Tuberculosis — United States, 2023

Results

Tuberculosis Incidence by Jurisdiction

In 2023, the 50 U.S. states and DC provisionally reported 9,615 TB cases, an increase of 1,295 cases (16%) compared with the 8,320 cases reported in 2022, an 8% increase compared with the 2019 prepandemic case count (8,895), and the highest number of cases reported since 2013 (9,556) (Figure). Overall, the U.S. TB rate increased by 15%, from 2.5 per 100,000 persons in 2022 to 2.9 in 2023 (Table 1). Forty states and DC reported an increase in both case counts and rates compared with those in 2022. As in 2022, California reported the highest number of cases in 2023 (2,113), and Alaska reported the highest rate (10.6). Eight states and DC reported TB rates higher than the national rate of 2.9 per 100,000 in 2023.

Tuberculosis Incidence by Demographic Characteristics

In 2023, among 9,573 TB cases in persons for whom birth origin was known, 7,259 (76%) occurred among non-U.S.–born persons, an 18% increase compared with the 6,177 such cases reported in 2022 (Table 2). The number of cases in U.S.-born persons in 2023 increased 9%, from 2,131 in 2022 to 2,314.^¶¶ The rate increased among non-U.S.–born persons from 13.1 in 2022 to 15.0 in 2023, and the rate among U.S.-born persons remained at 0.8 cases per 100,000 persons.

Among U.S.-born persons with TB, 33% (753) identified as Black or African American (Black), 27% (614) as Hispanic, 26% (591) as White, 6% (130) as Asian, 5% (106) as American Indian or Alaska Native, 3% (62) as Native Hawaiian or other Pacific Islander, and 1% (18) as multiple race. Among U.S.-born persons, the rate of TB in 2023 compared with 2022 increased 20% (11 cases) among Native Hawaiian or other Pacific Islander, 12% (81 cases) among Black, 11% (72 cases) among Hispanic, and 4% (22 cases) among White persons, and the rate declined 9% (–7 cases) among American Indian or Alaska Native, and 12% (–12 cases) among Asian persons. Among non-U.S.–born persons with TB, 40% (2,876) identified as Hispanic, 39% (2,804) as Asian, 13% (922) as Black, 4% (300) as White, 2% (115) as Native Hawaiian or other Pacific Islander, 1% (64) as multiple race, and 0.1% (six) as American Indian or Alaska Native persons. Among non-U.S.–born persons, the TB rate in 2023 compared with 2022 increased 29% (10 cases) among Native Hawaiian or other Pacific Islander, 28% (272 cases) among Black, 23% (598 cases) among Hispanic, and 10% (26) among White persons, among non-U.S.–born Asian persons, the rate declined 2% (65 cases).***

TB incidence increased in every age group in 2023 compared with 2022, with the largest relative increase among children aged 5–14 years (68 cases, corresponding to a 42% increase in case count and a 45% increase in rate). Among the 83% (8,013) of persons with TB in 2023 for whom HIV status was known, 5% were coinfected with TB and HIV.