Tuberculosis is still here in the United States. Massachusetts saw a 25% increase in the number of cases last year to 178 total cases, up from 142 in 2022, according to preliminary data from the Centers for Disease Control and Prevention (CDC). Connecticut saw a 24% increase in the number of cases last year to 67 total cases, up from 54 in 2021 and 2022. Nationally, cases rose 5% in 2022.
“I am concerned about the increased burden of TB cases and what it means for patients and our health care system,” said Dr. Sheela Shenoi, medical director of the infectious diseases program at Yale Medicine. “The rise in cases in the U.S. is a reflection of the worsening global TB epidemic.”
Tuberculosis is caused by the bacterium Mycobacterium tuberculosis, which typically infects the lungs. But TB bacteria can attack any part of the body including the kidney, spine, and brain. If left untreated, TB disease — or active TB — can be fatal.
Roughly 1 in 25 people across the country live with inactive TB, according to CDC data.
“It presents a risk for someone as they age or become immunocompromised,” said Dr. James Shepherd, a TB specialist at Yale Medicine. “They could reactivate that dormant TB organism that’s asleep inside of them and they could become sick with active TB and join the 8,000 [plus] people diagnosed with active TB in the U.S.”
According to the CDC, without treatment, 1 in 10 people with inactive TB will get sick with active TB, and potentially infect others.
“To eliminate TB, which is the CDC’s goal, it cannot be done without treating all of those inactive, latent TB infections,” Shepherd said. “And there are new drug regimens, well tolerated, highly effective that can be used to treat that group of people infected with latent TB.”
Last year, TB incidence – new and relapsed TB cases compared with 2021– increased 63% among Asians, 26% among Native Hawaiian /Other Pacific Islanders, 16% among American Indian/ Alaska Natives, and 7% among Hispanics. These findings, the CDC said, reflect ongoing health disparities and one that health care providers must address.
New England TB rates
Across New England, Connecticut had 1.8 reported cases per 100,000 people in 2022; 1.4 in Maine; 2.2 in Massachusetts; 0.8 in New Hampshire; 1.6 in Rhode Island, and 0.5 in Vermont.
In comparison, states attracting most immigrants arriving to the U.S. from countries with high TB cases had larger rates, including 4.7 cases per 100,000 people in California and 3.6 in Texas.
