One of the world’s deadliest diseases, tuberculosis, is making a ferocious comeback in Kansas. But somehow, we only just learned about this situation. Kansas’ leaders seem dedicated to avoiding all mention of the outbreak. Today, let’s explore why tuberculosis is returning with such a vengeance—and why the masters of the plains seem so nervous about discussing it, and why they need to discussing anyway.
(This post first went live on Patreon on 1/31/2025. Its audio ‘cast lives there too and is available now!)
SITREP: Kansas continues to be tuberculosis free—but only for animals
On the website for the Kansas Department of Agriculture, we find this curious text at the very beginning of its page devoted to animal diseases:
Kansas continues to be Brucellosis [info 1], Tuberculosis [info 2] and Pseudorabies [info 3] free due to a diligent effort to eradicate infectious and contagious livestock diseases throughout the state.
Alas, the leaders of Kansas can’t make the same boast about tuberculosis in humans. Tuberculosis is on the rise in the human population of the state.
This past week, the news exploded with information about the outbreak. For some weird reason, it seems like Kansas leaders are doing their best to minimize the worst outbreak of tuberculosis in the United States since about the 1950s.
Tuberculosis: ‘Our original arch-enemy’
Tuberculosis has likely killed more humans than any other disease that has ever existed. At the beginning of the 1800s, it’d killed one in seven people who’d ever lived. In Europe between 1600-1800CE, it killed one in four people. According to this documentary, it’s killed a billion people over the past 200 years. It infects one in four people worldwide with a disease that’s almost perfectly evolved to infect and slowly kill humans.
Almost 11 million people got infected with tuberculosis in 2023. Out of that number, about 1.25M people died of it. In terms of infectious diseases, it’s our #1 killer. Despite global efforts to prevent and treat tuberculosis, it remains one of the biggest killers of humanity—especially in poorer, less-developed countries. These days, most infected people live places like China, India, Pakistan, and Nigeria. About half of those dying live in SE Asia.
For many millennia, humans have suffered and died from tuberculosis. And we had no idea what even caused it for most of that. Folks called it consumption because victims wasted away, or the white death because victims got very pale, or “the king’s evil” because the touch of royalty was thought to cure it, or scrofula (from an old word for “brood sow”) for uncertain reasons. In some areas and periods, tuberculosis was romanticized—with young women trying to imitate its effects. In others, tuberculosis was stigmatized as a disease of the poor.
And now it’s exploding in Kansas.
What tuberculosis actually is
Now we know that tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. We suspect that the bacteria leaped from animals to humans about 4000-9000 years ago. But it might be far older than that.
Though most people think tuberculosis is a lung infection, it can infect other organs—including the brain.
Tuberculosis is an incredibly contagious and deadly disease. However, most infected people don’t show any signs of having it. Only about 10% of infected people show those signs. That’s when tuberculosis becomes deadly and requires treatment. Actively infected people spread it through the air whenever they cough, sneeze, spit, or even just talk.
In an otherwise healthy person who gets complete and adequate treatment, death is rare. But if one of those conditions isn’t met, its lethality goes through the roof. Even in a healthy person, though, drug-resistant strains of the disease are starting to make treatment difficult. Treatment takes 4-9 months and requires medications with side effects, which only adds to the difficulty.
Any time tuberculosis shows up in an area, especially in a wealthy, well-developed country, its health authorities should consider it their top priority. It’s just too easily spread and too lethal for any other response to be acceptable.
The Kansas tuberculosis outbreak has been simmering for a couple of years now
The outbreak we’re discussing today appears to center on Kansas City, Kansas. And it’s been coming to a head for a couple of years.
For those not familiar with Kansas, in the northeast corner of the state there’s a Kansas City, Missouri and a Kansas City, Kansas. The two towns are right up next to each other on either side of the state line and share a downtown district. The Missouri side is considerably larger with 508k people, compared to the Kansas side at 156k. Kansas City, Kansas lies within Wyandotte County. State officials say the outbreak is concentrated in that county.
World Health Organization (WHO) research released in 2024 indicated that record numbers of people worldwide had been infected with tuberculosis. In 2022, 7.5M were infected—and 8.2M in 2023. During the early COVID pandemic, infection rates for tuberculosis declined considerably. But by 2023, tuberculosis had surged back to the winner’s spot. That year, the US reported over 9k cases of tuberculosis (in 2022, we reported 8300).
In May 2024, experts were warning us that tuberculosis was becoming a serious problem again. Even though the United States is nowhere near as bad as the disease’s favorite haunts, American public-health experts still felt deep concern about it.
In August 2024, we got our first news about a spike in tuberculosis cases in Kansas. As one source noted:
Kansas has recorded 82 confirmed cases of active tuberculosis this year, which is almost double last year’s total of 46 cases. All of the active cases are being treated to limit the spread, Jill Bronaugh, a spokeswoman for the Kansas Department of Health and Environment, said in an email. More than half of this year’s cases, 57, originated in Wyandotte County, and six were reported from Johnson County.
At the time, two people had already died of it.
Most of the news about tuberculosis in Kansas in 2023 involved a worrisome outbreak of multidrug-resistant disease in 2022. The Centers for Disease Control (CDC) released a paper discussing this outbreak. In it, they noted one of the first cases involved a low-income resident who’d been born outside the United States. This person had likely been infected for many years before the disease activated. Once it activated, though, they spread it to 12 other people in four other households.
In total, 52 people caught tuberculosis in 2022 in Kansas, with those 13 people getting the multidrug-resistant strain.
