While U.S. tuberculosis declined substantially during the COVID-19 pandemic, cases are now returning to pre-pandemic levels.
A relative adjusts the oxygen mask of a tuberculosis patient at a TB hospital on World Tuberculosis Day in Hyderabad, India, on March 24, 2018. Credit: Mahesh Kumar A. / AP

Tuberculosis cases have increased for the second year in a row, according to a March 2023 report from the Atlanta-based Centers for Disease Control and Prevention. While incidence of tuberculosis within the U.S. declined substantially during the COVID-19 pandemic, cases of the disease are now returning to pre-pandemic levels.

“During 2022, reported TB incidence increased slightly,” the CDC reported. “Among non–U.S.-born persons with TB, the proportion who had recently arrived in the United States increased. Higher TB incidence among American Indian or Alaska Native and Native Hawaiian or other Pacific Islander persons compared with other race and ethnicity groups represents an ongoing health disparity.”

From 1993 to 2019, incidence of tuberculosis reports gradually declined nationwide. Incidence of the disease substantially declined in 2020, however, reaching just 2.2 cases per 100,000 persons.

“Proposed explanations for the decline include delayed or missed TB diagnoses, changes in migration and travel, and mortality among persons susceptible to TB reactivation,” the CDC reported.

In 2021, incidence of tuberculosis rebounded to 2.4 cases per 100,000 persons — still lower than the lowest pre-pandemic levels in recent years, 2.7.

“During 2022, the 50 U.S. states and the District of Columbia (DC) provisionally reported 8,300 TB cases to the National Tuberculosis Surveillance System,” the CDC reported. “TB incidence was calculated using midyear population estimates and stratified by birth origin and by race and ethnicity. During 2022, TB incidence increased slightly to 2.5 although it remained lower than during prepandemic years.”

“TB incidence appears to be returning to prepandemic levels,” the CDC reported. “TB disparities persist; addressing these disparities requires timely TB diagnosis and treatment to interrupt transmission and prevention of TB through treatment of latent TB infection.”

Story by Hunter Boyce, The Atlanta Journal-Constitution.