Tuberculosis Outbreaks
Tuberculosis Outbreaks April 2025
The World Health Organization (WHO) says Tuberculosis outbreaks will remain a global health risk in 2025. The WHO issued an updated Global Tuberculosis (TB) Report on October 29, 2024. The report revealed that approximately 8.2 million people were newly diagnosed with TB, a respiratory disease, in 2023, the highest number ever recorded by the WHO. According to the WHO's Global Tuberculosis Report 2024, there were 1.25 million fatalities in 192 countries and areas, led by India and Indonesia. The WHO says most people who develop TB live in the Regions of Southeast Asia, Africa (South Africa), Europe, and the Western Pacific. India (26%), Indonesia (10%), China (6.8%), the Philippines (6.8%), and Pakistan (6.3%) together accounted for 56% of the global TB burden.
The WHO's European Region reported over 172,000 people with new and relapsed TB in 2023 and more than 7,500 cases among children under 15 in 2023, a 10% increase from 2022. In the Region of the Americas, TB cases have increased by about 20% over the past five years.
As of March 25, 2025, UK Health Security Agency (UKHSA) data revealed a 13% increase in reported TB cases in 2024 (5,480) compared to 2023, which amounted to more than 600 additional notifications of people being diagnosed in 2024 (London and Midlands) compared to 2023.
Tuberculosis in Children 2025
The 2025 Tuberculosis Surveillance and Monitoring Report, released by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe on March 24, 2025, shows that children under 15 years of age accounted for 4.3% of those with new and relapsed TB in the WHO European Region, representing a 10% surge in pediatric TB for 2023, compared to 2022. The WHO estimates that 200,000 children die from TB annually.
Almost two-thirds of TB cases in children worldwide were either not reported or went undiagnosed and untreated. Of the children who developed TB in 2023, the diagnosis was confirmed in only 36%. Estimates show that about 67 million children with latent TB infection are at risk of developing active TB. In a prospective South African birth cohort study published by The Lancet in November 2024, M tuberculosis transmission was found to be consistently high throughout the first decade of life, leading to approximately 10% of children developing TB disease.
Tuberculosis Outbreaks in the United States
In 2024, 10,347 TB cases were provisionally reported by the U.S. CDC. The percentage increase in case counts (8%) and rates (6%) from 2023 to 2024. Thirty-four states and the District of Columbia reported increases in TB case counts.
The U.S. CDC Morbidity and Mortality Weekly Report (MMWR), published in June 2024, examined the most recent five years of National TB Indicators Project data. This data indicated that up to 13 million people in the U.S. (60 jurisdictions) live with latent TB infection. On March 28, 2024, the MMWR confirmed TB incidence increased in 2023 compared with 2022 among children aged 5–14 (68 cases, corresponding to a 42% increase in case count). The CDC reported 202 cases of TB in children ages four and younger in 2022, an increase from 160 cases in 2021. On January 23, 2024, USAID published its Annual TB Report to Congress, which indicated that global TB case notifications increased by 70% in 2022 compared to 2021.
A study published in September 2024 showed that tuberculosis infection (TBI) disproportionately affects non-US-born persons. Among persons born in countries with high rates, 9.9% had TBI. In an April 2024 analysis of TB incidence rates for racial/ethnic populations, incidence rate ratios were 14.2 times higher among younger American Indian or Alaska Native females. In January 2024, the CDC Tuberculosis Yellow Book 2024 reported that immigrants from countries with a high TB burden and long-term residents of high-burden countries have a 10× greater incidence of TB than the U.S. national average.
Tuberculosis Cases By U.S. States
The CDC reports that four U.S. states combined reported half of all U.S. TB cases in 2022: California (22.2%), Texas (13.2%), New York, including New York City (8.6%), and Florida (6.4%).
Alabama—The Alabama Department of Public Health confirmed 92 TB cases in 2023, compared to 65 in 2022. As of July 31, 2023, seven confirmed or suspected TB disease cases have been identified in individuals who worked in one or more poultry plants in Colbert, Franklin, Lawrence, or Lauderdale counties.
Alaska - The rate of tuberculosis in 2024 was 12.8 per 100,000 people in Alaska, up from the 2023 rate of 10.5 per 100,000. The CDC reported 96 TB cases in 2022, an increase of 70% (58) from 2021. Alaska's tuberculosis history was posted in 2017.
Arkansas - As of November 2024, the Arkansas Department of Health recorded over 100 TB cases in 2024, the first time in 15 years that the state has exceeded 100 TB cases in a year.
California — Approximately 22% of all TB cases in the U.S. are reported from California. In 2023, 243 people were reported with active TB disease in San Diego County. As of April 29, 2024, 14 cases of TB disease have been associated with a TB outbreak in Long Beach; nine people have been hospitalized, and one has died. Similar to the 2022 data (1,848), California reported an increase in TB cases in 2023 (2,113). In 2022, the California Health Department reported 1,750 TB cases in 2021, a 3% year-over-year increase.
