Tuberculosis on the Rise: 2023 Marks Decade's Highest U.S. Infection Rates

A report by the US Centers for Disease Control and Prevention states that more than forty US states have reported an increase in the number of cases infected with tuberculosis, and that the rates of the disease have increased among all age groups

by Sededin Dedovic
Tuberculosis on the Rise: 2023 Marks Decade's Highest U.S. Infection Rates
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The Centers for Disease Control and Prevention (CDC) announced last month that the number of tuberculosis (TB) cases in the United States in 2023 was the highest in the past decade. According to the report, over forty American states reported an increase in the number of TB cases, with rates rising among all age groups.

In 2023, a total of 9,600 cases were reported, marking a 16 percent jump compared to 2022 and the highest annual count since 2013. The number of infections dramatically decreased at the onset of the COVID-19 pandemic, but has since been steadily increasing.

The majority of cases were recorded among individuals born in other countries. The World Health Organization stated that in 2022, TB ranked second only to COVID-19 in infectious fatal diseases worldwide. CDC officials anticipated an increase in TB cases, but the number for 2023 was "slightly higher than expected," the report stated.

Despite the surge, the number and rate of new TB cases each year are lower than in the past, with the U.S. having a lower rate of new TB cases than most countries worldwide.

Exterior of the Center for Disease Control (CDC) headquarters is seen on October 13, 2014 in Atlanta, Georgia.

© Jessica McGowan / Getty Images

The new CDC statistics did not count the number of new TB infections in 2023, but rather the number of individuals exhibiting cough or other symptoms and receiving a diagnosis of the disease.

It is estimated that 85 percent of individuals counted in 2023 were infected at least a year or two earlier and had what is called latent tuberculosis, where the bacteria enter the body and hibernate in the lungs or other parts of the body.

Experts estimate that up to 13 million Americans have latent tuberculosis and are not contagious. Tuberculosis is caused by bacteria that typically attack the lungs and spreads through the air when an infectious person coughs or sneezes.

If not properly treated, it can be fatal. In the late 1800s, tuberculosis killed one out of every seven residents in the U.S. and Europe. However, the development of antibiotics and public health efforts have succeeded in treating infections and monitoring those who are contagious, leading to a decline in cases in recent decades.

Tuberculosis vaccines are in development, and healthcare workers who were focused on COVID are now returning to explore new approaches to TB prevention. New York, which saw a 28 percent increase in cases last year, is hiring new healthcare workers and increasingly using video surveillance of patients taking medication to maintain a high treatment rate, said city health secretary Dr.

Ashwin Vasan. According to the World Health Organization (WHO) data from 2019, tuberculosis (TB) remains the ninth leading cause of death worldwide and the leading cause of death from a single infectious agent, more prevalent than HIV/AIDS.

If a person has good immune resistance, the infection with inhaled bacilli is overcome in its infancy, and the disease usually does not develop. Only 10 percent of infected individuals will later develop tuberculosis during their lifetime, with the most common reason being a decline in immune resistance caused by stress, unhealthy lifestyles, malnutrition, poor living conditions, alcoholism, prolonged illness, HIV infection, etc.

Tuberculosis can occur in any part of the body, but it most commonly affects the lungs.

What are the symptoms?

The disease is mostly localized in the lungs but can affect other organs, leading to extrapulmonary tuberculosis, most commonly affecting the pleura, lymph nodes, skin, brain, meninges, kidneys, intestines, eyes, bones, etc.

Infection does not necessarily mean disease, and only in 10% of those infected does active tuberculosis develop. Whether infection and illness will occur depends on one hand on the pathogen itself (its infectiousness) and on the other hand, on the resistance of the organism that comes into contact with the bacillus.

The most common symptoms of tuberculosis are quite nonspecific and can be minimally expressed for a long time, so patients may not seek medical attention. Therefore, this is a very insidious disease. The most common symptoms include fatigue, loss of appetite and weight loss, increased night sweats, fever, along with a cough that is usually dry and persistent, occasionally accompanied by coughing up mucus, pus, or blood.

Difficulty breathing may be present if the disease has progressed, and chest pain occurs if the pleura is affected. If other organs are affected, the disease manifests with symptoms related to them. It is recommended that all individuals who cough for more than three weeks undergo a chest X-ray to rule out tuberculosis or another lung disease.

Coughing up blood is often the reason a patient seeks medical attention. Risk factors for tuberculosis include any immunocompromising conditions, malnutrition, cigarette smoking, alcohol and/or drug abuse, HIV infection. Additionally, socially disadvantaged populations, prisoners, and individuals living in close contact with tuberculosis patients are most likely to develop tuberculosis.