CDC: Tuberculosis Cases Fell Sharply During COVID-19 Pandemic

Tuberculosis (TB) diagnoses in 2021 were 13 percent lower than before the COVID-19 pandemic, following a 20 percent year-over-year decline in 2020, according to a news release from CDC. The agency attributes the decline to measures taken to control the spread of COVID-19, including physical distancing and mask wearing, as well as delayed or missed TB diagnoses due to the disruption of healthcare facilities caused by the pandemic. The similarity of symptoms of the two diseases may also have contributed to misdiagnoses, CDC said. Prior to the pandemic, TB diagnoses typically fell no more than 2 percent per year.

Cases in the United States decreased steadily from approximately 25,000 in 1993 to 7,173 in 2020, and the 2021 TB case rate of 2.4 per 100,000 people is among the lowest in the world. According to preliminary data for 2021, 7,860 cases and 526 deaths were reported in the U.S. But CDC estimates that as many as 13 million people in the U.S. are infected with latent TB, and ten percent of these individuals are expected to develop the disease (PDF).

“Delayed or missed tuberculosis disease diagnoses are threatening the health of people with TB disease and the communities where they live,” said Philip LoBue, MD, FACP, FCCP, the director of CDC’s Division of Tuberculosis Elimination. “A delayed or missed TB diagnosis leads to TB disease progression and can result in hospitalization or death—and the risk of transmitting TB to others.”

TB is a preventable, treatable bacterial disease spread through inhalation of infectious particles. According to NIOSH, prolonged proximity to an infected person is usually required for TB transmission, although in rare cases, transmission can occur after short exposures.

OSHA’s standard for Recording and Reporting Occupational Injuries and Illnesses (29 CFR 1904) requires employers to record cases of work-related tuberculosis. In 1997, OSHA announced a proposed rule on occupational exposure to tuberculosis, which the agency revoked in 2003, citing declining case rates and increased compliance among hospitals with federal guidelines for preventing transmission. Hospitals are among the settings where most TB transmission is most likely to occur.

Worldwide, TB kills more people than any other infectious disease except COVID-19, according to the World Health Organization. A total of 1.5 million people died from TB in 2020.