Over the past year, California has seen a substantial increase in tuberculosis (TB) cases, accompanied by a rising rate of deaths from the illness.

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In 2023, California, the most populous state in the United States, saw a 15 percent jump in TB cases compared to 2022, with 2,113 reported infections. This marked a return to pre-pandemic levels and the largest year-over-year increase in recent years, according to data from the California Department of Public Health.

The rise is particularly concerning because the death rate from TB has also climbed in recent years in the state. While 8.4 percent of TB patients died in 2010, that number rose to 13 percent in 2020.

The upward trend began in 2020, following a 20 percent drop in cases from 2019 to 2020. Experts believed this initial decline was likely due to reduced social interaction during the early stages of the COVID-19 pandemic.

Since 2020, TB cases have steadily risen each year to 24 percent in 2023, returning to the pre-pandemic level, according to the department’s recently updated TB 2023 snapshot.

California’s TB burden is considerably higher than the national average. The state reports 5.4 cases per 100,000 people, more than double the national rate of 2.5 cases per 100,000, according to the U.S. Centers for Disease Control and Prevention data.

The Centers’ latest data showed the United States recorded 8,331 TB cases in 2022, with up to 13 million people in the country living with latent TB infection (LTBI).

LTBI, a condition in which someone carries the TB bacteria but isn’t sick, can develop into active TB if left untreated. The California Department of Public Health estimates that over 2 million Californians, or 6 percent of the population, have LTBI.

The department has issued a health advisory urging healthcare providers to be vigilant in testing high-risk individuals. Those who have immigrated from countries with high TB rates, have weakened immune systems or have been in close contact with TB patients are at increased risk.

According to the department, the TB rate among people born outside the United States was 13 times higher than the rate among American-born persons.

TB, a bacterial lung infection spread through coughs and sneezes, can be life-threatening. While not everyone infected becomes sick, those who develop active TB will experience persistent coughing, weight loss, fever and night sweats. Alarmingly, TB symptoms can be varied or even absent, making early detection crucial.

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