The Silent Return of an Ancient Foe

The world has seen a troubling rise in tuberculosis (TB) cases, a lung infection often marked by a harsh cough. This resurgence began in January 2024 in Kansas City, Kansas, and nearby counties, with 147 people diagnosed as of early March 2025. Of these, 67 people became sick, while 80 others carried the disease without showing symptoms, a condition known as latent TB. TB is a global killer, second only to COVID-19 in recent years. It has been around for thousands of years, with evidence found in 9, 000-year-old remains. The ancient Greeks called it phthisis, noting how it caused people to waste away. Throughout history, it has been known by many names, such as consumption, the white plague, and the king's evil, reflecting its devastating impact. The disease is caused by Mycobacterium tuberculosis, which can be spread through the air when an infected person coughs, sings, or even breathes. It can also spread through unpasteurized dairy products or bone grafts, though this is rare. The exact origin of the recent outbreak in Kansas is unknown, but it has hit low-income communities hard, with two deaths reported.

The COVID-19 pandemic has played a significant role in TB's resurgence. Globally, TB cases increased by 4. 6 percent from 2020 to 2023, reversing decades of decline. In the U. S. , cases rose by over 15 percent from 2022 to 2023. Lockdowns and fear of COVID-19 made it difficult for people to access healthcare, leading to nearly 700, 000 excess TB deaths. Medical supply shortages and delays also contributed to this uptick. Treating TB is complex. Before the late 1930s, treatments included bloodletting, cod liver oil, and sanatoriums in high-altitude areas. The first antibiotic, streptomycin, became available in the 1940s, but resistance developed quickly. Isoniazid followed in the 1950s, with similar issues. Today, multidrug treatments are used, but they are toxic and require at least six months of uninterrupted therapy. Early detection and treatment are crucial to prevent the spread of the disease and the development of drug-resistant strains. People need to understand that TB is still a global health issue. Education about its transmission, treatment, and the need for eradication efforts is vital. Many people with latent TB may not know they have it, as they show no symptoms. Without awareness and testing, these individuals may unknowingly spread the disease.

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