to prevent further spread.
A Disease Older Than History
Long before modern medicine had names for it, tuberculosis haunted humanity. Archaeologists have discovered evidence of the disease in the remains of people who lived more than 9,000 years ago. Ancient bones from the Eastern Mediterranean show telltale signs of TB—making it one of the oldest known infectious diseases still affecting us today.
In classical Greece, Hippocrates described a condition he called phthisis, a word meaning “to waste away.” The name couldn’t have been more apt: TB has long been known for its ability to emaciate its victims, hollowing them out both physically and emotionally. In later centuries, the disease went by other names—“consumption,” “white plague,” and even “the robber of youth”—each reflecting the slow, devastating toll it took, especially on people in their physical prime.
The mystery surrounding TB persisted until the 19th century, when army physician Jean Antoine Villemin proved that it was contagious by transmitting it from sick animals to healthy ones. But it wasn’t until 1882 that German physician Robert Koch identified Mycobacterium tuberculosis, the bacterium behind the disease. That discovery would lay the foundation for World TB Day, observed annually on March 24 to raise awareness of this enduring public health threat.
How Tuberculosis Spreads (And Why That Matters Now)
Unlike many infectious diseases that require close contact or bodily fluids, tuberculosis is stealthier—and potentially more dangerous—because it spreads through the air. A single cough, a few words spoken, even simple breathing can release microscopic droplets carrying Mycobacterium tuberculosis. In confined indoor settings, these droplets can hang in the air for hours, ready to be inhaled by unsuspecting passersby.
That’s what makes TB uniquely tricky in crowded environments like prisons, shelters, shared housing, and even hospitals. While not everyone exposed to TB will get sick, those who do may either develop active TB—complete with symptoms like a chronic cough, fever, and night sweats—or fall into the category of latent TB, where the bacteria hide silently in the body, sometimes for years, without any signs. The latter are often unaware they’re carrying a contagious disease.
Adding to the concern are so-called “super spreaders,” individuals with especially infectious cases who unknowingly transmit TB to large numbers of people before a diagnosis is made. Public health experts stress that a single untreated TB patient can infect 10 to 15 people within a year. Multiply that by delays in diagnosis and treatment, and you begin to see how one case can quietly snowball into a full-blown outbreak.
Why Now? Pandemic Disruptions and the Perfect Storm
For decades, tuberculosis had been on a slow and steady decline—until the COVID-19 pandemic hit like a wrecking ball. In the scramble to address a new global crisis, routine care for longstanding diseases like TB fell through the cracks. Clinics closed, screenings were missed, treatment regimens were interrupted, and patients—fearing exposure to COVID—stayed home even when symptoms emerged.
Globally, TB cases rose by 4.6% between 2020 and 2023, effectively undoing years of progress. In the U.S., the numbers were even more jarring: a 15% spike in TB cases from 2022 to 2023 alone. These aren’t just statistics—they’re symptoms of a broken system struggling to juggle multiple public health threats at once.
The ripple effects extended far beyond doctor visits. Drug shortages plagued the healthcare supply chain, including critical TB medications like isoniazid and rifampin. These weren’t minor delays—they were roadblocks that left patients vulnerable to disease progression, and in some cases, created the conditions for drug-resistant strains of TB to flourish.
Symptoms You Shouldn’t Ignore
Tuberculosis isn’t always loud in its arrival. In fact, one of the reasons it slips under the radar is because it mimics common illnesses—especially during colder months when colds, flu, RSV, and COVID-19 are already crowding the diagnostic table. But while a lingering cough might seem harmless at first, it can be the first clue to something far more serious.
The hallmark signs of active TB include:
- A persistent cough lasting more than three weeks
- Low-grade fevers, often worse in the evening
- Night sweats that soak through clothes or sheets
- Unexplained weight loss and loss of appetite
- Fatigue and general weakness
- Coughing up blood (in advanced cases)
- Chest pain or difficulty breathing
These symptoms may develop slowly, which is why many people brush them off or get misdiagnosed with asthma, bronchitis, or other respiratory conditions. The real danger lies in this delay—because while someone is figuring out what’s wrong, they could be spreading TB without even knowing it.
Chest X-rays often reveal a telltale sign known as a cavitary lesion—a hollowed-out area in the lungs where the immune system has tried (and often failed) to trap the infection. But by then, the damage is already in motion.
A Treatment Story Full of Twists
The story of tuberculosis treatment reads like a timeline of medical trial and error—an ongoing tug-of-war between science and survival. Before antibiotics, TB patients were often sent to sanatoriums nestled in high-altitude locations like the Rockies or Adirondacks, where crisp air and rest were believed to be healing agents. Some treatments even involved oddball ideas like inhaling cow fumes or drinking raw milk—needless to say, none of these were based on solid evidence.
Everything changed in the 1940s with the discovery of streptomycin, the first true antibiotic to show promise against TB. For a moment, it felt like science had won. But TB, ever the crafty pathogen, quickly developed resistance. Next came isoniazid in the 1950s, followed by rifampin and other drugs, often combined into multi-drug regimens to outsmart the bacteria.
Today, curing TB is possible—but far from easy. Treatment for active TB typically involves a six-month course of antibiotics, taken religiously. Any interruptions can lead to multi-drug resistant TB (MDR-TB), which requires more toxic drugs, longer courses (sometimes up to 9–12 months or more), and even harsher side effects. For latent TB, shorter regimens exist—but many people never know they need them.
