Tuberculosis is spreading in California, officials say. Silent bacteria could be why

California is facing a steep rise in tuberculosis cases.

In 2023, the number of tuberculosis cases increased by 271, or 15%, from 2022, according to California Department of Public Health data released in February. The rate of TB in the Golden State has increased each year since 2020, with it now holding the highest number and one of the highest rates of TB cases in the country. And deaths are also mounting.

TB spreads through the air and through contact with someone who has the illness, according to the Centers for Disease Control and Prevention. Symptoms of TB are a severe cough that is often bloody, weight loss, fatigue, night sweats and fever. Once you have TB, it becomes easier to catch other illnesses as well. A case of TB can be lethal if not treated correctly.

“Despite being preventable, tuberculosis (TB) disease continues to cause significant suffering and death in the state of California,” the state Department of Public Health says.

The culprit for California’s TB spike is a bacteria that can go undetected for years, according to experts.

Tuberculosis-causing bacteria — Mycobacterium Tuberculosis — can live in the body for years without causing symptoms. This silent germ is called latent TB infection (LTBI), the CDC says.

“If you breathe air that has TB germs, you may get TB infection,” the CDC said. “This means you have only dormant (sleeping) TB germs in your body. These dormant germs are not making you sick, and you cannot pass these germs to anyone else. If these dormant TB germs in your body wake up and multiply, you will get sick with TB disease.”

According to the California Department of Public Health, 85% of the state’s tuberculosis cases in 2023 were estimated to be due to LTBI progressing to active TB.

“More than 2 million Californians (6% of the population) have LTBI. Without treatment, LTBI can progress to active TB,” the department says.

But there is a test that can prevent that.

“CDPH recommends that healthcare providers test and treat for latent TB infection (LTBI) among patients at risk for TB to prevent progression to active TB disease.”

According to the California Department of Public Health, testing for LTBI is an essential part of keeping TB numbers low.

People who live in close quarters are more likely to spread it to one another. Individuals in prisons or jails, as well as people in homeless shelters, are the most at-risk for TB, but so are people who live in crowded cities.

This may explain the increase in TB happening in metropolitan areas of California, like San Francisco.

Susannah Graves, the director of Tuberculosis Prevention and Control at the San Francisco Department of Public Health, told SF Gate in an interview that offices like hers are working to spread awareness about TB and let people know that it’s both preventable and curable.

“The goal is for people to understand their risks so that they can get tested and treated and cured before they get sick,” Graves told the outlet.

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