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  • The WHO has observed an increase in tuberculosis cases among children in Europe.

  • Additionally, the rate of successful treatment for this condition is significantly below the desired standards.

  • Experts suggest that the rising TB incidents in Europe could signal a potential escalation in the United States.

A recent study by the World Health Organization (WHO) highlights a surge in tuberculosis infections among children across Europe.

On March 24, the WHO reported a 10% rise in newly diagnosed or recurring cases of tuberculosis in children younger than 15 within its European Region, encompassing both Europe and Central Asia.

In 2023, there were 7,500 cases of TB noted, with over 2,400 affecting children under five, a demographic particularly vulnerable to severe complications or mortality from the illness.

Children now represent over 4% of all new or recurring TB cases in this region.

According to the WHO, the total number of new or returning TB cases in the European Region for 2023 was more than 172,000, maintaining the levels seen in 2022.

Although the mortality rate from TB has decreased, the reduction is less significant than the decreases observed pre-COVID-19 pandemic in 2020.

The treatment success rate for new or recurring TB cases stands at approximately 75% in the region, which is well below the global target of a 90% success rate.

The emergence of multidrug-resistant tuberculosis (MDRTB) is also alarming, with a treatment success rate of less than 60% in the region.

Several challenges have been identified in reversing the TB trend, including delayed diagnoses, the necessity for more effective treatments, and limited access to existing treatments.

These issues are compounded by a decrease in funding for international aid. For instance, the United States has historically contributed between $163 million and $816 million annually to the WHO over the last decade. However, in January, the Trump administration announced the U.S. withdrawal from the WHO and the cessation of its funding.

In light of these challenges, WHO leaders are calling on European and global leaders to intensify efforts to detect and treat tuberculosis.

“Ending TB is not a dream. It’s a choice. Sadly, the current TB burden and the troubling increase in TB cases among children are stark reminders that progress against this preventable and curable disease remains precarious,” stated Hans Henri P. Kluge, MD, WHO’s regional director for Europe, in an official statement.

Why are tuberculosis cases increasing?

U.S. health experts concur with Kluge’s findings on the rise in TB cases.

“The resurgence of TB in Europe and other regions can be attributed to disruptions in diagnostic and treatment services due to armed conflicts, COVID-related hesitations in seeking direct medical care, and diminished financial support,” explained William Schaffner, MD, an infectious disease expert and a professor at Vanderbilt University in Nashville, TN.

“Effective TB control requires contacting individuals for diagnosis, and following diagnosis, patients must undergo prolonged treatment with anti-TB medications,” Schaffner explained to Healthline.

“This process necessitates trained public health workers who can provide extensive education, supervision, and support over the months of treatment. Without adequate support for these workers, new cases may go undiagnosed or untreated, continuing the spread of TB,” he added.

Monica Gandhi, MD, an infectious disease specialist and professor at the University of California San Francisco, also highlighted multiple factors contributing to the rise in TB cases within the European Region.

“Even before these budget cuts, TB cases were on the rise in Europe, likely due to incomplete treatment courses, which can be lengthy and challenging for patients, a lack of TB testing, and the influx of refugees from areas like Ukraine, where multidrug-resistant TB is relatively more common,” Gandhi noted to Healthline.

Could TB spread to the United States?

Experts believe the situation in Europe should raise concerns in the U.S.

“Given that both Europe and the U.S. are considered high-income regions, what transpires in Europe often mirrors in the U.S.,” Gandhi mentioned. “Thus, we should anticipate a potential rise in TB cases here and start screening accordingly.”

“Infectious diseases do not recognize borders, and TB bacteria certainly do not require a passport to travel. Once it arrives here, the newly introduced TB infection can spread within the U.S., perpetuating the disease cycle in our population,” Schaffner added.

Jason Andrews, MD, an infectious disease specialist and professor at Stanford University, concurred.

“In our interconnected world, failing to control TB in any location affects global health, leading to rising cases or stalled progress in TB control worldwide,” he told Healthline.

“This is particularly concerning at a time when the U.S. is scaling back its financial contributions to global TB programs, exacerbating the situation,” he added.

The facts about tuberculosis

WHO officials report that nearly 11 million people globally contracted tuberculosis in 2023, with over 1.2 million fatalities from the disease that year.

They estimate that tuberculosis has reclaimed its position as the leading cause of death from a single infectious agent worldwide, after being overtaken by COVID-19 for three years.

The Centers for Disease Control and Prevention (CDC) identified more than 10,000 tuberculosis cases in the U.S. in 2024, marking a slight increase from 2023 and the fourth consecutive year of rising numbers.

Tuberculosis, historically known as “consumption,” is a highly contagious disease that primarily affects the lungs.

The disease is spread by airborne bacteria that can be inhaled by anyone nearby, making it one of the few diseases that can be transmitted without direct contact or even being in the same room at the same time.

“TB poses a global health threat because of its airborne nature. It can infect others without close contact, highlighting the need for vigilance everywhere,” said Andrews.

The tuberculosis bacteria can remain inactive in a person for years before symptoms appear. Symptoms include:

  • a persistent cough lasting more than three weeks

  • coughing up blood or phlegm

  • chest pain

  • unexplained fatigue

  • night sweats

  • loss of appetite and/or weight

Tuberculosis can be diagnosed through a skin or blood test, and a chest X-ray is typically performed for those who test positive.

Jimmy Johannes, MD, an internist, pulmonologist, and critical care specialist at MemorialCare Long Beach Medical Center in California, mentioned that tuberculosis can cause lasting lung damage and other complications.

He highlighted the severe impact of the disease on immunocompromised individuals, especially those living with HIV.

“For these individuals, tuberculosis is far from being a minor risk,” Johannes told Healthline.

Tuberculosis may require long-term treatment

Typically, a tuberculosis diagnosis necessitates a regimen of multiple medications over a span of six to nine months.

If the treatment course is not completed, the disease is likely to recur, possibly in a drug-resistant form.

“Treating tuberculosis is complex,” Johannes said.

He noted that, even after treatment, tuberculosis bacteria can remain in the body, usually kept in check by the immune system but capable of reactivation at any time.

“It’s like a dormant volcano within the body, ready to erupt,” he added.

Experts emphasize the stubborn and severe nature of tuberculosis but also stress the importance of bringing it under control.

“With the right diagnostic tools and effective medications available today, we have the capability to reduce TB cases to a footnote in history,” Schaffner stated.

“If we are committed and allocate the necessary resources, we can achieve global eradication of this disease,” he concluded.