11 tuberculosis cases linked to Bay Area casino, officials say

Public health officials have confirmed that 11 tuberculosis cases are tied to a casino in California.

The cases were reported in individuals who spent time at the California Grand Casino in Pacheco, 22 miles northeast of Oakland, between 2018 and 2023, the Contra Costa Health wrote in an emailed statement to SFGATE on Friday.

Tuberculosis is an infectious disease caused by bacteria that can spread in the air between people who are in close contact, especially indoors, according to the Centers for Disease Control and Prevention. The bacteria most commonly attacks the lungs, leading to a nagging and painful cough. Not everyone exposed to the bacteria becomes sick with the disease. 

Genetic testing revealed that 10 of the cases were linked. The 11th case has not been tested yet, the Contra Costa Health wrote. 

To control spread of TB in the United States, it’s standard for any confirmed case of tuberculosis to be genetically tested, Dr. Meera Sreenivasan, deputy health officer for Contra Costa County, said in a press conference. “When those individuals cough up the bacteria, we’re able to isolate the bacteria in the lab and these are bacteria that have DNA in them and through a process called whole-genome sequencing, we can then match different individuals’ DNA with another person’s TB DNA,” Sreenivasan said.

The county said it has reached out to 300 people who may have been exposed to TB at the casino. Anyone who visited the casino or worked there in the past five years and has not been contacted can call the county at 925-313-6740 to ask about being tested for TB, according to a press release issued by the county. 

Sreenivasan said it’s important for even those who don’t have symptoms to talk to their health care providers, because the bacteria can live inside an individual for many months or even years before that person gets sick and becomes contagious. When TB is inactive, the bacteria can still be identified and people can be treated to prevent them from becoming sick and contagious. 

Despite the outbreak, Sreenivasan said the risk of TB in the community “remains low.” She also noted that nothing about the way the casino is operated has put the community at risk. “It is really just a factor of how this bacteria is spread,” she said. “It’s spread through close contact of individuals.”

A person with TB is contagious and sick and the most common symptoms include “a persistent or bloody cough, fever, unexpected weight loss, night sweats and fatigue,” the county said in the release. 

California Grand Casino spokesperson Becky Warren said in a statement to SFGATE, “Our foremost commitment is to ensure the safety of our customers and employees. According to Contra Costa Health, none of the linked cases are currently contagious, nor do they involve our staff. Additionally, Contra Costa Health has not identified any ongoing sources of transmission at the card room. We are actively collaborating with the county on notifications and testing to uphold public health and safety.”

This breaking news story has been updated.