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Kansas tuberculosis outbreak is America's largest recorded since the 1950s
- WarOnPrivacy 2y agoFrom the article: An tuberculosis outbreak in Kansas has become the largest in recorded history in the US....the CDC started monitoring TB in the US in the 1950s. "This is mainly due to the rapid number of cases in the short amount of time. There are a few other states that currently have large outbreaks that are also ongoing." People with an active infection feel sick and can spread it to others, while people with a latent infection don't feel sick and can't spread it. It is treatable with antibiotics. State public health officials say there is "very low risk to the general public."
- ceejayoz 2y ago> It is treatable with antibiotics. Treating it casually has led to widespread resistance. https://en.wikipedia.org/wiki/Multidrug-resistant_tuberculosis https://en.wikipedia.org/wiki/Multidrug-resistant_tuberculos... https://en.wikipedia.org/wiki/Extensively_drug-resistant_tuberculosis https://en.wikipedia.org/wiki/Extensively_drug-resistant_tub... > People with an active infection feel sick and can spread it to others, while people with a latent infection don't feel sick and can't spread it. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2024/featured-topics/asymptomatic-tb https://www.who.int/teams/global-tuberculosis-programme/tb-r... "Analysis of data from 14 countries in Africa and Asia suggests that about two thirds of global TB transmission may be from asymptomatic TB (95% prediction interval: 27–92%)."
- Spooky23 2y agoYeah… understatement with respect to TB is pretty scary. There’s a limited set of effective antibiotics, some strains are resistant, and some drugs have severe side effects. You have to be a little suspicious of some of this — folks are looking for political reasons for scary disease outbreaks.
- eth0up 2y ago>Treating it casually has led to widespread resistance. I have long suspected this as part of why the subject isn't much discussed, despite being more prevalent than most realize. The elephant here is (aside from latent infection) the atypically long duration of treatment, which can exceed 6 months and is harsh. Many, even otherwise responsible people, will founder before the proper end of treatment and this, I think, is what terrifies health professionals - so much, that it almost seems to be avoided. It's probably time we start looking a bit harder for "natural" or alternate treatments. Some in medical journals, are under scrutiny, but inconclusive. Edit: I also think we'll be finding more about latent infections being involved in an array of other ailments, especially when mixed with the ultra prevalent EBV. And EBV is involved in a lot.
- tbrownaw 2y ago> It's probably time we start looking a bit harder for "natural" or alternate treatments. Is the idea that a different label would lead to higher compliance rates?
- eth0up 2y agoResistance. It's not quite the end of the world if TB becomes impervious to, say, catnip or whatever, which isn't front line medicine. And some options might have a more mechanical rather than biological mechanism/function. Compliance for a 6 month course of just about anything is difficult and more so for something that may seem asymptomatic. Oozing sores, foul oders and overt discomfort would probably help, but alas...
- Eisenstein 2y agoI'm sorry but this doesn't make sense. Antibiotic resistance to TB only affects those who have TB, so if another 'natural' medicine is found and TB gets resistant to it, then it is still just as bad for the people affected. Natural means nothing in this context. Effective medicine is effective medicine, and there is nothing that makes TB less prone to developing a resistance to a 'natural' effective medicine over any other effective medicine.
- JoBrad 2y agoOn top of it being more resistant, we haven’t made very many new medicines to fight it in the last ~50 years.
- llamaimperative 2y agoThis is the type of thing that'd normally show up on CDC's Morbidity and Mortality Weekly Report which has been published weekly since 1960 (my understanding is this is without fail). But unfortunately the current administration has decided an ideological purification is more important than keeping the American public apprised of threats to their health. So it wasn't published last week, and probably won't be this week either. "Politics don't matter" though ;) Bummer! https://www.cdc.gov/mmwr/ https://www.cdc.gov/mmwr/
- johnnyanmac 2y agoHow is it that Trump is so timely at cutting medical resources right before the moment it is most needed? Or perhaps such outbreaks are more common than you'd expect and it's the equivalent of leaving a firewall down for a day? And yeah, I'm aware a bigger factor in this freeze was hiding the very obvious Bird Flu pandemic. Can't hide the eggs getting more expensive though.
