Cases of tuberculosis declined slightly in the United States in 2025 after surging for several years, provisional surveillance data from the CDC showed.

According to the report, there were 10,260 TB cases reported in 2025, down 1% from 2024. There was a 2% drop in cases per 100,000 people.

Twenty-six states and the District of Columbia reported decreases in TB, which sickens more than 10 million people a year globally and kills more than 1 million, making it the deadliest infectious disease.

Kansas experienced the greatest decline among states with more than just a few cases, with infections falling 46%. Colorado, New Hampshire and North Dakota experienced some of the largest increases.

According to the data, 77% of cases were from people born outside the U.S. They had a rate of 15.4 TB cases per 100,000 people, compared with 0.8 cases among people born in the U.S.

The overall downturn followed a 4-year trend that saw U.S. cases increase each year from 2021 to 2024 — a surge related to the COVID-19 pandemic, according to Amesh A. Adalja, MD, FIDSA, an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security.

“In the immediate post-pandemic years, the rise in cases may have been driven by disruptions in health care, which decreased diagnoses and linkage to care (during the pandemic),” Adalja told Healio.

Prior to the pandemic, TB cases had been steadily dropping.

“The whole picture is more complex and would include understanding the burden not just of active TB in the U.S., but latent TB, which gives rise to the majority of the active cases in the U.S.,” Adalja said.

Latent TB infection occurs when a person is infected but does not feel sick and can turn into active TB at any time. Approximately 13 million people in the country have latent TB, the CDC estimates.