TB on rebound in US, but cases remain below pre-pandemic levels, CDC says
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Key takeaways:
- Tuberculosis incidence increased in 2022 compared with 2020 and 2021 but remained lower than incidence during the pre-pandemic years.
- Children aged 4 years and younger had the highest increase in cases among all age groups.
Cases of tuberculosis increased in the U.S. in 2022 but did not return to pre-pandemic levels, according to data published in a Morbidity and Mortality Weekly Report ahead of World TB Day.
“During the early COVID-19 pandemic (2020), U.S. incidence of reported TB substantially declined. Incidence partially rebounded in 2021 but remained lower than incidence during pre-pandemic years,” Kimberly R. Schildknecht, SnD, BSN, MPH, Epidemic Intelligence Service officer, and colleagues wrote.
They attributed these declines to delayed or missed TB diagnoses, changes in migration and travel and mortality among persons susceptible to TB reactivation.
Overall, the 2022 report showed that there was a 5% increase in cases in 2022 compared with 2021. In total, 8,300 TB cases were reported in 2022 and 7,874 in 2021, showing that TB incidence increased only slightly to 2.5 per 100,000 persons compared with 2.4 during 2021.
Similar to previous years, the states with the highest number of cases and highest TB incidence were California and Alaska, respectively, with 1,843 cases in California and an incidence of 13.1 cases per 100,000 people in Alaska.
Among the 8,248 TB cases reported among people with known birth origin, 73% occurred in non-U.S.-born people in 2022 compared with 72% in 2021. Among the 2,239 U.S.-born persons with TB in 2022, 30% identified as Black, 26% as Hispanic, 25% as white, 8% as Asian, 5% as American Indian or Alaska Native (AI/AN), and 2% as Native Hawaiian and other Pacific Islander (NH/OPI).
Among these groups, incidence in 2022 increased the most among Asian people (63%) followed by NH/OPI (26%), AI/AN (16%) and 7% among Hispanic people, whereas incidence declined 9% and 10% among Black and white people, respectively.
In addition to people of specific racial and ethnic groups, the report also showed a rebound in cases or “considerable increases” among specific age groups, specifically children aged 4 years and younger who had a 28.8% increase in cases, followed by those aged 15 to 24 years with a 23.7% increase.
People aged 65 years and older, who have the highest incidence of TB among the age groups (3.9 cases per 100,000 people) experienced a decrease in incidence of 1.8% in 2022.
Other populations of concern named in the report included people who are experiencing homelessness in the 12 months before their diagnosis, who had an increased incidence of infection (4.8%), as well as those living in correctional or long-term care facilities (3.5% and 1.7%, respectively). The CDC said this highlights the importance of entry and annual screenings in these settings.
“The message is loud and clear — TB is still here,” Philip LoBue, MD, FACP, FCCP, director of CDC’s Division of Tuberculosis Elimination, said in a press release.
“For the second year in a row, TB disease cases in the U.S. have continued to rise, with concerning increases among young children and other groups at increased risk for TB disease,” he said. “Communities, providers, and public health partners must work together to make sure we are reaching the right people with testing and treatment, so we can prevent and stop the spread of TB.”
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