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Tuberculosis cases rise, but public health agencies say they lack the resources to keep up

Nada Hassanein, on

Published in News & Features

A person can have what’s called latent tuberculosis, an infection that isn’t contagious and doesn’t show symptoms, but can become active and contagious if the immune system fails to contain it.

“[TB] can be insidious. It can look different ways,” Kelliher said. She noted that along with pulmonary TB, there are other types that affect the bones or kidneys. “TB can be a great pretender.”

Kelliher, who is Koyukon Athabascan and from Nome, Alaska, knows the disease well: Her birth grandmother died from it, and her other grandmother, who adopted her mom, had a lung resection because of the disease, she said.

“The effects of TB are multigenerational and cannot be overstated as far as the disease and the way that it has devastated our populations in the past,” she said. “We tend to live in closer quarters.”

U.S. territories, including the Marshall Islands, the Northern Mariana Islands and Guam also see high rates: In 2021, each had 280.6, 67.8 and 34.4 cases per 100,000 people, respectively.

Chibo Ahrum Shinagawa, senior program manager of infectious diseases at the San Francisco-based Association of Asian Pacific Community Health Organizations, works on outreach and access to care in Pacific Islander communities on the mainland. She also manages the national TB Elimination Alliance.


Her group works with the CDC and community organizations on education efforts designed to “break down the stigma of TB and connect those most vulnerable, those with the most language barriers, those that need that culturally relevant and culturally linguistic care, back to the public health departments,” said Shinagawa.

An estimated 13 million people in the U.S. are living with latent tuberculosis, the CDC says, and many of them don’t know they have the disease. Experts say awareness around risk factors is imperative, so that people can get tested and prevent spread in case it becomes active.

As Congress considers cutting the CDC’s budget, Benjamin said he hopes to see resources preserved and allocated to the agency for tuberculosis control so it can better support states’ efforts.

“There really needs to be a statewide effort to address this,” said Benjamin. “There needs to be a greater emphasis on tuberculosis. Not that the CDC is not trying; they need the resources to do it.”

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