Cases of tuberculosis, historically known as "the white plague," are rising in the United States following a temporary decline during the early days of the pandemic.
Over 10,600 cases were reported in 2024 - the highest annual total since 2013. Experts say this reflects a "rebound effect" as latent infections undiagnosed during the pandemic begin to activate.
Renuga Vivekanandan, MD, an infectious disease expert at Creighton University, explained that TB surveillance and treatment programs were disrupted nationwide during the height of the pandemic. She emphasized that many cases went undetected or untreated.
Additional factors include renewed international travel and migration from regions where TB remains prevalent. Public health departments, already stretched thin, have struggled to rebuild capacity.
Tuberculosis is a curable bacterial infection primarily affecting the lungs but capable of attacking other organs. It spreads via airborne particles when an infected person coughs, speaks, or sneezes.
Symptoms of active TB include persistent cough, chest pain, fatigue, weight loss, fever, and night sweats. In some cases, it can lead to severe complications involving the kidneys, spine, skin, or brain.
According to Dr. Masae Kawamura, former TB control director in San Francisco, lung-based TB accounts for more than 80% of cases - making transmission especially likely.
About one-quarter of the global population carries latent TB, though only 5-10% will develop active disease. Latent TB shows no symptoms and isn't contagious, but can progress without proper intervention.
Those at higher risk include travelers to or immigrants from high-TB-burden countries, individuals in crowded settings, immunocompromised persons, diabetics, smokers, and young children.
Treatment involves daily antibiotics such as isoniazid, rifampicin, pyrazinamide, and ethambutol over several months. Skipping doses risks developing drug-resistant strains, which are harder and costlier to treat.
Left untreated, TB proves fatal in roughly half of its victims. However, early detection and treatment of latent infections can prevent progression to active disease.
The U.S. Preventive Services Task Force currently advises targeted screening for at-risk populations only, not mass testing.