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CDC: TB rates in children under 5 rose 29% in 2022

March 23, 2023

Tuberculosis (TB) rates dipped early in the COVID-19 pandemic but rose in 2022, especially among children under 5 years, according to a new study from the Centers for Disease Control and Prevention (CDC).

“The message is loud and clear – TB is still here,” Philip LoBue, M.D., 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.”

There were about 8,300 cases of TB in the U.S. in 2022, an incidence rate of about 2.5 per 100,000 people, according to provisional data in a new Morbidity and Mortality Weekly Report. The case rate per 100,000 people was up from 2.4 in 2021 and 2.2 in 2020, but not as high as the pre-pandemic level of 2.7 in 2019. While cases had been trending downward for years, authors said changes in people’s travel habits and health care access in the early days of the pandemic may have contributed a larger decline in 2020.

Last year, the highest case count was in California, which had 1,843 cases, while the highest rate was in Alaska, which had about 13 cases per 100,000 people.

About 73% of cases were among people not born in the U.S., according to the report. Among U.S.-born people with TB, people who are Native Hawaiian, other Pacific Islander, American Indian and Alaska Native had the highest incidence rates.

People ages 65 and older had the highest TB rates in 2022. However, there was a 29% increase among children under 5 years and a 24% increase among people ages 15-24 years.

“The increase in TB incidence among children aged <4 years might represent both recent transmission in the United States and infection in countries with higher TB incidence,” authors wrote.

In addition to racial disparities, people who are homeless or reside in congregate settings like a correctional facility or long-term care facility are at higher risk. The CDC is partnering with community health clinics and other organizations to address disparities and raise awareness of TB.

“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,” Dr. LoBue said.

The World Health Organization (WHO) also announced Thursday, one day before World Tuberculosis Day, that it is stepping up its efforts to end TB. Worldwide, the disease causes about 1.6 million deaths each year.

“TB is preventable, treatable and curable, and yet this ancient scourge that has afflicted humanity for millennia continues to cause suffering and death for millions every year,” WHO Director-General Tedros Adhanom Ghebreyesus, Ph.D., M.Sc., said in a press release. “WHO is committed to supporting countries to step up their response, by expanding access to services to prevent, detect and treat TB as part of their journey towards universal health coverage, and to strengthen their defences against epidemics and pandemics.”



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