Florida In 2023, Florida reported 624 TB; in 2022, Florida confirmed 536 TB cases. In 2021, 500 tuberculosis cases were reported in Florida, representing a 21% increase from 2020 (412). Miami-Dade County leads Florida in TB cases.
Kansas—In 2025, the Kansas Department of Health and Environment reported 67 active TB cases and 79 latent cases in Wyandotte and Johnson counties (Kansas City) since the beginning of 2024. In September 2023, the CDC's Morbidity and Mortality Weekly Report confirmed an outbreak of multidrug-resistant TB in Kansas City.
Illinois Tuberculosis - In April 2024, the Chicago Department of Public Health (CDPH) spokesperson Jacob Martin said they were "aware of a small number of TB cases among new arrivals in different shelters throughout the city." As of April 2024, CDPH does not provide routine TB screening services to the public. Illinois (including Chicago) reported 353 tuberculosis cases in 2023 and 298 in 2023.
Massachusetts - The CDC confirmed that Massachusetts increased TB cases from 154 in 2022 to 224 in 2023.
Michigan —In 2023, there were 140 TB cases, an increase from 120 people with TB in 2022. The journal Clinical Infectious Diseases reported in January 2024 that the spillover of enzootic M. bovis from deer to humans and cattle continues to occur in Michigan. Four people in Michigan recently contracted TB linked to wild deer and domestic cattle, increasing the total number of zoonotic cases in Michigan to seven since 2002.
New York - New York City - Data for New York State, including New York City, indicates 894 TB cases in 2023 and 714 TB cases in 2022, an increase from 683 in 2021. Six hundred eighty-four confirmed TB cases were identified in NYC in 2023, an increase of 28% from 2022.
Texas - Texas reported 1,235 TB cases in 2023, compared to 1,100 cases in 2022. Data from 2023 indicates TB rates are accelerating in certain cities (Dallas, Fort Worth, Hidalgo County, Houston, San Antonio) in 2024. In 2022, 7,415 Texans were exposed to TB. Public health departments treated over 2,900 people for TB infection in 2022, and 50 Texans died of TB, the second most in any state.
Harris County Public Health was recognized by the CDC for its Tuberculosis Elimination Program in 2025. Harris County (Houston) reported the most TB cases (269) in 2022. In 2021, 998 TB patients were reported throughout Texas, representing an increase of 12.5% from 2020. In 2019, Texas's 32 border counties had an average TB incidence nearly triple the national rate. About 69% of people diagnosed with TB in Texas were non-U.S.-born.
Tuberculosis Outbreaks in the United States 2023
The U.S. CDC says the TB case count increases in 2023 underscore the ongoing global TB-associated morbidity and mortality. In 2023, 1,295 cases (16%) increased compared with the 2022 total. The rate in 2023 (2.9 per 100,000 persons) also increased compared to 2022 (2.5). Forty states and DC reported increases th case counts and rates in 2023. Four states reported the most TB cases: California (22.2%), Texas (13.2%), New York (New York City) (8.6%), and Florida (6.4%). In 2023, 7,259 (76%) TB cases occurred among non-U.S.–born persons, an 18% increase compared with the 6,177 such cases reported in 2022. The number of TB cases in US-born persons in 2023 increased by 9%, from 2,131 in 2022 to 2,314. On October 5, 2023, H.R. 1776 was filed to require the U.S. Agency for International Development (USAID), which leads the U.S. Government's global TB Strategy 2023–2030 efforts, to coordinate with federal agencies to update and implement programs for the global prevention, treatment, and eradication of tuberculosis.
Tuberculosis Outbreaks in the United States 2022
In 2022, among the 31,938 TB cases in US-born patients, researchers found substantially higher incidence among racial/ethnic minority populations. Compared with non-Hispanic Whites, TB incidence rate ratios were 4.4 times higher for Hispanics, 6.6 times higher for Asians, 6.8 times higher for Blacks, and 14.2 times higher for American Indian/Alaska Natives. In 2022, about 73% of reported TB cases that occurred in the U.S. were among non–U.S.-born persons.
Tuberculosis in The Region of The Americas
In the Americas, the PAHO reported that about 325,000 people fell ill from TB in 2023, and 35,000 died from TB, according to the WHO Global Tuberculosis Report. Data indicates 31,000 TB cases (1,900 children) in Mexico in 2022. The U.S.-Mexico Binational Committees for Tuberculosis. According to a report from Stop TB Canada, Canada diagnosed 1,971 people with TB in 2022.
