Health department reports fewer tuberculosis contacts this year; regional measles outbreak prompts preparedness steps

Nursing Director Ashley Burbs updated the Union County Consolidated Human Services Board on tuberculosis and the regional measles outbreak, reporting lower active TB case investigation work this year but increased measles activity nearby.

TB: Staff said 2024 had 12 active tuberculosis cases and 339 contacts requiring public-health follow-up; for 2025 the department reported eight total TB cases so far (including carryovers from last year) and a single new case, described as extrapulmonary and therefore not infectious via respiratory routes. Staff said there have been no new contacts requiring investigation this year, easing nursing workload compared with 2024.

Measles: Staff presented a regional update and preparedness steps. As of April 10, staff cited 712 reported measles cases in the affected states; Tennessee and Georgia were the closest states reporting positive cases. Staff said published counts understate likely spread and that most reported cases were unvaccinated or had unknown vaccination status. Meeting presenters said roughly 11 percent of reported cases had required hospitalization (mainly young children) and that at least two deaths in the reported cluster were children; one additional death was under investigation. Staff emphasized there were no confirmed measles cases in Union County, Monroe, or elsewhere in North Carolina at the time of the briefing.

Preparedness steps and clinical guidance reported at the meeting included: maintaining vaccine supply, planning a small local epidemiology (“epi”) team to participate in and debrief a tabletop exercise in Mecklenburg County later in the month, targeted outreach to school nurses and health-care providers, and providing informational materials in English and Spanish. Staff reiterated standard clinical guidance discussed in the meeting: do not give measles vaccine to a patient with suspected active measles disease; vaccinate eligible contacts promptly (within several days) to reduce transmission risk; and the health department can perform titers for people who are unsure of prior immunity. Meeting participants stated titer testing is available at the health department and reported a listed cost of $68 for titer testing.

Why this matters: lower TB contact numbers reduce immediate investigative burden on nurses, while the regional measles activity prompted stepped-up outreach and preparedness because of the potential risk to unvaccinated populations.

Details and clarifications from the meeting

- TB: 2024 active cases = 12; 2024 contacts = 339; 2025 cases to date = 8 (one new, extrapulmonary); 2025 new contacts = 0.

- Measles: staff cited 712 reported cases in the affected states as of April 10; approximately 11% hospitalization rate among reported cases (mostly children); at least two deaths confirmed in children; a larger share of reported cases were unvaccinated or had unknown vaccination status (staff said reported percentage may include unknowns). No local cases in Union County or Monroe County were reported at the meeting.

- Clinical guidance: suspected measles cases should not receive measles vaccine; close contacts should receive vaccine within several days when eligible; titer testing is available at the health department (cost cited as $68).

- Preparedness actions: staff will participate in a regional tabletop exercise in Mecklenburg County; the department plans targeted outreach to school nurses and providers; materials will be provided in English and Spanish.