12 things to know about the rise of tuberculosis in the U.S.
Tuberculosis has the eerie feel of an old disease, the kind people expect to find in history books, not in a fresh CDC report. But the numbers say TB is pushing its way back into view. CDC provisional data show the U.S. reported 10,260 TB cases in 2025, only slightly below 10,395 cases in 2024, and still well above the quieter pandemic-era low.
In 2023, the country recorded 9,633 cases, the highest count since 2013, with a rate of 2.9 cases per 100,000 people. For most Americans, the personal risk remains low. Still, the long downward trend has clearly been interrupted, and a disease many people mentally packed away as “the past” is quietly demanding attention again.
The reassuring part is also the warning. TB is preventable, detectable, and treatable, but only when it is found early, treated completely, and followed closely by local public health teams. CDC estimates that up to 13 million people in the U.S. have inactive, or latent, TB, and more than 80% of active TB cases come from long-standing, untreated latent infection.
That means this story is not only about headline-making outbreaks. It is also about silent infections, missed testing, delayed care, crowded rooms, and a cough that can seem small until the health system looks more closely.
TB Cases Have Risen Three Years in a Row
The first thing to know is that the rise did not appear from nowhere. CDC’s 2023 surveillance report showed 9,633 TB cases, a 15.6% increase from 2022 and the highest U.S. total since 2013.
CDC later reported that 2024 saw a fourth straight annual increase, with 10,395 cases, before 2025’s provisional count dipped slightly to 10,260. That small 2025 decline is welcome, but it does not erase the larger pattern.
The U.S. still has a low TB rate by global standards, yet the country is no longer gliding along the long decline that began in the 1990s. For readers, the practical point is simple: TB is not suddenly everywhere, but it is no longer safe to treat it like a relic.
COVID-19 Disrupted TB Detection
The 2020 drop in TB cases looked like good news at first glance, but public health experts have warned that it was partly a mirage. CDC data show TB cases fell sharply in 2020, then started climbing again in 2021, 2022, and 2023.
A CDC Emerging Infectious Diseases analysis links those changes to pandemic-era disruptions in testing, access to care, diagnosis, and reporting. Renuga Vivekanandan, M.D., professor at Creighton University School of Medicine, told Fox News Digital, “The COVID-19 pandemic effectively disrupted TB surveillance and treatment programs across the country.”
That quote explains the rebound in plain English. Some people who should have been screened, diagnosed, or treated earlier may have been missed, and now the delayed cases are showing up in the data.
Most U.S. TB Cases Are in People Born Outside the U.S.
CDC’s 2024 report shows that 77% of reported TB cases occurred among non-U.S.-born people, and the rate among non-U.S.-born people was 15.7 per 100,000, nearly 20 times the U.S.-born rate of 0.8 per 100,000.
Those numbers matter, but they need care. TB risk is often tied to exposure in places where the disease is more common, latent infection acquired years earlier, access to health care, crowded housing, work conditions, and trust in public systems.
CDC also reported that 51% of 2024 TB cases among non-U.S.-born people occurred among people who had lived in the U.S. for at least five years. That detail keeps the story honest. This is not a simple “border” story. It is a public health story about who gets screened, who gets treated, and who feels safe enough to seek care.
TB Is Rising in Children
Children are among the groups public health workers closely monitor because pediatric TB can indicate a more recent spread. CDC’s 2024 age data show that case counts increased across all age groups except adults 65 and older, and that children under 5 accounted for 3% of all U.S. TB cases.
Even more telling, CDC’s recent transmission data found that the share of cases attributed to recent transmission was highest among children 0 to 4, at 58%, compared with 4% among adults 65 and older. State patterns also vary.
California reported a 12-year high in TB cases in 2025, and Kansas drew national attention for a major outbreak in the Kansas City area. The overall public risk may still be low, but these local surges show how quickly TB can become a major task for small health departments.
Urban Crowding and Housing Instability Are Drivers
TB spreads through the air, especially through close, prolonged indoor exposure, which means the shape of daily life matters. CDC’s 2024 large-outbreak data showed six large TB outbreaks involving 129 cases, and children under 15 accounted for 36% of those cases.
CDC also found that recent transmission was higher than the national average among people reporting substance use, incarceration, and homelessness. That does not mean TB is caused by poverty alone, but it does mean cramped rooms, shelters, correctional facilities, unstable housing, and delayed access to care can give the bacteria more chances to move.
TB is a medical disease, but it travels through social conditions. When ventilation is poor, and people have few choices about where they sleep, recover, or isolate, public health gets harder.
Public Health Departments Are Stretched Thin
Containing TB takes time, staff, trust, and steady follow-up. It is not as simple as handing someone a prescription and moving on. Local health departments often handle contact tracing, testing, home visits, isolation support, medication monitoring, and outreach to people who may not have stable housing or regular primary care.
CDC’s 2024 outbreak data show why that work matters: nearly 80% of cases in new large outbreaks were identified through contact investigations.
CDC’s executive commentary put the need directly: “Maintaining nationwide capacity to prevent, detect, and stop recent transmission and outbreaks remains crucial.” That is the heart of the public health warning. When TB programs are understaffed or underfunded, a single case can take longer to find, and longer delays give TB more room.
Drug-Resistant TB Is a Small but Serious Threat
Most U.S. TB is still treatable with standard medicines, but drug resistance is the kind of small number public health workers take seriously. CDC reported 115 multidrug-resistant TB cases in 2024, representing 1.5% of cases with susceptibility results for isoniazid and rifampin. Of those, 12 were pre-extensively drug-resistant, and 5 were extensively drug-resistant.
