Concerning Rise in Tuberculosis Cases in the U.S.
Health officials have raised alarms about a potentially deadly disease often referred to as “the white plague,” which has been on the rise in the United States since the COVID pandemic.
Tuberculosis (TB) earned its nickname from the pallid appearance of those infected. There was a noticeable decline in cases during 2020, around the onset of COVID-19. Experts suggest this drop was likely due to underdiagnoses and fewer screenings at that time. However, cases have risen steadily each year since then.
According to recent data from the Centers for Disease Control and Prevention, over 10,600 cases were reported in 2024, which amounts to roughly three incidents per 100,000 people. This marks the third consecutive yearly increase and the highest annual total since 2013.
Even with this uptick, TB rates in the U.S. are relatively low compared to many other regions globally; for context, the worldwide average stands at about 131 cases per 100,000, making U.S. rates nearly 40 times lower.
TB is a bacterial infection that primarily affects the lungs but can also impact other organs. The bacteria spread through the air, often when an infected person coughs, sneezes, or even talks.
Dr. Renuga Vivekanandan, a professor at Creighton University and VP of CHI Health, expressed concern over the rising TB cases but highlighted that this trend was somewhat predictable. She explained that the COVID-19 pandemic had disrupted TB treatment and monitoring programs across the nation.
“What we’re witnessing now is largely a rebound effect – latent TB infections that weren’t addressed during the pandemic are reactivating,” she stated. Additionally, the resurgence in international travel and increased migration from TB-endemic regions have also contributed to this increase.
This situation has placed added pressure on healthcare systems. With local and state TB programs experiencing understaffing during the pandemic, those capacities are yet to fully recover.
It’s estimated that about 25% of the population might have been infected with TB bacteria, yet only around 5% to 10% will progress to active disease, according to health agencies.
Latent TB infection occurs when a person is infected, but the bacteria remain inactive, meaning it’s not contagious. However, there’s a risk that this dormant infection can evolve into active TB in a small percentage of cases.
Individuals who are symptomatic may face a range of mild issues, including cough, fatigue, weight loss, and even night sweats; in more serious cases, organs like the kidneys and spine could also be affected.
Dr. Masae Kawamura, a former TB control director in San Francisco, emphasized that TB can compromise any organ but is particularly dangerous when it infects the lungs, as this facilitates airborne transmission.
For those experiencing mild symptoms, it’s easy to confuse them with a cold or allergies, and this might prevent timely diagnosis. The good news? TB is both preventable and treatable.
People at heightened risk, such as those frequently traveling to high-burden TB countries or living in crowded conditions, should consult their healthcare providers regarding TB testing. Other at-risk groups include individuals with diabetes, malnutrition, heavy alcohol use, or compromised immune systems.
Typically, healthcare professionals will use skin or blood tests for initial detection, followed by imaging or sputum tests to confirm active disease.
Treatment for TB generally involves a course of antibiotics lasting four to six months. Individuals must complete their full medication regimen; failure to do so can lead to drug-resistant forms of TB, which are more complicated and costly to treat.
If untreated, TB can be fatal in nearly half of those affected. Dr. Vivekanandan underscored the importance of addressing latent infections to prevent progression to active and infectious disease.
The U.S. Preventive Services Task Force advises that screening should be limited to high-risk populations rather than conducted universally.
