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Tuberculosis is surging across the United States, with case counts reaching their highest level since 2011 and reversing three decades of steady decline — raising fresh alarms among public health officials nationwide.
According to Stateline, the Centers for Disease Control and Prevention recorded 10,347 tuberculosis (TB) cases across the country in 2024 — an 8% jump from the 9,622 cases reported in 2023. Thirty-four states and the District of Columbia reported increases from 2023 to 2024. New York alone reported 967 cases.
TB is a bacterial infection that primarily attacks the lungs. It spreads through the air when an infected person coughs, speaks, or sneezes. Before the COVID-19 pandemic, it was the world's deadliest infectious disease, killing roughly 1.5 million people each year, according to the World Health Organization.
The disease comes in two forms: active and latent. A person with active TB can spread it to others. A person with latent TB cannot spread the disease, but can develop active TB at any time. Health experts warn that TB is often missed because it can look like influenza or RSV, and delays in treatment have fueled a rise in antibiotic-resistant strains.
Treating one person with active TB costs an average of $43,900, compared to roughly $857 for treating a latent infection before it becomes active, according to the California Department of Public Health.
Costs Crushing Local Health Departments
The financial strain is hitting local agencies hard. In Johnson County, Iowa, spending on TB containment — including contact tracing, home visits, and hotel quarantine stays — jumped from $17,000 in 2020 to $65,000 last year. An additional $13,000 was spent on language translation services, as many cases were found in immigrant communities.
Danielle Pettit-Majewski, director of the Johnson County public health department, said the county recently learned it would have to absorb the full cost of home visits on its own after the state said the rising caseload made it too expensive to help.
"I was kind of dumbfounded," Pettit-Majewski said. "It was surprising."
Fear Is Keeping Patients Away
Experts say fear — particularly among immigrant communities — is making the problem worse. Many people at risk for TB are avoiding medical care amid President Trump's immigration crackdown, which could lead to fewer recorded diagnoses in 2025 — but more undetected cases spreading through communities.
Dr. Michael Lauzardo, an associate professor at the University of Florida's division of infectious diseases and director of the Florida TB Physicians Network, put it plainly.
"I think the numbers will be lower because people are afraid," Lauzardo said. "A lot of the people at risk for TB are not seeking care, I suspect."
Munira Maalimisaq, a family nurse practitioner and CEO of Inspire Change Clinic, a nonprofit health care center in Minneapolis, said fear has been widespread in immigrant communities she serves. After President Donald Trump was elected, her clinic had to remove a routine intake question asking where patients were from — a question designed to assess their exposure to TB in countries where it is more common.
"That was a big barrier, because people would just not answer that question," Maalimisaq said. "If I don't get screened for it, there's no way that my provider is going to diagnose me."
Funding Cuts Adding To The Crisis
Public health agencies are also facing significant funding pressure. Earlier this month, the Trump administration told Congress it intends to rescind $600 million in public health funds from four states: California, Colorado, Illinois, and Minnesota. Some of those grants specifically targeted TB programs.
California, Colorado, Illinois, and Minnesota have all filed suit to block the cuts, arguing that the administration is targeting them with "devastating funding cuts to basic public health infrastructure based on political animus." A federal judge has temporarily halted the cuts.
Donna Hope Wegener, executive director of the National Tuberculosis Coalition of America, said preliminary state data suggests cases grew by between 10% and 20% from 2024 to 2025.
"There are a number of tuberculosis program managers that are reporting double-digit increases," Wegener said. "These back-to-back increases that states are contending with are certainly alarming."
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