Tuberculosis in Africa
Researchers reported in The Lancet Child & Adolescent Health that a study conducted in South Africa found that unvaccinated children who grow up in a setting where TB transmission is common have a risk of up to 10% developing the disease by age ten. This high incidence of TB was likely driven by the consistently high M tuberculosis transmission rates throughout this period. Protection from disease with age (even as the annual risk of infection remains consistent) might suggest immune maturation over time, protection as children are reinfected with M tuberculosis, or early-life immunological hits, such as following viral infection, which facilitate disease. In South Africa, the BCG vaccine is given routinely to newborns at birth. In 2024, South Africa is conducting TB vaccine research.
Nigeria (4.6% ) and the Democratic Republic of Congo (3.1%) are the eight countries that account for about two-thirds of the population estimated to have developed TB in 2023.
Tuberculosis Europe
The WHO published the 2023 Global TB Report on November 7, 2023. The TB surveillance and monitoring report from the WHO Regional Office for Europe and the European Centre for Disease Prevention and Control (ECDC) estimated that 229,000 people were diagnosed with TB in the European Region in 2022. In 2022, 53 WHO/Europe Member States reported 220,000 TB cases. The ECDC stated the EU/EEA is not on track to reach the goal of ending the TB epidemic by 2030.
Tuberculosis, WHO Southeast Asia Region
India accounted for about 25% of the global TB burden. In 2021, the estimated TB incidence was 2,950,000, and an estimated 506,000 people died from TB. In 2020, compared to 2019, there was a 15.4% decrease in TB death totals, with 28 out of India's 36 states showing a decline. In addition, deaths by TB for individuals living with HIV decreased by 16% across India. The Government of India's Central TB Division within the Ministry of Health & Family Welfare leads the BCG vaccination efforts.
Tuberculosis United Kingdom
The UKHSA annual TB report shows provisional data for 2024, showing a 13% annual increase in TB cases. In 2023, TB cases in England increased by 11% compared to 2022. In 2022, non-UK-born individuals born in India, Pakistan, Bangladesh, Eritrea, Nigeria, and Romania continued to account for 79.1% of TB notifications in England. In 2021, the highest TB rates were in London, accounting for 35.5%.
Zoonotic Tuberculosis Outbreaks
Tuberculosis (TB) is an ancient disease caused by Mycobacterium tuberculosis (MTB) that spreads through the air and affects people's lungs. "Consumption" and "Phthisis" were terms historically used to describe TB, which was responsible for one in four deaths in the 19th century. Zoonotic tuberculosis is a form of TB in people caused by Mycobacterium bovis, which belongs to the M. tuberculosis complex. There are an estimated 140,000 cases of zoonotic tuberculosis each year, which results in approximately 11,400 deaths. In 2022, Heads of State adopted the UN High-Level Political Declaration on the Fight Against Tuberculosis, reaffirming their commitment to ending the global tuberculosis epidemic, including a call for action against zoonotic tuberculosis.
Tuberculosis Tests
Science Translational Medicine published a study on April 9, 2025, that found a smartphone-sized device can deliver tuberculosis (TB) test results at the point of care in less than an hour. The portable lab-in-tube assay uses a DNA-enrichment membrane and cellulose disc containing DNA amplification and molecular diagnostic reagents to provide results without a conventional lab-based DNA isolation procedure.
The U.S. CDC expanded its tuberculosis testing recommendations for people entering the U.S. on January 16, 2024. The instructions in this document supersede all previous Tuberculosis Technical Instructions, Updates to the Technical Instructions, and communications to panel physicians and international refugee resettlement organizations. These instructions must be followed for all applicants' tuberculosis disease screening and treatment. The molecular testing requirement, interferon-gamma release assay (IGRA) testing for adults, and changes to drug susceptibility testing (DST) defined in these instructions go into effect no later than October 1, 2024; all other components of these instructions go into effect January 24, 2024.
As of November 3, 2023, the U.S. CDC recommends testing persons at increased risk for TB infection as part of routine health care using TB blood tests, when possible. Among 3,647 healthcare providers, approximately 53% reported routinely testing non–U.S.-born patients for TB in 2023. On October 30, 2023, The Lancet published an assessment of the diagnostic accuracy of the Cepheid Mycobacterium tuberculosis Host Response prototype cartridge (MTB-HR) in children with presumptive tuberculosis. This candidate test measures a three-gene transcriptomic signature from fingerstick blood. MTB-HR differentiated children with culture-confirmed tuberculosis from those with unlikely tuberculosis with a sensitivity of 59·8% (95% CI 50·8–68·4). TB testing is expected to reach $2.7 billion in 2027 at a CAGR of more than 6%.
The journal Science Advances published results from a study on January 3, 2023, which suggests that passive cough features distinguish TB from non-TB subjects and are associated with bacterial burden and disease severity. Although cough counts did not discriminate between coughs related to TB versus other conditions, cough scalogram characteristics were associated with identifying coughs due to pulmonary TB.
Tuberculosis Vaccines
Various TB vaccines have been authorized worldwide as of March 2025.
