Houston leads Texas in tuberculosis rates, Harris County report finds

Houston is still carrying Texas’ heaviest tuberculosis burden, with Harris County Public Health’s latest report showing an active TB rate of 5.5 cases per 100,000 people, above both the state and national averages. For a disease many people think of as old-fashioned, the numbers say it remains a live public-health problem in Houston.

The county’s report covers tuberculosis trends, risk factors and prevention strategies from 2018 through 2024, giving health officials a six-year look at a disease that has not gone away. Houston Public Health and Harris County Public Health have both framed TB as something that must be tracked, screened and treated continuously, not only after outbreaks but as part of routine communicable-disease work.

The concentration is unmistakable. Texas recorded 1,097 TB diagnoses in 2022, and Harris County had 267 cases, the most of any county in the state. That total was more than Dallas County’s 121, Bexar County’s 62 and Tarrant County’s 52, helping explain why Houston remains at the center of Texas TB reporting.

The risk is not limited to one neighborhood or one group. Houston Health Department says TB can affect anyone and spreads through the air from people with active disease in the lungs or throat. It can be fatal if untreated, but it is curable with proper medical care. Symptoms include a cough lasting two or more weeks, coughing up blood, chest pain when coughing, night sweats, chills, fever, weight loss and loss of appetite.

The broader trend is not easing. The Centers for Disease Control and Prevention says the United States had 10,388 TB cases in 2024, up from 9,633 in 2023, with the national rate rising from 2.9 to 3.1 cases per 100,000 people. Texas was one of four states that accounted for about half of all U.S. TB cases last year, alongside California, New York and Florida.

Local health agencies say the response depends on early detection. Houston Health Department says its mission is to reduce TB prevalence in the greater Houston area by screening, identifying and treating people with TB and by working with providers to make sure patients get proper care. Harris County Public Health says confirmed or suspected cases must be reported within one working day under Texas law, a requirement that underscores how quickly public health teams move when TB is suspected.

For Harris County residents, the practical lesson is straightforward: a lingering cough, known exposure or other TB symptoms should not be brushed aside. In a county that continues to lead Texas in cases, testing and treatment remain the fastest way to keep a curable disease from spreading.