It’s “all hands on deck” in Delaware, with officials estimating that more than 600 individuals may have been exposed to tuberculosis at one local long-term care facility.

Public health officials say that exposure spread from one individual at ManorCare Health Services Foulk Road and occurred during a nine-month period starting in January 2017. Delaware health officials say they’re coordinating with neighboring health agencies on the matter since 35 former residents and staff member now live in seven other states.

“This is an all hands-on-deck approach for us,” Karyl Rattay, M.D., Division of Public Health director, said in a press release. “The most important thing we want people to know is that TB is treatable. That’s why it’s so important for us to reach out to all former residents and staff, to encourage them to get tested as soon as possible. Manor house leadership is working closely with the DPH and taking every measure necessary to protecting the health of its residents and staff.”

If left untreated, tuberculosis can be life-threatening. The division says it is providing free screenings and treatment to former residents, and it has also set up a call center starting today (Tuesday) to address the expected high volume of calls following the outbreak.

State officials note that TB is mostly on the decline across the U.S., with about 9,600 cases nationwide in 2015. Vigilance, however, is crucial. TB can be inhaled into the lungs when someone nearby with the disease coughs, sneezes, sings or laughs, according to the release. Symptoms can include a progressively worsening cough lasting more than two weeks, fatigue, weakness, weight loss, night sweats, fever, chills and chest pain. The disease is treatable and curable, they note, typically by taking several meds over the course of six to nine months.

ManorCare spokeswoman Kelly Kessler in a statement that her organization was notified about the possibility of active TB in April, and it has taken proactive steps to ensure there is no risk to its employees or residents.

“We continue to work closely with local healthcare authorities and feel there is no risk at the center,” she said.