2025: Tuberculosis infections rise in Kansas
Since January 1st this year, Kansas state health officials reported 67 cases of tuberculosis in Kansas City. Sixty of those cases are in Wyandotte County. Seven more are in Johnson County, which lies directly south of Wyandotte. Another 79 people have tested positive for the latent form of the disease. Those officials are stressing that people in Kansas have nothing to worry about.
But this outbreak is still one of the biggest since officials began tracking the disease. It’s definitely the worst one Kansas has ever had. One source even calls it “unprecedented.” During 2024, Kansas reported 109 total active cases and 626 latent, a marked increase in active cases reported in 2023 (51 active, 1259 latent). Again, of those 109 cases, 67 were in Kansas City.
This increase also tracks with the overall increase in United States disease cases.
But it doesn’t sound like health officials really raised any alarms regarding events that could have spread the disease.
Yay, just what we all needed: A superspreader event
As just one example, the Kansas City Chiefs game took place in Kansas City, Missouri just a few days ago on the 26th. Almost 75,000 people attended it. I don’t think any of those folks had this ancient disease on their minds.
Days later, health officials conceded that yes, tuberculosis spread may have occurred. But they’re way more concerned about the flu. According to one local hospital’s director of infection prevention:
Just because people attended the Chiefs AFC championship win or another crowded event, [Ginny] Boos told USA TODAY, “that doesn’t mean that you are now suddenly at risk for having TB. That is just not likely the case at all.”
But if you sat next to someone in the nosebleeds of Arrowhead Stadium who was coughing and, say, had the flu, Boos added, “you have a pretty good chance of maybe getting that.”
The flu both infects and kills a lot more people in the United States than tuberculosis does, of course. As that story points out, last flu season, almost a half million people were hospitalized for it, and 28k people died of complications of the flu.
Influenza also hits victims way faster and more dramatically, so sufferers tend to be way more obvious—and noticed much earlier. By contrast, tuberculosis can infect people for years without ever becoming active and lethal.
But that’s exactly what the problem is with it.
A marathon, not a sprint is what makes this the biggest infectious killer of all time
Tuberculosis is a slow burn of a disease. It’s a marathon, not a sprint. That’s why it’s the biggest killer of humankind, not the flu. (The flu hit newbie numbers in comparison, causing 200M vs tuberculosis’ 1B deaths through all of our history.)
As anyone who played the Pandemic 2 mobile game knows, fast-killing, dramatic diseases get noticed way earlier—and addressed more vigorously. Madagascar’s quickness with closing ports and airports used to be a meme from that game for that exact reason. In the game, if they even noticed a mild cough going around then they’d close all points of entrance. Once that happened, you’d never get them infected—and would thus lose, since the object of the game is to infect and kill everyone on Earth.

Tuberculosis is the disease that wins at the infect-everyone-on-Earth Olympics. It’s a slow, methodical, patient killer of a disease. The bacteria itself multiplies very slowly. It patiently seeks its prey in our immune system. It feasts in secret before bursting forth. Thanks to many millennia of evolving alongside us, it knows how to deal with every single defense our bodies can offer.
The only things it didn’t know how to deal with were antibiotics. But thanks to infected people not taking their full courses of treatment, it’s recently evolved to deal with many of those, too. This new trend of multidrug-resistant bacteria should be setting off all kinds of alarm bells in health authorities’ minds.
Don’t panic, but do be aware and watchful
I’m not saying all this because I want people to panic. I don’t think that’s a helpful response, even for those living in Kansas City, Kansas. People in Kansas have other things to worry about, like being in Kansas in the first place. And as Ginny Boos said, flu really is the more pressing concern for most of us. I am however saying this:
Increasingly, we’re an international community.
We travel abroad, often to countries facing serious problems with tuberculosis, or we have friends and loved ones who travel to or hail from those countries. Many of us live in poor or working-class conditions, and many of us have compromised health. So we have many reasons to be concerned about tuberculosis, even barring its death toll abroad.
So my gentle suggestion is to be aware of people showing any symptoms of tuberculosis. If you can’t talk to them comfortably, at least steer clear of them. When traveling somewhere facing a lot of tuberculosis infections, be mindful of your environment and take precautions. If you can do it comfortably, encourage sick people to see their doctors—because this is such a terrible disease, most states offer free diagnosis and treatment. Encourage those getting treatment to finish all of their medications, even if they feel much better before finishing.
Maybe we’ll win this war one day soon
The White Plague is getting extra attention lately. Already, we have a 4-month treatment regimen—even if Kansas is facing a shortage of that medication right now. The shorter the treatment plan, the more likely sick people will complete it. (Also: SERIOUSLY, Kansas? REALLY?)
All through today’s topic, you might have noticed a major emphasis on faster treatments. The reason for it is simple: people who abandon treatment too early still have the bacteria in their systems. And that remaining bacteria evolves more drug-resistant capabilities. So everyone in research and treatment focuses on making sure more people complete these medication regimens.
More than that, new research has hinted at several very promising treatments for drug-resistant tuberculosis. We’re already in the trial phase of those treatments. One of the best aspects of them is fewer side effects—which can lead sick people to abandon treatment too early.
An ancient, impossibly-patient killer prowls among the global village. Hopefully, we’ll defeat it someday soon.
NEXT UP: The Pope recently warned Catholics about ‘brain rot,’ which means the Endtimes must be nigh. We’ll see what’s got his skirts so aflutter—and why he might have extra reason to want Catholics to avoid social media. See you soon! <3
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