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N.D. (AP) – North Dakota health officials say a total of 26 cases of active tuberculosis have been linked to an outbreak that originated in the Grand Forks area.

Officials say that the total includes two TB cases in 2010, 20 cases in 2012, and 4 cases so far in 2013. Twenty-three of those cases have been in Grand Forks County. Three other cases in Cass and Stutsman counties have been linked back to the Grand Forks outbreak.

TB is a contagious disease that typically attacks the lungs, though it also can affect the kidneys, spine and brain. General symptoms include fatigue, weight loss, fever and night sweats.  Health officials have linked the outbreak to homeless visitors who exposed a family who gave them shelter.