Tuberculosis (TB) in Grand Rapids, Michigan

Tuberculosis (TB) is an important public health concern in Michigan, including the Grand Rapids area. Understanding how TB spreads, how to recognize symptoms, and where to get help locally can protect you, your family, and our community.

What Is Tuberculosis (TB)?

Tuberculosis is an infection caused by a bacterium called Mycobacterium tuberculosis. It can affect almost any part of the body, but it most commonly affects the lungs.

When TB affects the lungs, it is called pulmonary TB and can be contagious. TB in other parts of the body (such as the kidneys, spine, or brain) is usually not infectious.

How TB Spreads in the Community

TB spreads through the air. When someone with active TB disease in the lungs or throat:

  • Coughs
  • Sneezes
  • Speaks loudly or sings

they release tiny droplets containing TB bacteria. People nearby can breathe in these bacteria and become infected.

You cannot get TB from:

  • Shaking hands
  • Sharing dishes, food, or drinks
  • Bed linens, clothing, or toilet seats
  • Touching doorknobs or other surfaces

TB bacteria usually settle in the lungs first. From there, they can spread through the blood or lymphatic system to other parts of the body, such as the kidneys, spine, or brain.

Latent TB Infection vs. Active TB Disease

Latent TB Infection

In many people, the immune system is strong enough to control the TB bacteria. The bacteria stay in the body but become inactive. This is called latent TB infection.

People with latent TB infection:

  • Have TB bacteria in their body
  • Do not feel sick
  • Have no symptoms
  • Cannot spread TB to others

Latent TB can last for years. However, if the immune system becomes weakened later, the bacteria can “wake up” and cause active TB disease.

Active TB Disease

TB disease (active TB) happens when the TB bacteria are actively multiplying and causing illness.

Active TB disease:

  • Can occur soon after infection or many years later
  • Is more likely if your immune system is weak (for example, due to HIV, cancer treatment, poorly controlled diabetes, or certain medications)
  • Can be contagious if it affects the lungs or throat

A person with TB disease:

  • Has active TB bacteria in their body
  • Usually has symptoms
  • May be able to spread TB to others (if the lungs or throat are involved)

TB in Michigan and Grand Rapids

In the United States, thousands of people are diagnosed with TB each year. Michigan reports hundreds of TB cases annually, and Kent County typically sees a small but steady number of cases each year.

Key patterns in Michigan and Grand Rapids:

  • Many TB cases occur in people who were born outside the U.S. where TB is more common.
  • TB is more likely to spread in overcrowded housing, homeless shelters, and correctional facilities.
  • Seasonal factors, like cold West Michigan winters, can lead to more time spent indoors in close contact, which can slightly increase opportunities for TB to spread in homes, shelters, and workplaces.

Local public health agencies such as the Kent County Health Department and Grand Rapids Public Health work closely with hospitals like Corewell Health (formerly Spectrum Health), Trinity Health Grand Rapids, Metro Health, and Mercy Health to monitor, test, and treat TB.

Who Is at Higher Risk for TB?

Higher Risk of TB Exposure

You may be more likely to be exposed to TB bacteria if you:

  • Live or work closely with someone who has active TB disease in the lungs
  • Recently returned from, or spent a long time in, a country where TB is common
  • Live or work in:
    • Homeless shelters
    • Correctional facilities (jails or prisons)
    • Group homes or other crowded housing
  • Work in healthcare settings with TB patients (for example, at Spectrum Health, Trinity Health Grand Rapids, Metro Health, Mercy Health, or local clinics)

Higher Risk of Developing TB Disease After Infection

You are more likely to develop active TB disease after infection if you:

  • Have HIV infection
  • Have poorly controlled diabetes
  • Have cancer or are receiving chemotherapy
  • Have kidney failure
  • Are taking medications that weaken the immune system (such as long-term steroids or certain biologic drugs)
  • Are severely malnourished
  • Are an older adult
  • Are a young child, especially under 5 years of age

Symptoms of Active TB Disease

Active TB disease often develops slowly, over weeks to months. Symptoms can be mild at first and may be mistaken for a cold, flu, or pneumonia.

Common Symptoms of Active TB

  • Persistent cough (lasting 3 weeks or longer)
  • Coughing up mucus or sputum
  • Sometimes coughing up blood-stained sputum
  • Fever
  • Night sweats (waking up with soaked sheets or clothing)
  • Tiredness or fatigue
  • Malaise (feeling generally unwell)
  • Unexplained weight loss
  • Loss of appetite
  • Swollen glands (lymph nodes), especially in the neck

Important: Some people with active TB disease have only mild symptoms or no obvious symptoms at first. If you have risk factors and a long-lasting cough or unexplained weight loss, you should be evaluated for TB.

When You Should Be Tested for TB in Grand Rapids

You should talk to your doctor or local clinic about TB testing if you:

  • Live or work in close contact with someone recently diagnosed with TB disease of the lungs
  • Have HIV infection or another condition that weakens your immune system
  • Have poorly controlled diabetes
  • Have kidney failure
  • Are starting medications that suppress the immune system (for example, for rheumatoid arthritis, inflammatory bowel disease, or after organ transplant)
  • Have lived or traveled for a long time (usually 1 month or more) in a country where TB is common
  • Work in:
    • Hospitals (Spectrum Health, Trinity Health Grand Rapids, Metro Health, Mercy Health)
    • Nursing homes or long-term care facilities
    • Homeless shelters or correctional facilities
  • Have any symptoms of TB, especially a persistent cough, night sweats, fever, or unexplained weight loss

How TB Is Diagnosed

If your Grand Rapids healthcare provider thinks you might have TB, they may recommend several tests.

