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What to know about tuberculosis as it surfaces in Maine and North Carolina. Who is at risk?

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What to know about tuberculosis as it surfaces in Maine and North Carolina. Who is at risk?

This article reviews key clinical and public health considerations surrounding recent tuberculosis (TB) cases reported in Maine, North Carolina, and California. Although TB remains relatively rare in the United States, it continues to cause more than 1 million deaths annually worldwide and poses ongoing risks, particularly for individuals with weakened immune systems or those who live or work in congregate settings. Experts from Northeastern University outline the biology of Mycobacterium tuberculosis, distinguishing between latent, non-transmissible infection and active disease capable of spreading through respiratory droplets. They emphasize that while most U.S. cases occur among individuals who have immigrated from or traveled to TB-endemic regions, transmission within the country is limited due to robust public health contact tracing. The article summarizes key symptoms, diagnostic approaches, and the prolonged multi-drug treatment required to eradicate this slow-growing pathogen, noting challenges such as adherence and the risk of antibiotic resistance. National surveillance data show long-term declines in incidence since the 1990s, with short-term increases in 2022–2024 followed by preliminary declines in 2025. Overall, the piece underscores that although TB is curable, even a single active case warrants attention due to its potential severity, lengthy treatment course, and public health implications.

Author:

Cynthia McCormick Hibbert, Northeastern Global News

Audiences:

Community Based Organizations, Educators, General Public, Outreach Workers

Topic:

Diagnosis, General TB Information, TB, TB Prevention, TB Treatment

Language:

English

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Five things to know about tuberculosis as it surfaces in Maine and North Carolina

Recent weeks have seen a handful of new Tuberculosis (TB) cases reported in states including Maine, North Carolina and California. While TB is rare in the U.S., even a single active case warrants attention. This article provides an overview of what TB is & how it spreads. TB is caused by a bacterium (Mycobacterium tuberculosis) that typically attacks the lungs, forming lesions called “tubercles,” and can destroy lung tissue — severe disease can lead to respiratory failure. There are two main forms: (1) Latent TB—not transmissible and often symptom-free; people may carry it for years without knowing.  (2) Active TB—infectious and symptomatic; the one public-health authorities worry about.  TB spreads via respiratory droplets (coughing, talking) — especially in crowded or poorly ventilated settings, like shelters, prisons, nursing homes, or other communal living/working environments. The following summarizes the risk factors and which populations are most vulnerable. People at greater risk include:- Individuals with weakened immune systems (e.g., due to HIV, organ transplants, diabetes, substance abuse). - Residents or workers in group-living or group-working settings: homeless shelters, jails/prisons, nursing homes, hospitals, etc.- Recent immigrants or travelers from regions where TB is more common globally — although U.S. residents traveling or exposed abroad can also bring TB into local communities. The following are symptoms, diagnosis and treatment information: - Common symptoms of active TB: persistent or progressing cough (often non-productive), shortness of breath, night sweats, unexplained weight loss, swollen lymph nodes. - Diagnosis involves a combination of methods: skin tests (TB exposure), blood/breath/sputum tests, and chest X-rays to confirm active infection. - TB is curable — but treatment is long: typically 6 months of antibiotics (initially a four-drug regimen for two months, followed by a two-drug course), and more severe cases can require up to nine months. - Proper treatment adherence is crucial: stopping early (because of side-effects or other reasons) can lead to persistent disease or antibiotic resistance.- TB cases in the U.S. had been declining for decades (since 1993, when there were over 25,000 cases). Recently, though, there was a “blip upward”: cases rose 15.6% from 2022 to 2023, then climbed again into 2024. Encouragingly, for 2025 to date, preliminary figures show a decline: 5,310 cases among U.S. residents so far, compared with 6,227 at the same point last year. Still, experts note that “even a single active case is cause for concern,” given TB’s severity and treatability. Why this matters and what we should watch:- Even though TB is less transmissible than flu or COVID-19, it remains serious — untreated, it can destroy lung tissue and cause death. - The reemergence, even if sporadic, of active cases in states like Maine and North Carolina suggests the need for vigilant public-health surveillance, rapid testing, robust contact tracing, and ensuring full adherence to long-term treatment.- Vulnerable populations — people in congregate settings, those with weakened immunity, and individuals with global mobility — remain at higher risk.

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What You Need To Know About Tuberculosis

This is a flipbook from the Multnomah County Health Department for patients with tuberculosis (TB) disease. The flipbook has information on TB disease, testing, case management, treatment, and more. The material is also available in Russian, Chinese, Somali, Vietnamese, and Spanish.

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What You Need to Know About Tuberculosis

The purpose of this flipbook is to assist healthcare workers in providing patient education around TB testing, TB infection and TB disease. Panels for patients include simple text and images to reinforce key messages and corresponding panels for providers include easy to deliver script and teaching points.

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Global resources for the prevention,
management, and elimination of TB.