Do I need a tuberculosis vaccine in Illinois? What to know as Kansas fights outbreak
As Kansas grapples with a deadly tuberculosis outbreak, Illinois public health officials are keeping a vigilant watch to ensure any cases within the state are reported and mitigated.
The Illinois Department of Public Health reported 353 tuberculosis cases in 2023, the most recent year for which data is available. Three of those cases were in St. Clair County, and two were in Madison County. Illinois reported more tuberculosis cases across the state in 2023 than in recent years, with 298 cases reported in 2022 and 254 in 2021, according to IDPH.
“Illinois typically has had a little bit of a higher number for tuberculosis,” Dr. Vidya Sundareshan, infectious diseases specialist with Southern Illinois University Medicine and medical advisor to Sangamon County Department of Public Health, told the News-Democrat in a Feb. 13 interview.
Tuberculosis is considered a “reportable disease” in Illinois, but the state health department doesn’t publicly report the numbers as frequently as it updates the respiratory virus dashboard. Some reasons for this are there are strict criteria to count a tuberculosis case, the period of infection risk after exposure lasts a lifetime and it’s a slow-growing bacterial infection, Sundareshan said.
While tuberculosis is a more widespread issue in India, China, Russia and African countries, there were 9,615 cases reported in the U.S. in 2023.
“It’s one of the oldest diseases that’s known to humankind, and we still kind of struggle to find a way to control it because there are so many public health implications,” Sundareshan said.
Chicago has a disproportionately high number of the state’s tuberculosis cases, but it’s a statewide issue, including in the metro-east.
The tuberculosis outbreak in Kansas, for which related cases were first reported in January, has killed two people and caused at least 67 to need treatment for active infections, CNN reported.
More on tuberculosis
When someone is exposed to tuberculosis and they have a solid immune system, most are typically able to contain the infection and don’t really experience symptoms. This is called a latent tuberculosis infection.
But when someone’s immune system is not able to fight off the infection, or someone’s latent infection reactivates, it becomes tuberculosis disease. It typically starts off as a pulmonary disease, spread through airborne particles that are inhaled.
Common pulmonary tuberculosis symptoms include coughing up blood, relentless coughing, fever, night sweats, weight loss and fatigue.
Extra-pulmonary tuberculosis can also be developed, and especially for those with a compromised immune system, the infection can disseminate and cause enlarged lymph nodes, tuberculosis meningitis, adrenal problems and infection around the heart.
“The mortality is high without treatment,” Sundareshan said.
The World Health Organization reports untreated tuberculosis disease has a mortality rate of about 50%.
Those at the greatest risk of developing tuberculosis disease after infection include people older than 65, children younger than 5, people living in congregate settings, people receiving immunocompromising medications and those with certain pre-existing health conditions.
“People with HIV have a higher risk of reactivation disease or getting tuberculosis disease after exposure,” Sundareshan said.
Someone who is exposed to tuberculosis has a 15% lifetime risk of developing tuberculosis disease, but the greatest risk is within the first year of exposure and the likelihood decreases as time passes.
Nursing students and professionals entering the health care field are often tested for tuberculosis exposure upon matriculation or hiring, and one of the most common tests uses a blood sample. Common diagnostic tools for tuberculosis disease include chest X-rays and sputum testing.
There is a tuberculosis vaccine, but it’s not generally used in the U.S., according to the Centers for Disease Control and Prevention, since the disease isn’t as common. The CDC does recommend people with latent tuberculosis infections undergo treatment, though it likely won’t be as intense as treatments for those with tuberculosis disease.
“We do have very effective treatments for tuberculosis,” Sundareshan said.
Tuberculosis disease is treated through a combination therapy, and patients usually start out taking four medications at once for about two months, then drop to two medications for an additional six months. The disease requires a very long course of treatment, Sundareshan said, from around six months to treat pulmonary tuberculosis up to a year for those with tuberculosis meningitis.
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