- sieabahlpark 2y ago[dead]
- llamaimperative 2y ago> Or perhaps such outbreaks are more common than you'd expect and it's the equivalent of leaving a firewall down for a day? I think this + bad luck, really.
- throwup238 2y agoLuck is the intersection of preparation and opportunity. In this case lots of opportunity and zero preparation.
- llamaimperative 2y agoWell said!
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- levocardia 2y agoHow can this possibly be America's largest TB outbreak in history? TB was killing thousands of people per year in America in the 1800s.
- PhoenixReborn 2y agoThe crucial word in the headline is "recorded". I doubt that record-keeping in the 1800s was as comprehensive as it is today. Additionally, from the article: > the CDC started monitoring TB in the US in the 1950s.
- lolinder 2y agoEh, "recorded history" is totally the wrong phrase. When we say "recorded history" we don't mean "the window of time in which we have detailed records up to our modern standards", we specifically mean "the window of time in which we have records of any sort", contrasted with "prehistory". The phrase they were looking for is "largest on record" or even better "largest since 195X". > For broader world history, recorded history begins with the accounts of the ancient world around the 4th millennium BCE, and it coincides with the invention of writing. EDIT: Downvote away, but I'd be interested to hear from someone who believes that "recorded history" is not incorrect and confusing usage here, with an explanation rather than a drive by vote. https://en.m.wikipedia.org/wiki/Recorded_history https://en.m.wikipedia.org/wiki/Recorded_history
- Havoc 2y agoIs the CDC still a thing or did an executive order defund them too?
- malfist 2y agoThey were ordered to halt all publications, cancel trainings and not communicate with state health departments
- Havoc 2y ago[flagged]
- krapp 2y ago[flagged]
- hedora 2y agoIt’s funny because they didn’t actually defund them. That would have saved taxpayer money, and allowing second order positive effects like that would prevent it from being an unmitigated disaster.
- nejsjsjsbsb 2y ago[flagged]
- hedora 2y agoWell done hanging this comment off an incorrectly flagged thread!
- api 2y agoWhat is the supposed rationale for this? Or is this just a general ideological purge of the government? This is going to be a crazy four years, if it’s only four.
- NotYourLawyer 2y agoWeird. Where did it come from? It’s basically unheard of in the US.
- ceejayoz 2y agoWe have roughly 10k cases a year. https://www.cdc.gov/tb-surveillance-report-2023/summary/national.html https://www.cdc.gov/tb-surveillance-report-2023/summary/nati...
- NotYourLawyer 2y agoOh wow, That’s still not much, but I was under the impression it was a lot less common than that.
- doodlebugging 2y agoHere is an early article about the outbreak. [0] [0] https://www.unmc.edu/healthsecurity/transmission/2023/09/05/kansas-multidrug-resistant-tb-outbreak-in-an-unlikely-spot/ https://www.unmc.edu/healthsecurity/transmission/2023/09/05/... Appears that it originated within a family group involving 6 kids and 7 adults.
- admissionsguy 2y agoIt came from abroad.
- doodlebugging 2y agoYes. The question is how did it balloon so quickly if these people were identified an receiving treatment? Is this a breakdown in the case monitoring among Kansas City medical community or something else? The original cases were in low income people who had been born outside the US but whose children were born in the US according to the paper.
- ziddoap 2y agoFrom where? When? Baffles me that someone would write something so definitively yet not expand on it in any way at all. Not saying you're wrong (I have no idea), but what a low-effort comment. I'm curious, you seem (or claim, at least) to know something, can you help me satisfy my curiosity?
- 1oooqooq 2y ago[dead]
- madhadron 2y agoThe BCG vaccine is not protective against tuberculosis in adults. It helps prevent miliary tuberculosis in children. I did my graduate work on tuberculosis. Those of us who weren't vaccinated because of our country of origin refused to be because the vaccine wouldn't help us and it changes testing for TB from a quick skin test to a lung x-ray. It's not barbaric or corrupt or anti-vaccine in this case. It's details of this particular vaccine.
- 1oooqooq 2y agoall countries vaccine children, wich then prevents such outbreaks. what am I missing? ceejayoz: exactly the point of the last remark on my annecdote.
- ceejayoz 2y agoThe US does not widely vaccinate children for TB.
