{"id":253320,"date":"2026-07-27T23:34:12","date_gmt":"2026-07-27T23:34:12","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-pa\/253320\/"},"modified":"2026-07-27T23:34:12","modified_gmt":"2026-07-27T23:34:12","slug":"pittsburgh-experts-explain-why-tuberculosis-cases-are-on-the-rise","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-pa\/253320\/","title":{"rendered":"Pittsburgh experts explain why tuberculosis cases are on the rise"},"content":{"rendered":"

A disease once considered a romantic affliction<\/a> has made a comeback in the U.S. on the heels of the covid-19 pandemic.<\/p>\n

Since multidrug treatments became widely available in the mid-20th century, tuberculosis has been largely manageable where organized health care is available. After decades of decline in the U.S., however, cases rose each year after the 2020 pandemic (except in 2025) and remain above pre-pandemic levels<\/a>.<\/p>\n

That rise occurred primarily due to health care gaps generated by the pandemic combined with the rise of antibiotic-resistant tuberculosis, which was found in more than 1 in 10 cases in the U.S. in 2023, according to the Centers for Disease Control and Prevention<\/a>.<\/p>\n

\u201cWhile the reasons behind this increase are complex and multifactorial, public health experts point to factors such as disruptions in health care access, delayed diagnosis and treatment, increased travel and population mobility and ongoing transmission among individuals with untreated active TB disease,\u201d said Lauren Brungo, Pulmonary Clinic<\/a> public health nurse supervisor at the Allegheny County Health Department.<\/p>\n

Cogs of a comeback<\/p>\n

Dr. Philana Ling Lin, director of the University of Pittsburgh\u2019s division of infectious diseases, agreed that public health and socio-economic factors have played the largest role in the U.S.<\/p>\n

The rate of U.S. tuberculosis cases per 100,000 people dropped from 2.7 to 2.2 in one year with the advent of the pandemic in 2020 \u2014 but that wasn\u2019t necessarily because fewer people were getting sick.<\/p>\n

\u201cMany factors that influence TB transmission and outcomes are related to health care access and healthcare-seeking behaviors rather than the disease itself,\u201d said Brungo.<\/p>\n

Diagnosis, containment and drug resistance are complicated by latent TB, a noncontagious infection with no symptoms. In latent cases, protective cells wall off infected lung tissue, trapping live bacteria inside. Because patients feel well, some may skip or stop the standard 12-week, two-drug treatment, which Brungo said can significantly reduce the risk of active disease.<\/p>\n

\u201cIf I were to infect 10 people with [tuberculosis], only one of them will become symptomatic,\u201d said Lin. \u201cThe rest of them become infected, but their own immune system is able to contain that infection, so they have no symptoms. And unless they were told that they were exposed to someone with tuberculosis, they might not get tested on a regular basis to know.<\/p>\n

\u201cThe testing isn\u2019t perfect \u2014 it probably misses a quarter of people who are infected.\u201d<\/p>\n

If another disease or medication suppresses the immune system of a latent TB carrier, the disease becomes active. In some impoverished areas, the triggering disease is often HIV. Active TB can often occur immediately after an initial infection, months or years removed from latent infection, or never. But the result is a contagious condition (that can be spread for the first two to three weeks, according to the Mayo Clinic) presenting a range of symptoms including cough, coughing up blood or mucus, chest pain, labored breathing, chills, night sweats, weight loss, loss of appetite and tiredness that is transmitted via aerosol.<\/p>\n

Active tuberculosis antibiotic regimens featuring four drugs typically last at least six months, according to the World TB Center.<\/p>\n

The complexity of treatment can be problematic for curtailing its spread and evolution.<\/p>\n

\u201cWhat happens is, especially for people who don\u2019t have access to health care, they stop treatment once they start feeling better and then the condition relapses,\u201d said Lin. \u201cAnd that, unfortunately, is very common if you have limited access to health care.\u201d<\/p>\n

If left untreated, globally, tuberculosis is fatal around 50% of the time, according to the World Health Organization<\/a>. When treated, lethality drops to 12%.<\/p>\n

Issues of access<\/p>\n

Covid made control more problematic.<\/p>\n

\u201cTuberculosis is one of those diseases where politics plays a huge role in public health care,\u201d said Lin. \u201cWhen there\u2019s political turmoil, then public health can\u2019t really be delivered. You can\u2019t make the diagnosis and you can\u2019t provide treatment.\u201d<\/p>\n

Due to the progression of latent tuberculosis, tuberculosis cases are treated with care at the county level by Health Department officials to differentiate between drug-susceptible and resistant forms, make efforts to contain and track cases and report numbers to the state and the CDC.<\/p>\n