And that’s part of the problem. TB treatment is not just physically taxing—it’s psychologically draining. Patients must endure months of side effects while juggling work, family, and, in some cases, the stigma of having an infectious disease. Even after “cure,” the experience often leaves a mark. Many patients report lasting health issues, fatigue, or fear of relapse.
Who’s Most at Risk Today?
Tuberculosis doesn’t discriminate—but it definitely plays favorites. While anyone can technically catch TB, certain groups are disproportionately affected due to a mix of social, environmental, and medical factors. And in the U.S., the data paints a clear picture: TB tends to hit hardest where healthcare access is already limited.
Those most at risk include:
- People experiencing homelessness: Crowded shelters, poor ventilation, and lack of consistent medical care create a perfect breeding ground for transmission.
- Incarcerated individuals: Prisons are notorious for TB outbreaks due to shared airspace and delayed diagnoses.
- Immigrants from TB-endemic countries: Individuals from parts of Asia, Africa, Latin America, and Eastern Europe often arrive with latent TB, which can become active years later—especially if their immune systems weaken.
- Ethnic and racial minorities: In states like Colorado, over 85% of TB cases occur among people identifying as Hispanic, Black, or Asian, despite these groups comprising a much smaller percentage of the overall population. This disparity reflects broader systemic issues in healthcare access and socioeconomic conditions.
- People with weakened immune systems: Individuals living with HIV, diabetes, or undergoing treatments like chemotherapy are more likely to develop active TB if exposed. In fact, a diabetes diagnosis is currently one of the strongest medical predictors for TB progression in the U.S.
- Children and older adults: These age groups often have less robust immune defenses. TB cases in children are especially alarming—they’re not only more vulnerable to severe outcomes but also indicate recent transmission within a community.
- Healthcare workers: Those on the front lines—especially in emergency rooms or respiratory wards—face ongoing risk of exposure, which is why regular TB testing remains standard protocol in many facilities.
What You Can Do to Protect Yourself and Others
Tuberculosis may be ancient, but the tools to fight it are in your hands—if you know how to use them. Whether you’re concerned about your own health or looking to help safeguard your community, here’s a breakdown of practical, proactive steps you can take.
1. Know the Symptoms—And Don’t Brush Them Off
If you have a persistent cough, night sweats, fatigue, or unexplained weight loss, don’t assume it’s “just a cold” or allergies. Especially if these symptoms last more than a few weeks, it’s time to talk to a doctor.
2. Get Tested If You’re At Risk
Been around someone with TB? Traveled to or lived in a country where TB is common? Work in healthcare or corrections? You may be carrying latent TB without knowing it. A simple blood test or skin test can reveal whether you’re infected—and early treatment can stop it from ever becoming active.
3. Complete the Full Course of Treatment
Stopping antibiotics too soon is a recipe for disaster. It not only increases your risk of getting sick again but also contributes to drug-resistant TB, which is much harder (and more painful) to treat. Stick to your medication plan, even if you start feeling better halfway through.
4. Don’t Wait—Seek Help Early
Early intervention is key. The longer TB goes untreated, the more it spreads. If you’re feeling sick—or even just suspicious—contact a healthcare provider as soon as possible.
5. Practice Respiratory Hygiene
Cover your mouth when coughing or sneezing, and wear a mask if you’re feeling unwell. In TB hotspots or shared housing environments, good ventilation and air circulation also reduce the risk of transmission.
6. Support Public Health Measures
TB isn’t just a medical issue—it’s a public health one. Encourage screening programs, awareness campaigns, and community outreach efforts, especially in at-risk populations. Being informed and involved helps keep everyone safer.
7. Destigmatize the Diagnosis
TB still carries a social stigma in many communities, which keeps people from getting tested or treated. A little empathy can go a long way. Remember: TB is a disease, not a character flaw.
8. Keep Up With Your Health Checkups
Regular doctor visits can help catch TB before it becomes symptomatic—especially if you’re in a higher-risk group due to age, occupation, or medical history.
9. Stay Informed About Local Outbreaks
Follow updates from your local health department. Being aware of outbreaks in your region can help you take timely precautions and recognize symptoms earlier.
10. Advocate for Access
Push for better healthcare access in underserved areas. TB thrives where healthcare falters. Supporting policies that fund diagnostics, medication, and outreach can break the cycle of infection.
Old Foe, New Urgency
Tuberculosis isn’t some ancient threat preserved in medical textbooks—it’s here, it’s real, and it’s reminding us that public health victories can be undone if we’re not paying attention. The Kansas outbreak wasn’t just a medical anomaly—it was a warning shot. A reminder that diseases don’t vanish just because we stop talking about them.
In a time when healthcare systems are stretched and misinformation spreads faster than airborne bacteria, TB is taking advantage of the cracks. From latent carriers who don’t even know they’re infected to the rise of drug-resistant strains, this isn’t just a historical comeback—it’s a modern problem with real consequences.
But here’s the hopeful part: we’re not powerless. Early detection, widespread education, equitable healthcare access, and a serious investment in prevention can still shift the tide. It starts with awareness—and continues with action. Because when it comes to tuberculosis, turning a blind eye is the most dangerous symptom of all.