- et-al 2y agoTo back this up, here's one perspective: > TB continues to be one of the major public health threats. BCG is the only available vaccine against TB and confers significant protection against the childhood disease. However, the protective efficacy of BCG against adult pulmonary TB, which represents a larger burden of disease, is highly variable. https://pmc.ncbi.nlm.nih.gov/articles/PMC8712472/#abstract1 https://pmc.ncbi.nlm.nih.gov/articles/PMC8712472/#abstract1
- deleted 2y ago[deleted]
- netman21 2y agoLargest in recorded history is a bit of hyperbole. In the 1800s something like 80% of all Americans had the TB bacillus and of those that came down with TB a huge percentage died.
- cushychicken 2y agoI agree, the emphasis probably should be on “recorded”, not “largest”.
- raffraffraff 2y agoI assumed that the emphasis is correctly on "outbreak", ie: a single statistically significant increase, as opposed to a progressive increase over centuries (which is what led to the huge numbers in the 19th century)
- lolinder 2y agoYeah, the phrase they were looking for is "largest on record", or more precisely "largest in the CDC's records". "Recorded history" has a very specific definition that places it in contrast with "prehistory": it's the time period in which we have written records of any sort, as opposed to the time period in which there is no surviving writing. That both phrases have "record" in them doesn't make them synonymous.
- hinkley 2y agoLargest means a very different thing when the us population is 40 million versus 400m. What’s a heinous tragedy in one could be an existential threat in the other.
- boringg 2y agoHow are you going to get people to click on the article without hyperbole?
- odyssey7 2y agoThat’s pretty much what I was looking for in clicking on the article, by what logic or rationale they made that statement.
- mhandley 2y agoNot being from the US, I find it odd that the article didn't mention anything about vaccination. Until 2005, pretty much everyone in the UK received the BCG vaccine. After that the TB rate fell too low to merit routine vaccination, but even today it's still given routinely in a few areas where the rate merits it, or if there's elevated risk of exposure via family from abroad, etc. Has vaccination in general become such a divisive topic in the US that articles about diseases for which we used to routinely vaccinate don't even mention that a vaccine is available and greatly reduces the risk of the most severe forms of TB, such as TB meningitis?
- ksenzee 2y agoIt’s a valid question, but I don’t think the current vaccine-unfriendly climate in the US is the reason why the BCG vaccine wasn’t mentioned. BCG wasn’t routinely given in the US even in the last half of the 20th century when vaccines were universally popular. I was surprised to learn a TB vaccine even existed when I started a public health−adjacent job in the 2000s. Our public health establishment just isn’t convinced it’s worth giving here.
- BeetleB 2y agoThe US medical community never accepted the effectiveness of that vaccine. They don't think it does a good job at prevention and it makes it harder to detect as anyone whose had that vaccine treats positive with the skin test.
- ksenzee 2y agoAll of the above, as well as the fact that the incidence of TB is already so low that the vaccine could cause more harm than it prevents.
- rob74 2y agoAside from TB, you could also call this "the tragedy of vaccination": vaccination causes the incidence of a life-threatening disease to become so low that people consider the vaccine to cause more harm than it prevents - until the vaccination rate becomes so low that the life-threatening disease is back.
- williadc 2y agoJohn Green, author of "The Fault in Our Stars", "Turtles All the Way Down", "The Anthropocene Reviewed", and other fine books is releasing a book called "Everything is Tuberculosis." If you are interested in the topic or just like to read well-written prose, I recommend joining me in pre-ordering it.
- shanedrgn 2y agoOn that train with you, counting down the days until March!
- spuz 2y agoFor what reasons do you recommend it?
- biohcacker84 2y agoBecause even bad writers have fans.
- williadc 2y agoTwo reasons: I enjoy Green's work; he's been researching this subject for a few years, so I expect a pretty thorough analysis.
- dennis_jeeves2 2y agoTurtles All the Way Down - second this book.
- 3eb7988a1663 2y agoI had a TB scare last year. Coworker was exposed to a confirmed case. Got tested, and we all turned up negative. I then asked if I could get a TB vaccine, but was told no, because it makes the TB visual assessment test useless. So, to aid future potential diagnoses, I need to be able to be infected by the genuine article.
