Kansas is experiencing one of the largest tuberculosis epidemics (TB) never recorded in the United States, because the powers of public health at the level of the state and the federal government have been considerably reduced.
Epidemics like these can become more common and dangerous, because the efforts of officials are paralyzed and their communications are limited, according to experts.
“You can think of tuberculosis epidemics like a canary in coal Health.
“What makes them happen is a weakening of our public health infrastructure.”
Since January 2024, 67 active cases of tuberculosis have been identified in two Kansas counties – more than the usual number of cases for the whole state in one year, despite the counties representing together less than 3% of the population of the state, in our opinion, census data from 2023.
“It’s certainly more than a small blip,” said Dowdy. “It is one of the biggest epidemics of tuberculosis that we saw in the country during the 30, 40, 50 years.”
The state has also detected at least 79 latent cases of tuberculosis, in which patients do not have active symptoms but can develop and spread active disease later.
The state is currently monitoring 384 people who have tests and treatments, Kansas officials said.
Public health officials in Kansas and the United States Centers for Disease Control and Prevention (CDC) “work together to mitigate the risk of tuberculosis in the community and ensure the safety of all individuals”, Jill Bronaugh, Director of Communications For the Kansas department of the department of the Kansas of Health and Environment department, said in a statement.
But the risk for the general public remains low, she said.
“We are also working with schools and businesses to help prevent the spread of tuberculosis by supporting efforts to monitor symptoms and provide education,” said Bronaugh.
It is a difficult battle in a state that has seen the powerful public health powers following the pandemic.
The governor of Kansas was prohibited from closing businesses in the event of an emergency of public health in 2021. And the legislator prohibited officials from the public health of the State and the county to impose tests, of the isolation and closures due to infectious diseases in 2023.
Tuberculosis tends to spread when people spend a lot of time in crowded conditions such as prisons, prisons and homeless shelters. These are also places where people often lack access to adequate health care, which can make infections more likely.
Other factors such as malnutrition, HIV / AIDS and other conditions of immune suppression put people more risky to fall sick.
But what really causes tuberculosis epidemics is the inability for public health professionals, said Dowdy.
“It’s not that we don’t know how to do it,” said Dowdy about treating TB patients and preventing bacteria from spreading. “These are the conditions that underlie this which allow these epidemics to take place.”
When there is a way to detect the first cases, and there are enough health workers to trace and test contacts and support patients who test positive, epidemics can be stopped before even starting.
But when the systems are incomplete or dismantled and there are not enough health workers or resources to go around, “it is easier for this kind of thing to pass either,” said Dowdy.
“The inhabitants of Kansas are doing a good job with this. They simply don’t have the resources they need, “he said.
At the national level, the Trump administration limited what the CDC and other federal health agencies can do by instituting a Blackout of communications in his first weeks.
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The prohibition of external communications includes the restraint of the publication of the weekly ratio of morbidity and mortality (MMWR), a much appreciated epidémiological digest which updates the public and the doctors on emerging and continuous epidemics, among other crises.
Friday, Hundreds of pages have also been deleted from the health agency websites Comply with Donald Trump’s executive decree to remove references to race, sex, sexual identity and disability, among other identities. Some of these pages have now been restored, sometimes with modifications and omissions due to order.
Epidemics such as that of Kansas speak of the importance of coordination between states and national entities such as the CDC, Dowdy said.
“We can only see these kinds of events when you can look from a large scale point of view, and that is why our national agencies are there, but we can only respond to them at the local level, C ‘ Is our state and local health the agencies there for, “he said.
“The importance of being able to coordinate between them and the maintenance of force at the national and national and local levels cannot really be overestimated,” added Dowdy. “The disturbances of these systems certainly increase the risk of such epidemics like this.”
Internationally, the dissolution of the American Agency for International Development (USAID) means that global epidemics of preventable diseases such as tuberculosis could increase.
John Green, the author, star of YouTube and defender of tuberculosis, said that he had worked for months in partnership with private donors, the Philippines and the USAID on a project of $ 85 million to end to tuberculosis in two regions of the Philippines.
“This could provide a plan to eliminate tuberculosis worldwide-except that … does not happen,” he wrote in a job On Bluesky.
Global epidemics are the main engine of tuberculosis cases in the United States.
Although the Kansas epidemic is important, it represented less than 1% of all cases of tuberculosis in the United States last year. About two-thirds of cases are detected among people born outside the United States, pointing to greater transmission outside the country.
The current epidemic in Kansas occurs in the same place as a different epidemic detected in 2021-2022. Tantobble, the strain of the disease in this epidemic has shown resistance to several treatments of tuberculosis, called multidistant tuberculosis (MDR), which can make epidemics more difficult to contain.
There is no sign that this case group shows resistance to treatments – but if the MDR TB had to spread, it could be more difficult to check now.
TB-MD epidemics are often detected by notable peaks in CDC surveillance reports, which can be affected by the order of the gag on American health agencies.
THE report During the 2021-2022 epidemic in Kansas, for example, was published in the now silent MMWR.