Due to a significant increase in the incidence of tuberculosis (TB), the California Department of Public Health (CDPH) is recommending health care providers consider TB as a cause of respiratory illness.

In 2023, annual reported cases of TB in California increased 15% to 2,113. Since 2020, TB cases have increased each year, for a total increase of 24%. The percentage of people with TB who die has also been increasing: In 2020, 13% of people with TB died before or during treatment, compared to 8.4% in 2010.

Most TB cases in California (>80%) are attributable to people with unidentified or untreated latent TB infection progressing to active TB disease – and are thus preventable through testing and treating.

To prevent progression to active TB disease, CDPH recommends testing and treating for latent TB infection among patients with prolonged symptoms (weight loss, hemoptysis, fever or night sweats, persistent cough <2 weeks) and risk factors for TB. Risk factors for TB include:

• Living outside the US in a country with an elevated TB rate. TB in California particularly impacts people who were born outside the US, with more than 80% of cases occurring in this group.
• Being immunocompromised
• Having close contact with an individual with active TB disease
• Having lived in a congregate setting, such as jail or prison
• Experiencing homelessness

Health care providers can use CDPH’s TB Risk Assessment to determine whom they should test for latent TB infection. Providers are also required to report any suspected or confirmed cases of TB to their local public health department.

Additional Resources:

• CDC: Guidelines for the Treatment of Latent Tuberculosis Infection
• CDPH Provider Alert: Substantial Increase in Tuberculosis in California: Recommendations for California Healthcare Providers
• CDPH: Provider Resources and Tools for TB Testing and Treatment  (including Adult and Pediatric TB Risk Assessments​)