In the United States, reported tuberculosis (TB) disease diagnoses fell 20% in 2020 and remained 13% lower in 2021 compared with years prior to the COVID-19 pandemic, according to preliminary data released by the Centers for Disease Control and Prevention (CDC) on World Tuberculosis Day, March 24.

"Although the United States has reported a record low number of cases, too many people still suffer from TB disease in this country. The COVID-19 pandemic has had a substantial effect on U.S. TB disease trends," CDC director Rochelle Walensky, MD, MPH, said in a statement. "The continued, substantial reduction from prepandemic levels raises concern for missed or delayed TB diagnoses. In addition, CDC estimates that up to 13 million people in the U.S. have latent TB infection, and without treatment, risk developing active TB disease in the future."

According to the CDC, the new data suggest that the pandemic has had a substantial effect on TB trends in the United States. Before COVID-19, TB disease diagnoses typically declined between 1% and 2% each year. The 2020 and 2021 declines may be related to factors associated with the pandemic, for example:

  • Efforts to prevent COVID-19, such as social distancing and wearing masks, may also reduce the spread of TB.
  • Widespread disruptions to health care during the pandemic may have delayed TB diagnoses, as COVID-19 has strained public health services, including those related to TB prevention and control.
  • Similarities in COVID-19 and TB symptoms may have led to missed or delayed TB diagnoses. According to the CDC, case reports have revealed that some people with TB were evaluated for COVID-19 but not tested for TB during multiple encounters with health care systems.

In an effort to prevent and control TB, the CDC has launched the Think. Test. Treat TB campaign to help raise awareness of TB and recognize the importance of TB prevention.

“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, 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. The nation must ensure that healthcare providers understand how to diagnose and distinguish TB disease from potential cases of COVID-19.”

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