- ksenzee 2y agoThat’s one reason the BCG vaccine isn’t given in the US, but it’s also because the data on whether it’s effective in adults is really inconsistent. It seems to vary based on geography (maybe distance from the equator? they’re not sure). If we were going to administer it routinely, it would be for infants, where the data is better.
- throwup238 2y agoCan confirm. I got the vaccine in the Soviet Union as a kid and tested positive in the US for school admission and when volunteering with special kids. It’s a huge pain in the ass every time because doctors insist on a course of antibiotics that is particularly hard on the liver or kidneys so I have to spend significant time fighting them and getting an exception from administration.
- BeetleB 2y agoThat's silly. There's a globule test that doesn't give a false positive for vaccinated people. Perhaps it's more recent than when you last had to go through this?
- throwup238 2y agoWhat’s the name for that test? I last had one in the late 2000s
- BeetleB 2y agohttps://www.cdc.gov/tb/testing/blood-test.html https://www.cdc.gov/tb/testing/blood-test.html Developed in the 90's. Approved by the FDA in 2005. Probably took a while for it to become widespread. The thing is: The protocol for a positive skin test wasn't "Here, take this 9 month treatment." It was "You need a chest X-Ray to show it's not active. If not, you're good to go!" Especially if they know you've received the vaccine. And no one should have made you go through the treatment multiple times - it's pointless, because even if you never had the vaccine but had latent/active TB, you will always test positive with the skin test. Knowing you'd gone through treatment once should have sufficed. I know a nurse who definitely has latent TB (i.e. no vaccine). And she never had problems after a positive skin test - her employers always knew about it and as long as she had a clean chest X-Ray, she was deemed fit to interact with (at risk) patients. Whoever made you go through treatment was incompetent.
- LarsKrimi 2y agoFun historical incident, but the "Spanish Flu" was traced back to Fort Riley Kansas. I think some people highlight a specific pig farm even. Now, the CDC do not list any infections of H1N5 in Kansas yet, but... Worth looking out for in anticipation maybe? Is there any reason why Kansas would be different than other states in particular?
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- metadat 2y agoIs there public reporting for actions taken by the current American Presidential Presidency? It would be useful and highly informative to be able to visit a single page to see daily/quarterly/bi-annual/annual diffs of which efforts habe received signoff.
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- stefantalpalaru 2y ago[dead]
- aaronbrethorst 2y agoI have a lot of disagreements with HL Mencken, but I’ve found myself thinking about this quote of his a lot lately…for whatever reason. “Democracy is the theory that the common people know what they want, and deserve to get it good and hard.”
- mjmsmith 2y ago"As democracy is perfected, the office represents, more and more closely, the inner soul of the people."
- CHB0403085482 2y agoTo me, TB is ultimate test of character. Stopping TB means you care for your common man: https://youtu.be/GFLb5h2O2Ww?t=75 https://youtu.be/GFLb5h2O2Ww?t=75
- tim333 2y agoI was shocked that that said 2bn people carry TB, though it seems from recent research the number is much lower https://www.iavi.org/iavi-report/upending-the-dogma-of-tb-latency-will-it-offer-new-clues-for-vaccine-research/ https://www.iavi.org/iavi-report/upending-the-dogma-of-tb-la... I'm surprised people put up with it when there's a vaccine.
- mrguyorama 2y agoNobody "puts up" with TB. Poor countries and communities cannot afford the options on the market. TB wont be solved until we put people before profit.
- tim333 2y ago>The cost of BCG is US$2–3 (£1.12–1.70) per dose (from https://pmc.ncbi.nlm.nih.gov/articles/PMC2083037/ https://pmc.ncbi.nlm.nih.gov/articles/PMC2083037/) Even for poor countries it's not much. In the UK when I had it they sent a nurse round to the school and all the kids lined up and they did like one a minute. Free to us lot of course on the NHS. I think it was quite nasty and leaves a scar though.
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- habakul 2y ago[dead]
- chairmansteve 2y agoShhhh.... don't tell the CDC.
- TaoWay 2y ago[dead]
- gigatexal 2y agoIf RFK jr becomes HHS lead and is able to push anti-vax policies this could only get worse.
- anonfordays 2y agoMy friend's husband is a physician that works along the Mexican border and volunteers at migrant shelters. He said the amount of TB that comes through the border is shocking.