That is not a huge share, and the U.S. is not facing a drug-resistant TB crisis at the scale seen in some countries. Still, resistant TB is harder to treat, takes longer to treat, and is more expensive.
CDC notes that delays in recognizing resistance or access to effective drugs can increase transmission and worsen resistance. The practical lesson is not fear. It is a follow-through. Finishing treatment matters because unfinished or incorrect treatment can give the bacteria more room to survive and adapt.
TB Disproportionately Affects Marginalized Communities
TB is often called a disease of inequality because risk follows the places where health systems, housing, and social safety nets are weakest. CDC’s 2023 report found that 90.1% of TB cases occurred among people who identified as racial and ethnic minorities, and the incidence rate among non-U.S.-born people was 18.5 times higher than among U.S.-born people that year.
In 2024, CDC data showed large outbreaks were often linked to social networks and settings where contact tracing is hard, and recent transmission was more common among people reporting homelessness, incarceration, and substance use.
This is where the public conversation needs more empathy. TB is not a moral failure. It is a disease that finds cracks in housing, health care, work conditions, and trust. If those cracks widen, the bacteria get more chances.
Immigration Crackdowns May Be Undermining TB Control
TB control depends on people saying yes to testing, treatment, contact tracing, and follow-up. Fear can break that chain. CDC data show most U.S. TB cases occur among non-U.S.-born people, but the same data show many cases are linked to people who have lived in the U.S. for years, not only recent arrivals.
That matters because public health success depends on trust across immigrant communities, workplaces, schools, clinics, and local agencies. If people worry that seeking care could bring legal trouble, stigma, job loss, or family disruption, they may delay testing until they are much sicker.
That delay is bad for them and bad for everyone around them. The calm public health answer is not to blame. There is a clear separation between care and fear, plus easier access to screening, treatment, and culturally competent outreach.
The TB Vaccine Story in the U.S. Is Complicated
The TB vaccine, called BCG, is widely used in many countries, but the U.S. does not routinely give it to the general population. CDC explains that BCG is not generally used in the U.S. because TB risk is low, protection against adult pulmonary TB is variable, and the vaccine can cause a false-positive TB skin test.
CDC also says TB blood tests are preferred for people who have received BCG because the vaccine does not affect those tests. That makes the vaccine story easy to misunderstand. A person can be vaccinated elsewhere and still need evaluation if they are at risk.
A person in the U.S. may never have been offered BCG because the national strategy has historically leaned on screening, treatment of latent infection, contact tracing, and targeted public health response. The rise in cases may renew interest in better vaccines, but for now, testing and treatment remain the main U.S. tools.
TB Is Preventable And Treatable If Signs Are Known
This is the section ordinary readers should remember most. CDC says active TB disease in the lungs can cause a cough lasting three weeks or longer, fatigue, chest pain, coughing up blood or sputum, weight loss, weakness, loss of appetite, chills, fever, and night sweats.
Latent TB causes no symptoms and cannot spread to others, but the CDC estimates up to 13 million people in the U.S. have inactive TB, and without treatment, about 5% to 10% of infected people develop active disease over their lifetimes.
Masae Kawamura, M.D., a former TB control director in San Francisco, told Fox News Digital, “TB can affect any organ of the body, but it causes disease in the lung in over 80% of cases.” Non-alarmist advice: contact a health care provider or local health department if you have a cough lasting three weeks or more, TB-like symptoms, close exposure to someone with active TB, HIV, or another immune-weakening condition, or time spent in a higher-risk setting.
What Experts Say Needs to Happen Next
The next step is not to panic. It is attention. CDC’s 2025 provisional report says TB cases remained elevated over pre-pandemic levels, even with the slight 2025 dip, and CDC’s 2024 commentary says the fourth year of rising cases moved the country away from the goal of eliminating TB.
The same CDC commentary states that TB disease is preventable and curable, and that identifying and treating latent TB infection can prevent people from developing contagious disease. Vivekanandan put the practical message clearly: “The good news is that TB is both preventable and treatable.”
What needs to happen now is not mysterious: faster diagnosis, better screening for high-risk groups, stronger local TB teams, safe isolation support when needed, help completing treatment, and outreach that reduces stigma instead of driving people underground. The tools exist. The question is how seriously the country chooses to use them.
Reflective Close
TB’s rise is not a reason to panic, but it is a reason to stop treating the disease like a ghost from old medical textbooks. It is still here, still airborne, still shaped by crowded rooms and delayed care, and still beatable when public health systems are given the time and trust they need.
The quiet lesson is simple. Diseases do not disappear just because the public stops thinking about them. Sometimes they wait in the background until the cracks widen.
Key Takeaways
The U.S. reported 9,633 TB cases in 2023, 10,395 in 2024, and a provisional 10,260 in 2025, keeping the country above pre-pandemic levels despite a slight dip last year.
Most 2024 cases occurred among non-U.S.-born people, but recent transmission and large outbreaks also continue inside the U.S., especially in settings shaped by crowding, homelessness, incarceration, and limited access to care.
CDC estimates up to 13 million people in the U.S. have latent TB, and drug-resistant TB remains rare but serious, with 115 MDR-TB cases in 2024. The average person’s risk is still low, but the public health message is clear: know the symptoms, take long coughs seriously, get tested if you are at risk, and support the local health systems that keep one case from becoming a cluster.
Disclaimer – This list is solely the author’s opinion based on research and publicly available information. It is not intended to be professional advice.
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