\u201c[The County Health Department] will actually provide medications for those people who need it. They will go to the home, and if they find a case of tuberculosis, they do a contact investigation,\u201d said Lin. \u201cThey will basically interview everyone in the household and everyone that person has been in close contact with and test them to make sure that they\u2019re not infected.\u201d<\/p>\n

They don\u2019t stop there.<\/p>\n

\u201cThey will bring the medications to them. They make every investment to try to make sure that those patients have been provided for, regardless of what kind of access to health care they have,\u201d Lin said.<\/p>\n

Additionally, the directly observed therapy the department employs, wherein a professional watches a patient complete their regimen, is the standard of care in the U.S.<\/p>\n

\u201cWith covid, basically we lost that ability to keep track of patients and their treatments, making the diagnosis,\u201d said Lin. \u201cAnd so this is the first increase we\u2019ve seen in decades.\u201d<\/p>\n

From 2021 to 2023, the CDC says the U.S. experienced shortages<\/a> of TB drugs due to financial, access and supply challenges. Meanwhile, health care costs skyrocketed.<\/p>\n

U.S. health care costs amounted to an increase of more than $15,000 per person, according to the Centers for Medicare and Medicaid Services. Insurers cover about 74% of those costs, spawning an associated rise in premiums.<\/p>\n

\u201cPublic health experts have noted that rising health care costs and barriers to preventive care may contribute to delayed diagnosis, reduced follow-up after positive TB screening tests, and lower rates of treatment for latent TB infection,\u201d said Brungo.<\/p>\n

Vaccines, treatments and legislation<\/p>\n

In recent weeks, researchers at the University of Surrey in England have identified a potential \u201ccontrol switch\u201d<\/a> protein that new treatments might target to keep tuberculosis bacteria from accessing the energy it needs to survive. Additionally, the FDA recently approved <\/a>the first generic version of Priftin, an antibiotic used to treat tuberculosis.<\/p>\n

Lin spoke to several other new developments in the works.<\/p>\n

\u201cWhen they first developed medications for tuberculosis, the treatment was two years,\u201d she said. \u201cSo, it\u2019s considered a modern medical miracle that we got it down to six months. And then in the last year or so, there have been trials <\/a>to shorten that drug treatment down to four months. That\u2019s a huge deal.\u201d<\/p>\n

No tuberculosis vaccine is currently in use in the U.S. In areas where tuberculosis is rampant, however, the Bacille Calmette-Gu\u00e9rin vaccine is administered to infants to prevent severe symptoms that occur when tuberculosis moves outside the lungs to cause conditions like meningitis. While effective at that task, Lin says it\u2019s only about 40 to 50% effective at curtailing lung tuberculosis in adults.<\/p>\n

\u201cThere are many [vaccines] in the pipeline that are being tested, better drugs \u2026 I don\u2019t know that there\u2019s a clear winner yet,\u201d said Lin. \u201cThe pipeline for medications is not great. Industry is very much interested in the payer, not necessarily the public health good.\u201d<\/p>\n

To that end, a bipartisan group of lawmakers recently reintroduced the Pasteur Act<\/a>. If passed, the federal government would pay up to $300 million annually to drug companies to incentivize them to develop new drugs that combat antimicrobial-resistant forms of disease. Currently, 2.8 million resistant infections occur in the U.S. each year, killing 35,000, according to the CDC.<\/p>\n

\u201cFor many companies that make medications, short portions of antibiotics are not something that they\u2019re interested in,\u201d said Lin. \u201cAnd they want customers who are able to pay. Tuberculosis is an infection of the poor. Most drug companies are not interested in making medications for tuberculosis for customers who cannot necessarily pay.\u201d<\/p>\n

Tuberculosis by the numbers <\/p>\n

13 million estimated Americans have latent TB <\/p>\n

25% of the world\u2019s population has latent TB <\/p>\n

3 per 100,000 U.S. incidence rate <\/p>\n

1.7 per 100,000 Pennsylvania incidence rate <\/p>\n

1.45 per 100,000 Allegheny County incidence rate <\/p>\n

Six months is the typical treatment for active TB <\/p>\n

12 weeks is the typical treatment for latent TB <\/p>\n

50% fatal if untreated globally <\/p>\n

12% fatal when treated <\/p>\n

Sources: Allegheny County Health Department, Cleveland Clinic, World Health Organization <\/p>\n","protected":false},"excerpt":{"rendered":"A disease once considered a romantic affliction has made a comeback in the U.S. on the heels of…\n","protected":false},"author":2,"featured_media":253321,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[73,75,74],"class_list":["post-253320","post","type-post","status-publish","format-standard","has-post-thumbnail","category-pittsburgh","tag-pittsburgh","tag-pittsburgh-headlines","tag-pittsburgh-news"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/posts\/253320","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/comments?post=253320"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/posts\/253320\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/media\/253321"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/media?parent=253320"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/categories?post=253320"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/tags?post=253320"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}