After Near Eradication, the World’s Deadliest Infection Is Making a Fierce Comeback in the U.S.
Tuberculosis cases in the United States rose for the fourth consecutive year in 2024, reversing decades of progress. The Centers for Disease Control and Prevention reported 10,388 cases—a 7.9 percent increase from 2023. The upward trend marks a troubling reversal from the elimination goal set 35 years ago, when officials believed the disease could be eradicated entirely.
The Infection Has Killed Over 1 Billion People Since 1882
Tuberculosis is the world’s deadliest infectious disease, claiming more lives than smallpox, malaria, HIV/AIDS, cholera, and influenza combined since Robert Koch identified the bacterium in 1882. This airborne infection spreads through tiny droplets from coughs and sneezes, typically attacking the lungs but capable of damaging any organ. Treatment requires months of antibiotics, and delayed care can be fatal.
By the Late 1980s, Deaths Had Plummeted 90 Percent
The arrival of antibiotics in the 1950s transformed tuberculosis from a persistent killer into a treatable disease. Within decades, U.S. deaths dropped dramatically—by over 90 percent by the late 1980s. The medical community celebrated what appeared to be an inevitable victory, with case numbers continuing their long downward slide.
Congress Eliminated Federal Funding in 1972, Assuming Victory Was Assured
Overconfidence in the disease’s defeat led to a costly miscalculation. In 1972, Congress eliminated dedicated federal funding for tuberculosis programs, convinced the infection was heading toward extinction. Public health infrastructure weakened as resources shifted elsewhere. The decision reflected a widespread belief that TB had been relegated to history—an assumption that would later prove dangerously premature.
Thirty-Nine Jurisdictions Reported Increases Between 2023 and 2024
The reversal became clear in recent surveillance data. Of 52 reporting jurisdictions, 39 documented rising case counts and rates from 2023 to 2024, according to the CDC. Five jurisdictions saw increases of 50 percent or more. The nationwide incidence rate reached 3.1 cases per 100,000 people—still among the world’s lowest, but signaling eroding control.
Kansas Experienced One of the Largest Outbreaks in Modern History
In 2024, Kansas saw one of the most significant tuberculosis outbreaks in the United States in decades. Health officials identified 68 active cases and 91 latent infections linked to a single event in the Kansas City metro area. Nationwide, six states reported large outbreaks ranging from 10 to 64 cases each, with nearly 80 percent of cases detected through contact investigations.
The COVID-19 Pandemic Diverted Resources and Attention From TB Control
Health experts identify the coronavirus pandemic as a key driver of tuberculosis resurgence. COVID-19 overwhelmed healthcare systems, disrupting routine surveillance, diagnosis, and treatment programs. As infrastructure recovered, latent infections reactivated and transmission rebounded. Epidemiologists had anticipated this pattern, highlighting how disruptions in one area create vulnerabilities across public health.
Experts Call TB a Social Disease That Thrives on Poverty and Overcrowding
Beyond pandemic effects, deeper structural issues fuel tuberculosis spread. Researchers describe it as a “canary in the coalmine” for systemic failures in healthcare access and infrastructure. The bacterium thrives in conditions of poverty, overcrowded housing, malnutrition, and inadequate working conditions. As economic pressures grow in many communities, environments reminiscent of Victorian-era slums are reemerging, creating ideal conditions for transmission.
Funding Cuts Could Cause 340,000 Child Deaths Over the Next Decade
Recent reductions in global health programs carry severe consequences. Researchers at Harvard and Boston Universities project that current U.S. funding cuts could lead to 2.5 million additional pediatric tuberculosis cases and 340,000 child deaths over the next ten years. Leonardo Martinez, assistant professor of epidemiology at Boston University, emphasized that sustained international funding had previously driven down incidence in high-burden countries.
Infectious Diseases Cross Borders
While impacts may strike other regions first, tuberculosis respects no national boundaries. Modern travel and migration mean outbreaks anywhere can eventually affect everywhere. Public health experts stress that sustained investment and international cooperation are essential. The recent U.S. resurgence shows how quickly hard-won progress can unravel when prevention programs lose focus and resources.