California Casino Confirms Tuberculosis Cases Over Several Years

About one-hour drive east of San Francisco, an apparent tuberculosis (TB) outbreak has been active for several years.

Contra Costa Health (CCH) today announced that anyone who has spent time inside California Grand Casino since 2018 should consider getting a TB test.

CCH's recommendation is in response to recent casino staff and customers being confirmed with TB at the 5900 block of Pacheco Boulevard location.

Of the 11 confirmed TB cases, ten are genetically linked, and the majority are associated with staff or customers at the casino. The 11th TB case has not yet been genetically tested.

As of November 2, 2023, CCH has contacted more than 300 people who may have been exposed to active TB and is working with California Grand management to provide health education to staff and to encourage testing.

With a population of over 1.1 million, Contra Costa County is located in the East Bay of San Francisco.

CCH has not identified a current or ongoing source of TB transmission at the casino. 

In 2022, Contra Costa County reported 61 TB cases and 11 related deaths for 2022.

Throughout California, 1,843 new TB cases were reported in 2022, a five percent increase compared with 2021.

The U.S. CDC recently reported that TB cases increased by 5% in 2022, reaching 8,300.

"We are making this recommendation now because there is new evidence that TB may have spread among people who spent time at the casino from 2018 to 2023," said Dr. Meera Sreenivasan, deputy health officer for Contra Costa County, in a press release.

"TB can live inside someone for years without showing signs of its presence."

TB is an ancient disease caused by Mycobacterium tuberculosis that spreads through the air.

TB can spread when a person who has developed symptoms coughs or breathes out droplets containing the bacteria, particularly in an enclosed space over a long period, such as several hours.

"TB can cause serious illness, but it is treatable and curable with medicine, especially when caught early. That is why it's important to take a test, even if you do not feel sick."

If you believe you may have been exposed to TB, talk to your healthcare provider or call CCH's TB Client Services Program at 925-313-6740 if you are uninsured or need advice about the next steps.

Visit cchealth.org/tb for more information about TB.

TB bacteria can live inside a person for months or years without causing any symptoms, so even people with no symptoms should talk to their healthcare providers about getting a TB test if they believe they may have been exposed.

TB can generally be prevented with a 100-year-old vaccine.

In the U.S., TICE® BCG vaccination is considered for people who meet specific criteria and are considered for children with a negative TB test and who are continually exposed and cannot be separated from adults who are untreated or ineffectively treated for TB.

As of 2023, there are about 16 versions of the BCG vaccine in use globally, with numerous vaccine candidates in development.