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TB Case Counts and Rates by County, 2023 - 2024

^{The Impact of TB In Texas, 2025 [1]}

In 2025, 9,280 Texans were exposed to TB. TB is an infectious disease, which means that someone can spread the germs before realizing they are sick. Health departments conduct public health follow up to identify people who were exposed to TB and connect them to care.

Public health departments treated 2,882 people for TB infection in 2025. TB infection is not contagious, but if left untreated, it can lead to active TB disease. Preventing TB is one of DSHS’s goals.

1,295 people were diagnosed with TB in 2025. Texas ranks #2 among U.S. states for TB cases. The number of cases reported in 2025 increased by 1.3 percent from 2024, when 1,279 cases were reported. The Texas TB rate in 2025 was 4.12 cases per 100,000 people. Texas has a higher TB case rate than the national rate.

Texans still die of TB every year. In 2025, 50 Texans died of TB. TB is preventable and can be treated and cured.

Early detection can help to prevent TB-related deaths. The DSHS recommends that health care providers stay current with TB testing recommendations and report TB to their local or regional health department as soon as possible TB is suspected.
 

If diagnosed late, young children are at risk for severe forms of TB.

• Children under the age of five are at greater risk of being diagnosed with a more deadly form of TB, such as TB meningitis, if exposed.
• In 2025, 363 children under the age of five were exposed to TB:
• In 2025, 30 children under the age of five were diagnosed with TB:
  • Of the 30 children diagnosed with TB, 6.7 percent had TB meningitis. Only 1.2 percent of adults with TB were diagnosed with TB meningitis. 
• Although doctors can treat TB meningitis, children can end up with permanent disability if not connected to care early enough. 
• In 2025, there were no TB-related deaths in a child under the age of five. 

Top 10 Texas counties with the most TB cases - 2025

• Harris: 302
• Dallas: 156
• Tarrant: 87
• Bexar: 75
• Hidalgo: 64
• Travis: 58
• Walker: 50
• Collin: 43
• Cameron: 39
• Denton: 34

TB disproportionately impacts people living along the Texas-Mexico border.

In 2025, border counties accounted for 15.0 percent of TB cases in Texas, although only 9.5 percent of the Texas population lived in a border county.
 

TB can spread in congregate settings.

Congregate settings are places where several people gather and share space for a period of time. Examples include assisted living facilities and nursing homes, homeless shelters, and correctional facilities such as jails and prisons across the state.

• 8 people (0.6 percent) in long-term care facilities
• 32 people (2.5 percent) were diagnosed in a city or county jail
• 87 people (6.7 percent) were diagnosed in other correctional facilities:
  • 10 were diagnosed in a federal prison
  • 77 were diagnosed in other correctional facilities (detention facilities and Immigrations and Customs Enforcement [ICE] facilities)
• 51 people (3.9 percent) were diagnosed in a Texas Department of Criminal Justice (TDCJ) facility; TDCJ is the state’s correctional prison system.
   

TB can be found everywhere, in any community. While many counties reported TB, most of the 2025 reported cases came from metropolitan areas. The counties with the highest number of TB cases are Harris, Dallas, Tarrant, Bexar, Hidalgo, Travis, Cameron, Walker, Collin, and Denton.

TB can affect any Texan, but some risk factors make some people more likely to develop TB disease after exposure, or more likely to be exposed in certain settings. Having one or more of these risks factors can increase someone's chance of getting TB:

• Born in a country outside the U.S., where TB is common (66.6 percent)
• Living with diabetes (22.6 percent)
• Current or past drug and alcohol use (17.1 percent)
• Recent exposure to someone with TB disease of the lungs
• Living in congregate settings (including prisons or detention centers) (13.6 percent)
• Experiencing homelessness (4.2 percent)

Texas is diverse. Texas is home to three of the country’s top 10 largest cities and has the longest stretch of border with Mexico among any U.S. state.

• In the last decade, Texas has grown by 15.9 percent, reaching over 29 million people (U.S. Census Bureau).
• As the Texas population grows, so can the number of people with TB risk factors.

Yes, drug-resistant TB (DR-TB) was reported in Texas in 2025.

• In 2025, Texas reported 112 people diagnosed with TB to have drug resistance to at least one TB medication.
• Among those, nine cases (0.6 percent of all cases) were resistant to at least rifampin and isoniazid, two of the most important medications used to kill the TB germs. This is known as multi-drug-resistant TB (MDR-TB).
• While doctors can treat MDR-TB, it costs much more than treating drug-susceptible TB.
• DSHS works with TB clinics across the state to ensure patients with drug-resistant TB have access to life-saving treatments. 

*Source: Centers for Disease Control and Prevention’s 2020 estimates. Direct treatment costs include inpatient care and estimated outpatient costs.

• Texas TB Slide Set, 2022 

1. Source: DSHS TB and Hansen’s Disease Section, 2024 and 2025 data are provisional