Tuberculosis Cases Rise as Public Health Agencies Struggle to Keep Up

Costs for contact tracing, home visits, and treatment have surged in Johnson County, Iowa and other areas as TB diagnoses increase nationwide.

Mar. 2, 2026 at 5:23pm by Ben Kaplan

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Tuberculosis cases have been rising across the United States since 2021, with a 8% increase reported in 2024 compared to the previous year. Public health agencies are facing growing costs to contain the outbreaks, including for contact tracing, home visits to ensure patients take their medications, and hotel rooms for quarantine. Some states have reported double-digit increases in TB cases from 2024 to 2025, straining already limited public health budgets. Immigrant communities and those in detention facilities are disproportionately affected, and experts warn the Trump administration's immigration crackdown may have deterred some from seeking care, leading to underreported cases.

Why it matters

Tuberculosis remains a leading infectious disease killer globally, and the rise in cases in the U.S. highlights the need for robust public health infrastructure and funding to contain outbreaks. The disproportionate impact on immigrant communities and those in detention facilities also raises concerns about health equity and access to care. Unchecked TB cases can lead to the development of drug-resistant strains, making the disease even harder to treat.

The details

In Johnson County, Iowa, the cost of TB containment efforts has surged from $17,000 in 2020 to $65,000 last year, driven by an increase in latent infections from 27 to 90 over that time period. The state has now informed the county that it can no longer help cover the costs of home visits to ensure patients take their medications, forcing the county to pay for them on its own. Nationwide, 34 states and D.C. reported increases in TB cases from 2023 to 2024, with the total number of cases reaching 10,347 - the highest level since 2011. Preliminary data suggests another 10-20% increase from 2024 to 2025. Public health experts warn the Trump administration's immigration crackdown may have deterred some from seeking care, leading to underreported cases.

  • In 2024, there were 10,347 reported TB cases nationwide, up 8% from the 9,622 cases reported the year before.
  • The case numbers for 2025 won't be released until the end of March.

The players

Danielle Pettit-Majewski

Director of the Johnson County, Iowa public health department.

Donna Hope Wegener

Executive director of the National Tuberculosis Coalition of America.

Tommy Camden

Health program manager at the City of San Antonio's tuberculosis clinic.

Dr. Michael Lauzardo

University of Florida associate professor at the division of infectious diseases and global medicine and director of the Florida TB Physicians Network.

Munira Maalimisaq

Family nurse practitioner in Minneapolis and CEO of Inspire Change Clinic.

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What they’re saying

“These back-to-back increases that states are contending with are certainly alarming.”

— Donna Hope Wegener, Executive director of the National Tuberculosis Coalition of America

“I think the numbers will be lower because people are afraid. A lot of the people at risk for TB are not seeking care, I suspect.”

— Dr. Michael Lauzardo, University of Florida associate professor

“The whole thing delays seeking care. If I don't get screened for it, there's no way that my provider is going to diagnose me.”

— Munira Maalimisaq, Family nurse practitioner

What’s next

The judge in the case will decide on Tuesday whether or not to allow Walker Reed Quinn out on bail.

The takeaway

This rise in tuberculosis cases highlights the need for sustained public health funding and outreach, especially to vulnerable communities, to contain outbreaks and prevent the development of drug-resistant strains. The disproportionate impact on immigrant populations also underscores the importance of ensuring access to care regardless of immigration status.