California health officials are Crypen Exchangeadvising visitors of a Bay Area casino to get tested for tuberculosis after 11 cases were traced back to the facility.

County health organization Contra Costa Health (CCH) issued the warning last week saying visitors and staff that were in Pacheco's California Grand Casino between 2018 and 2023 may have been exposed to the illness.

CHH reported that 10 cases were genetically tested and linked to people who spent time in the casino, while the 11th is awaiting confirmation. Thus far, 300 people have been contacted and informed of a potential exposure, though anyone who entered the building in the last five years is advised to seek out testing even if they have not yet received a message.

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New evidence on how the cases started

Dr. Meera Sreenivasan, deputy health officer for Contra Costa County, said in a statement the advisory has come now thanks to new evidence connecting the cases' origin.

"TB can live inside someone for years without showing signs of its presence. That is why it's important to take a test, even if you do not feel sick," said Sreenivasan. "TB can cause serious illness, but it is treatable and curable with medicine, especially when caught early."

CCH warned that TB bacteria can live inside a person for months or years without causing any symptoms, so testing is advised even for people showing no signs of sickness. When symptoms do occur, they can include a persistent or bloody cough, fever, unexpected weight loss, night sweats and fatigue.

Infected people can spread the disease via saliva droplets expelled into the air via coughing or breathing, especially in close quarters. The germs are especially transmittable in an enclosed environment over an extended period of time.

CCH and the casino are working in tandem to identify if there is a current or ongoing source of transmission and to ensure appropriate screening and health precautions.

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What is tuberculosis?

According to the Centers for Disease Control and Prevention (CDC), tuberculosis is caused by bacterium Mycobacterium tuberculosis that usually attacks the lungs, though the bacteria can also attack the kidney, spine, brain and other parts of the body.

TB bacteria is spread from person to person through the air when an infected person expels droplets through activities like coughing, sneezing, speaking or singing. The people around them can inhale the bacteria and become infected, allowing the bacteria to grow in the lungs then spread to other body parts through the blood stream.

TB of the lungs or throat is the most infectious, as TB of the liver, spine or other body parts generally is not spreadable.

While TB is spread through inhalation of the bacteria from the air, it cannot be spread via:

• shaking someone’s hand
• sharing food or drink
• touching bed linens or toilet seats
• sharing toothbrushes

Symptoms of TB include:

• a bad cough that lasts 3 weeks or longer
• pain in the chest
• coughing up blood or sputum (phlegm from deep inside the lungs)
• weakness or fatigue
• weight loss
• no appetite
• chills
• fever
• sweating at night

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