Medical History and Exam

Your doctor will:

  • Ask about your symptoms
  • Review your medical history and risk factors
  • Ask about travel, work, and living conditions
  • Perform a physical examination

TB Tests

Common tests used in West Michigan include:

  • Skin test (Mantoux tuberculin skin test)
    A small amount of testing fluid is injected under the skin of your forearm. You return in 48–72 hours so a healthcare provider can check for a reaction.

  • Blood test for TB (Interferon-Gamma Release Assay, such as QuantiFERON-TB)
    This is a blood test that can help show if you have been infected with TB bacteria. It is often used for people who have had the BCG vaccine or who may not return for a skin test reading.

  • Chest X-ray
    A chest X-ray can show whether TB has affected your lungs.

  • Sputum tests
    If you have a cough, you may be asked to cough up sputum (phlegm). The lab checks for TB bacteria using:

    • Microscopy (looking for bacteria under a microscope)
    • Culture (growing the bacteria)
    • Molecular tests (PCR) to detect TB DNA and drug resistance

These tests are available through local hospitals, clinics, and public health services in Grand Rapids.

Treatment for TB Infection and TB Disease

Treatment for Latent TB Infection

If you have latent TB infection (TB bacteria in your body but no symptoms and not contagious), your doctor may recommend:

  • A course of oral medications (tablets), often taken for several months
  • In some cases, regular chest X-rays or follow-up visits

Treating latent TB infection reduces your risk of developing active TB disease in the future.

Treatment for Active TB Disease

If you have TB disease, you will be treated with:

  • A combination of special antibiotics
  • Taken for at least 6 months (sometimes longer)

In Grand Rapids, TB treatment is usually coordinated by:

  • Hospital-based specialists (infectious disease or pulmonary doctors) at:
    • Corewell Health (Spectrum Health)
    • Trinity Health Grand Rapids
    • Metro Health
    • Mercy Health
  • Public health nurses and TB programs at the Kent County Health Department

You may receive some medications through a program called Directly Observed Therapy (DOT), where a nurse or health worker watches you take your medicine. This helps ensure the full course is completed and reduces the risk of drug-resistant TB.

TB can be cured if:

  • The correct medications are taken
  • You take them every day as prescribed
  • You complete the entire treatment course

Side Effects of TB Medications

Like all medications, TB drugs can cause side effects. Your doctor will monitor you with:

  • Regular checkups
  • Blood tests
  • Sputum tests
  • Urine tests
  • Chest X-rays, as needed

Possible Side Effects Include

  • Nausea or vomiting
  • Unexplained fever or tiredness
  • Tingling (“pins and needles”) or numbness in hands or feet
  • Joint pains
  • Skin rash, itching, or unusual bruising
  • Jaundice (yellowing of the skin or eyes)
  • Dark urine
    • Note: Orange/red urine can be a normal side effect of some TB medications and is usually not harmful.
  • Visual changes, such as:
    • Blurred vision
    • Difficulty seeing red and green colors

Contact your doctor or TB nurse immediately if you notice:

  • Yellow skin or eyes
  • Severe nausea or vomiting
  • Vision changes
  • Severe rash or trouble breathing
  • Extreme fatigue or weakness

TB Vaccination (BCG) in Michigan

The vaccine against TB is called Bacillus Calmette–Guérin (BCG).

In Michigan, including Grand Rapids:

  • BCG vaccination is not recommended for the general population because the overall risk of TB exposure is low.
  • BCG is reserved for specific high-risk situations, based on an individual risk assessment.

BCG may be considered for:

  • Children under 5 years who will be traveling to or living for a long time in countries where TB is common
  • Certain close contacts of people with TB-related conditions, based on specialist advice

BCG is not routinely given in Grand Rapids schools or pediatric practices. If you are planning international travel with a young child or have unique risk factors, speak with your pediatrician or family doctor.

Local TB Resources in Grand Rapids, MI

If you live in the Grand Rapids or Kent County area and are concerned about TB, you can:

  • Talk with your primary care provider or pediatrician
  • Visit local hospitals or clinics:
    • Corewell Health (Spectrum Health)
    • Trinity Health Grand Rapids
    • Metro Health
    • Mercy Health
  • Contact your local health department:
    • Kent County Health Department – TB Program
      • Offers TB testing, evaluation, and treatment coordination
      • Can provide information on free or low-cost services

In an emergency (such as severe breathing problems, coughing up large amounts of blood, or signs of severe allergic reaction), always call 911 or go to the nearest emergency department.

Key Points About TB in Grand Rapids

  • TB disease is an illness caused by active TB bacteria in the body.
  • A person with TB disease can have symptoms and may spread TB if the lungs or throat are involved.
  • Latent TB infection means TB bacteria are present but inactive; there are no symptoms and it is not contagious.
  • Symptoms of active TB can include a long-lasting cough, fever, night sweats, weight loss, fatigue, and swollen glands. Some people have only mild symptoms.
  • TB can be cured with the right combination of antibiotics taken for the full course.
  • TB medications can cause side effects, so regular monitoring by your doctor or TB nurse is essential.
  • In Michigan, the BCG vaccine is not routinely used; it is reserved for specific high-risk situations.
  • Local resources in Grand Rapids, including the Kent County Health Department and major hospital systems, provide TB testing, treatment, and support.

If you think you may have been exposed to TB or have symptoms, contact your Grand Rapids healthcare provider or the Kent County Health Department as soon as possible for testing and guidance.