Tuberculosis Cases Increased 16% Last Year

Despite being both preventable and curable, tuberculosis (TB) remains a global health risk. Last year, TB continued to be a leading cause of death worldwide.

Traditionally, the United States had one of the lowest TB rates globally.

Unfortunately, TB cases in the U.S. have now increased for four consecutive years amidst the worldwide resurgence of this contagious disease, which usually affects the lungs, as reported by the U.S. Centers for Disease Control and Prevention (CDC).

Published on March 28, 2024, the CDC's most recent MMWR indicates a 16% increase in overall TB cases across various demographics and 50 states in 2023. These TB cases were concentrated in about eight states, including Washington, D.C.

This MMWR presented these highlights: 

As in 2022, California reported the highest number of cases in 2023 (2,113), followed by Texas (1,235), and Alaska reported the highest rate (10.6).

In 2023, 7,259 (76%) TB cases occurred among non-U.S.–born persons, an 18% increase compared to 2022.

In the U.S., TB incidence increased in every age group in 2023 compared with 2022. The most significant relative increase was among children, corresponding to a 42% increase in case count.

Among persons with TB in 2023 for whom HIV status was known, 5% were coinfected with TB and HIV.

The MMWR offered some good news.

Approximately 85% of TB cases in the U.S. were attributed to the reactivation of latent TB infection (LTBI) rather than recent transmission. This finding indicates that sustained transmission of TB leading to outbreaks is uncommon.

Furthermore, TB elimination activities should include increased testing among populations at risk and treating persons with LTBI or TB disease.

To prevent transmission and reduce morbidity, TB disease must be detected quickly, effective treatment must be initiated promptly, and all exposed persons must be identified, evaluated, and treated if infected, says the CDC.

This approach has proven successful. It led to a 66% reduction in TB cases in the first 25 years of implementation.

One aspect of TB prevention has not improved in 2024. 

Access to the U.S. FDA-approved TB-prevention vaccine (BCG) remains restricted to public health agencies and unavailable in local clinics or pharmacies.

From a vaccine development perspective, enhanced BCG-type vaccine candidates are conducting late-stage clinical trials in 2024.

Internationally, TB cases have increased in the WHO Regional Office for Europe.

The European Centre for Disease Prevention and Control reported over 170,000 incident TB cases in 2022. Despite the notable progress achieved in the fight against TB, European countries still face various challenges in reaching the goal of ending the TB epidemic in the WHO European Region.

The new Tuberculosis action plan for the WHO European Region 2023–2030 has been published.

Note: This news article was updated on April 3, 2024, to include updated TB case data.