Tuberculosis Outbreaks

Tuberculosis Outbreaks 2024

The World Health Organization (WHO) issued a new report on tuberculosis (TB) on October 29, 2024, revealing that approximately 8.2 million people were newly diagnosed with TB in 2023, the highest number ever recorded by the WHO. This represents a 9% increase from the 7.5 million reported in 2022. TB is the world's top infectious disease killer, with 1.25 million fatalities in 192 countries and areas, led by India and Indonesia. The WHO says most people who developed TB live in the Regions of Southeast Asia, Africa (South Africa), Europe, and the Western Pacific.

Tuberculosis in Children

The WHO estimates 1.2 million children develop TB disease and 200,000 children die worldwide each year. 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.

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.

Tuberculosis Outbreaks in the United States

As of November 9, 2024, the U.S. CDC reported 6,798 TB cases in 2024, led by California and New York (NYC). The CDC reported an increase of 16% compared with 2022. 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 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 9.9% had TBI. In an April 2024 analysis of TB incidence rates for racial/ethnic populations, incidence rate ratios were 14.2 higher among younger American Indian or Alaska Native females. In January 2024, the CDC Tuberculosis Yellow Book 2024 reported 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 US national average.

Tuberculosis Cases By U.S. States

The CDC reports 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 Tuberculosis - 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 have worked in one or more poultry plants in Colbert, Franklin, Lawrence, or Lauderdale counties.

Alaska Tuberculosis - In 2023, Alaska reported the highest rate (10.6) of TB infections in the U.S. The CDC reported 96 TB cases in 2022, an increase of 70% (58) from 2021. Alaska reported the highest TB incidence (13.1). "We have this silent endemic disease that continues to linger, and it's going to take a lot of time and effort," Dr. Anne Zink, the state's chief medical officer, stated.

Arkansas—The Arkansas Department of Health recorded over 100 cases in the state as of November 2024, the first time in 15 years that Arkansas has surpassed 100 TB cases in a year.

California Tuberculosis - Approximately 22% of all TB cases in the U.S. are reported from California. As of April 29, 14 cases of TB disease have been associated with a TB outbreak in Long Beach; nine people have been hospitalized at some point in their illness, and one person has died. Similar to 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 Tuberculosis - In 2023, Florida reported 624 TB cases. 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.

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 Tuberculosis - The CDC confirmed Massachusetts increased TB cases from 154 in 2022 to 224 in 2023.

Michigan Tuberculosis - 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 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. There were 684 confirmed TB cases identified in NYC in 2023, an increase of 28% from 2022.

Texas Tuberculosis - In 2023, Texas reported 1,235 TB cases, compared to 1,100 cases in 2022. Recent data indicates TB rates are accelerating in certain cities (Dallas, Ft. Worth, Hidalgo County, Houston, San Antonio) in 2024. About 69% of people diagnosed with TB in Texas were non-U.S. born. 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 Country (Houston) reported the most TB cases (267) in 2022. In 2021, 998 TB patients were reported throughout Texas, representing an increase of 12.5% from 2020. In 2019, Texas' 32 border counties had an average TB incidence nearly triple the national rate.

Tuberculosis Outbreaks United States 2023

The U.S. CDC says TB case count increases in 2023 underscores the ongoing global TB-associated morbidity and mortality. In 2023, there was an increase of 1,295 cases (16%) 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 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 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.

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 tuberculosis (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 among eight countries that accounted for about two-thirds of the global number of people 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 UK Health Security Agency (UKHSA) annual TB report shows tuberculosis cases in England rose 10.7% in 2023 compared to 2022 (4,850 compared to 4,380). 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

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, and prescribing a short-course treatment regimen if a diagnosis of LTBI is made. 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, that data suggest 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.