CDC Reports U.S. TB Rates Among World's Lowest on World TB Day

The Centers for Disease Control and Prevention published provisional 2025 tuberculosis data on March 23, timed to coincide with World TB Day, reaffirming that the United States maintains one of the lowest TB incidence rates anywhere in the world despite a multi-year climb in case counts.

The release continued a pattern the CDC has followed for years: using World TB Day as a milestone to assess the national situation and issue a director's letter summarizing where things stand. World TB Day is observed on March 24, the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes TB.

The backdrop for this year's report is a sustained upward trend. In 2024, the national TB case count was 10,388 and the corresponding incidence rate was 3.1 per 100,000 population, representing a 7.9% increase in case count and a 6.9% increase in rate compared with 2023. That marked a fourth consecutive year of increasing TB case counts.

Yet the cumulative long-term decline still tells a different story. In 1989, there were 23,495 TB disease cases reported, and the TB incidence rate was 9.5 per 100,000 population. In 2024, 35 years later, the United States reported 10,388 TB cases with a corresponding incidence rate of 3.1. The National Tuberculosis Surveillance System data show that the United States has achieved a 56% decrease in cases and a 68% decrease in the incidence rate since 1989, resulting in one of the lowest incidence rates in the world.

Geography still drives much of the domestic burden. Approximately half of all TB cases in the U.S. were reported by four states: California, Texas, New York, and Florida. Incidence rates per 100,000 persons were highest in Alaska at 12.3, New York City at 9.8, Hawaii at 8.1, and California at 5.3.

The global picture remains far more severe. In 2023, an estimated 10.8 million people fell ill with TB and there were an estimated 1.25 million deaths worldwide, and between 2020 and 2023 the TB incidence rate is estimated to have increased by 4.6%, reversing declines of about 2% per year between 2010 and 2020. India, Indonesia, China, the Philippines, and Pakistan together accounted for over 50% of the global TB burden.

Within the United States, not all populations share equally in the low national rate. Non-U.S.-born individuals face infection rates nearly 20 times higher than their U.S.-born counterparts. In 2023, 572 TB deaths were reported, and despite the increase in TB cases each year since 2020, the TB death rate has remained stable at 0.2 per 100,000 population.

Despite the increases, the United States continues to maintain one of the lowest TB incidence rates in the world, and domestic TB transmission remains rare. Whether the provisional 2025 figures show any deceleration in the post-pandemic climb will be central to the CDC's elimination calculus as the country moves deeper into the decade.