Ending TB Takes Teamwork

Tuberculosis, or TB, has been a part of the human story for thousands of years, first showing up in written records more than 3,000 years ago. For centuries, humans have been fighting Tuberculosis, or TB, with roughly one in seven people dying from the disease in the U.S. and Europe in the late 1800s. The story is much different today, with improved medical interventions, diagnostic capabilities and clinical practices. A changing world also means new challenges, challenges the TB Elimination team at the Metro Public Health Department (MPHD) works to meet every day.

TB is spread from person to person, transmitted through the air when someone who is infected speaks, coughs or sings. Other people who breathe in those TB germs can become infected. For those who do become infected, the germ can sit dormant for years (referred to as TB infection, or latent TB) before progressing to a symptomatic case of TB Disease. This often yearslong delay in disease progression is one reason why MPHD's work to conduct robust contact investigations is so important, as latent TB can be easily treated, preventing the symptomatic and contagious version of TB Disease. While treating active TB is a priority, ensuring the infection does not spread to the community is also a key part of MPHD's TB Elimination team's mission. Contact investigations involve identifying those who might be at risk of contracting TB and offering each individual testing and treatment. The TB Elimination team conducts contact investigations for every case of TB disease, showing that fighting TB goes beyond a drug regimen.

Over the past ten years, more TB cases investigated by MPHD have had a connection to behavioral risk factors like substance misuse, language barriers, unstable housing, mental health challenges and past incarceration. In 2025, 79% of MPHD's TB cases had one of those social barriers. Compounding that, more than half of MPHD's patients with TB require hospitalization at some point during treatment. These complex, multi-faceted cases of TB can be resource-intensive, highlighting the importance of early detection and treatment, and above all prevention.

The TB Elimination team employs a strong team of communicable disease investigators, making sure those at a heightened risk of developing TB are aware of what they can do to protect themselves. They speak with community members about the real risk of TB while providing culturally competent resources. Those interactions are also designed to reduce the stigma around TB, which can mean future cases will be more willing to cooperate with contact investigators and ultimately prevent secondary cases. Outreach, contact investigations and strong clinical support are all important parts of the strategy to end TB in Nashville.

Learn more about MPHD's TB Elimination program