San Francisco's Department of Public Health is investigating two active cases of tuberculosis connected to The Crazy Horse, a strip club that has operated on Market Street for more than three decades. The agency confirmed it is looking into cases “associated with” the establishment, though officials stress the risk to the general public remains low at this time.
According to NBC Bay Area, the health department was notified of the first confirmed case in early October and began contact tracing. The reports do not specify exposure dates or which groups may have been exposed. Officials said tracing is ongoing and the general-public risk is low, and that they will update the public if that changes. As the New York Post also reported, the department advised people at risk of tuberculosis to get tested and treated.
Why the Two Cases Aren't Automatically an Outbreak
The two cases do not, by themselves, establish a shared exposure. Dr. Peter Chin-Hong told NBC Bay Area, “We're not even sure at this point whether the two cases are actually acquired at the establishment, or they got it somewhere else.” He also said an early TB test may be negative because the bacteria grow slowly, so a later test may be needed.
That slow-growing bacteria can also make it difficult to determine when an exposure occurred. TB spreads through the air, and the risk rises with sustained close contact with someone who has contagious disease. Dr. Abraar Karan told NBC Bay Area that crowded spaces with poor ventilation can also increase the chance of transmission.
Active Versus Latent Infection
Tuberculosis most often attacks the lungs and can exist in two forms: latent, where a person carries the bacteria without symptoms and isn't contagious, or active, which is contagious and serious. Per UCSF, active TB spreads through airborne droplets released when an infected person coughs, sneezes, or speaks. Left untreated, a latent infection can eventually develop into the active, contagious form. Symptoms of active disease can include a cough lasting more than three weeks, coughing up blood, fatigue, and unintentional weight loss.
This isn't the city's first brush with TB concerns this year. San Francisco's health department declared a tuberculosis outbreak at Archbishop Riordan High School in late January after three people associated with the school were diagnosed with active TB disease dating back to November 2025, according to UCSF's report. The city went on to identify more than 50 people connected to the school with latent TB infection following that announcement.
Statewide Numbers Offer Context
Tuberculosis cases have been ticking upward across California. The state's 2025 case count was the highest reported since 2013, according to the California Department of Public Health, which noted that outside the COVID-19 pandemic years, annual totals had held steady between 2,000 and 2,200 cases since 2012. The federal government has also been tracking the trend: a provisional March report from the Centers for Disease Control and Prevention offered an early look at 2025 TB case data compared with prior years.
San Francisco TB cases in context
A separate investigation at Archbishop Riordan High School provides another point of comparison: in a March 4, 2026 update, the San Francisco Department of Public Health reported four laboratory-confirmed active TB cases associated with the school since November 2025, as well as three suspected active cases awaiting final culture results. That investigation is separate from the inquiry involving The Crazy Horse. Across the city, the department reported 91 active TB cases among residents in 2024, an incidence of 10.9 per 100,000 people—35% higher than in 2023 and 58% higher than in 2022, according to its 2024 case update.
For now, San Francisco health officials maintain that the situation tied to The Crazy Horse does not pose an elevated risk to the broader public, even as contact tracing continues. The Crazy Horse has not responded to a request for comment, according to the New York Post.
