Do I need a tuberculosis vaccine in NC? What to know about the outbreak (+ how to stay safe)
The Kansas City area is at the epicenter of an “unprecedented” tuberculosis outbreak, which is among the largest in U.S. history, the Kansas City Star reported. As of Friday, 67 people were being treated for TB in Kansas, according to Kansas’ Division of Public Health.
Should North Carolina residents be worried?
Dr. David Weber, an infectious disease specialist at the UNC School of Medicine, and Dr. Nicholas Turner, an infectious disease specialist at Duke Health, say no.
There were 215 cases of TB reported in North Carolina in 2023, an increase from 164 cases in 2022, according to data from the N.C. Department of Health and Human Services.
But it’s unlikely the outbreak in Kansas will spread to North Carolina.
“They have a pretty good idea who has been infected and who is infectious, so I don’t see much risk for this cropping up elsewhere in the country from this particular outbreak, Weber said. “Even going to Kansas City, I think, would be a low risk.”
Since health officials are closely monitoring the outbreak, Turner said cases will likely be contained.
“We don’t have any evidence that the Kansas cases will be tied to anybody outside of the state,”said Turner.
Here’s what you need to know about TB.
How does TB spread?
TB is a contagious illness that spreads from person to person through the air, according to the N.C. Department of Health and Human Services.
When a person with TB coughs, speaks or sings, people nearby can breathe in the bacteria and become infected, NCDHHS says.
“Family members, roommates and close friends of the sick person are more likely to become infected than the general public,” NCDHHS says. “This is because they spend long periods of time together in enclosed spaces like a home or car.”
However, most people get infected with TB don’t get sick, according to NCDHSS. That’s because their bodies can fight the germs, a condition known as latent TB infection (LTBI).
People with LTBI cannot infect other people, but without proper treatment, the infection can turn into active TB.
Who is most at risk of contracting TB?
Turner said roughly three quarters of TB cases reported in North Carolina were in people born outside of the U.S., noting that those individuals likely had a past TB exposure.
Other factors can increase your risk of developing active TB, according to Healthline, such as:
having a weakened immune system due to cancer, HIV or other conditions
living in overcrowded conditions
traveling to countries with high rates of TB
frequent close contact with someone that has active TB disease
working in healthcare settings that service high risk populations
What are the symptoms of TB?
One of the most common symptoms of TB is consumption, or “wasting away and losing weight,” Weber said.
The Centers for Disease Control and Prevention says TB disease in the lungs symptoms can also include:
A bad cough that lasts 3 weeks or longer
Pain in the chest
Coughing up blood or sputum (phlegm) from deep inside the lungs
Weakness or fatigue
No appetite
Chills
Fever
Sweating
Additionally, symptoms of TB in other parts of the body depend on the area affected. For example, TB disease of the lymph nodes may cause a firm red or purple swelling under the skin, and TB disease of the kidney can cause blood in the urine.
How is TB treated?
TB treatment depends on the type of infection, according to the CDC.
Treatment for those with inactive TB consists of a combination of different medicines that can take up to nine months, the CDC says.
For those with active TB, treatment can take the same amount of time, but there are more medicinal options.
The side effects for these medications can be minor. For example, patients can experience skin rash, upset stomach and nausea, but taking the medication with food can help your body absorb the medicine better.
Side effects can also be more serious, such as liver injury, flu-like symptoms or tingling or numbness in your hands or feet. If you experience serious side effects, you should contact your health care provide immediately.
Should you get the TB vaccine?
The TB vaccine is not widely recommended.
This is because the TB vaccine isn’t effective in most people, Weber said, adding that he’s only administered the vaccine only a couple of times during his career.
But another vaccine — the BCG vaccine, formally called the Bacillus Calmette-Guérin vaccine which was developed more than a century ago — is somewhat effective in infants, Turner said.
“It’s by no means a perfect vaccine,” said Turner. “Its benefits wear off pretty quickly, and so the protection against TB in adults or TB at any point later in life is actually, unfortunately, not very good.”
Since the vaccine is rarely recommended, Turner said it’s not readily available in the U.S.
“It tends to be given to infants in countries with high incidence rates,” Turner said. “I’m not personally aware of any pharmacies that keep it in stock.”
How to prevent TB infections
Masking is one of the most effective ways to prevent TB infections, Weber and Turner said.
“[N-95 masks] work against flu and RSV, and we have a lot of flu right now,” Weber said. “They work against COVID, they work against TB, they work against mumps, measles, rubella and pertussis. So anything that goes through the air, a mask will work.”
Turner also pointed out that the state has a system that notifies people of potential TB exposures.
Health care providers in the state must notify their local health departments if they suspect or diagnose TB. The health department will then investigate and contact people who may have been exposed to TB.
“Just being responsive if you get a call from a local public health department that notified you of a potential exposure” can help prevent severe TB infections, Turner said. “They will typically give some instructions on the next steps for getting screened and, if necessary, getting the preventative treatments for it.”
Healthline also offers the following tips for preventing TB infections:
Avoid close contact with people who have active TB disease.
Wash your hands often and cover your mouth when coughing or sneezing.
Eat a nutritious diet and exercise regularly to keep your immune system strong.
If you’re traveling to a high-risk area and you have a compromised immune system, talk with a doctor about preventive treatments.
This story was originally published January 30, 2025 at 8:18 AM with the headline "Do I need a tuberculosis vaccine in NC? What to know about the outbreak (+ how to stay safe)."
