A concerning disease, often referred to as the “white plague,” is reportedly on the rise in the United States following the pandemic, according to health officials. The term tuberculosis (TB) is derived from the pale look of those afflicted by the illness.
Experts indicate that tuberculosis cases have used a general upward trend since the pandemic began, even though numbers dipped in 2020—most likely due to a decline in diagnoses and screening during the COVID-19 crisis.
Data from the Centers for Disease Control and Prevention (CDC) suggests that there will be over 10,600 confirmed cases in 2024, translating to about 3 per 100,000 individuals. This marks the third consecutive annual increase, and it represents the highest annual case total since 2013.
Despite this rise, tuberculosis rates in the U.S. are still relatively low compared to many global regions. The World Health Organization notes that the worldwide average stands at approximately 131 cases per 100,000, indicating U.S. rates are around 40 times less.
According to Johns Hopkins University, TB is a treatable bacterial infection mainly affecting the lungs but can also spread to other parts of the body. It spreads through airborne particles when an infected person coughs, sneezes, or even talks.
Renuga Vivekanandan, MD, a medicine professor at Creighton University, stated that the current rise in tuberculosis cases, while alarming, was somewhat expected. She explained that the disruption of TB surveillance and treatment programs during the COVID-19 pandemic contributed significantly to this uptick.
“What we’re experiencing now can be seen primarily as a rebound effect, with latent TB infections that were previously undiagnosed becoming active,” Vivekanandan noted. Furthermore, increased international travel and migration from countries where TB is more common also play a role in this increase. The added burden on the healthcare system is concerning, as local public health TB programs are still recovering from pandemic-related staffing shortages.
Symptoms of TB
Health authorities estimate that about a quarter of the population may carry Mycobacterium tuberculosis, the bacteria responsible for TB, although only about 5% to 10% will go on to develop the active disease. Latent TB infections are non-contagious but can eventually lead to active disease in a subset of individuals.
Active tuberculosis is contagious, primarily affecting individuals with TB in the lungs or throat, making symptoms like cough, chest pain, fatigue, weight loss, weakness, fever, and night sweats more pronounced. In some rarer cases, TB can also impact other organs such as the kidneys or brain.
Dr. Masae Kawamura, a former tuberculosis control director, has highlighted the potential severity of the disease. “People often misunderstand occasional coughs, attributing them to allergies or lingering colds, rather than recognizing possible TB,” she cautioned.
Understanding Risk Factors, Treatment, and Prevention
“There is good news,” Vivekanandan mentioned; “tuberculosis is preventable and treatable.” Those at risk—such as individuals from countries with high TB infection rates, frequent travelers, or those in crowded living conditions—are encouraged to consult with healthcare providers regarding TB testing.
Individuals with conditions like diabetes, malnutrition, and chronic tobacco or alcohol use also face higher risks, as do young children and infants. Testing typically involves skin or blood tests followed by imaging or sputum tests to confirm active disease.
Medical professionals usually treat tuberculosis with antibiotics taken daily over four to six months. However, completing the full regimen is crucial to avoid developing drug-resistant strains, which are notably harder to treat and more costly.
Failure to treat TB can be dire, with a high mortality rate among those affected. The key takeaway is that latent TB, which lacks symptoms and is not contagious, can and should be treated before it escalates to an active, contagious form. Identifying and addressing potential infections remains a powerful measure for protecting both individuals and communities.
The U.S. Preventive Services Task Force recommends screening particularly for those at increased risk rather than the general population.
