• Posted March 29, 2024

U.S. TB Cases Reach Highest Level in a Decade

Tuberculosis cases are on the rise in the United States, with the number of reported infections in 2023 the highest seen in a decade.

Forty states logged an increase in tuberculosis (TB) cases, and rates were up among all age groups, the study from the U.S. Centers for Disease Control and Prevention found. More than 9,600 cases were reported, a 16% increase from 2022 and the highest since 2013.

"Although TB incidence in the United States is among the lowest in the world and most U.S. residents are at minimal risk, TB continues to cause substantial global morbidity and mortality," the researchers wrote in the March 28 issue of the CDC publication Morbidity and Mortality Weekly Report.

"This post-pandemic increase in U.S. cases highlights the importance of continuing to engage communities with higher TB rates and their medical providers in TB elimination efforts and strengthening the capacity in public health programs to carry out critical disease control and prevention strategies," they added.

Experts point to a surge in TB cases internationally -- the World Health Organization has said TB was behind only COVID in infectious fatal diseases worldwide in 2022, the Associated Press reported. There have also been big spikes in migration and post-pandemic international travel, which likely fueled the spread of TB.

But other factors are at play, including other illnesses that weaken the immune system and allow latent TB infections to surface.

The 2023 count “was a little more than was expected,” Dr. Philip LoBue, director of the CDC's Division of Tuberculosis Elimination, told the AP.

Tuberculosis is caused by bacteria that attack the lungs, and is spread through the air when an infected person coughs or sneezes. If not treated properly, it can be fatal, according to the CDC.

Importantly, an estimated 85% of the people counted in 2023 were infected at least a year or two earlier and had what's called latent TB, occurring when the bacteria hibernates in the lungs or other parts of the body. Experts estimate as many as 13 million Americans have latent TB and are not contagious, the AP reported.

Although the spread of COVID-19 may have played a part in causing latent TB infections to reactivate, “I would consider it an unknown at this point,” LoBue said.

“It's too early to tell” what will happen to TB trends in the next few years, he added.

Meanwhile, TB vaccines are being developed, and public health workers who were focused on COVID are now trying new approaches to preventing TB. But federal TB funding for state and local health department efforts has been flat, and one of the key antibiotics used against TB has been in short supply in recent years, the AP reported.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on tuberculosis.

SOURCE: Morbidity and Mortality Weekly Report, March 28, 2024; Associated Press