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TB Case Counts and Rates by County, 2022-2023: A–B | C | D–F | G–H | I–L | M–P | R–S | T–Z | TDCJ | Texas

The Impact of TB In Texas, 2022^[1]

In 2022, 7,415 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 perform public health follow up to identify people who were exposed to TB and connect them to care.

Public health departments treated over 2,900 people for TB infection in 2022. TB infection is not contagious, but if left untreated it can lead to active TB disease. Preventing TB is one of the goals of DSHS.

1,097 people were diagnosed with TB in 2022. Texas ranks #2 among U.S. states with the most TB. The number of cases reported in 2022 represents an increase of 9.9 percent from 2021 when 998 cases were reported. The Texas TB rate in 2021 (most recent data available) was 3.38 cases per 100,000 persons. Texas has a higher TB case rate than the national rate.

Can someone die of TB?

Texans still die of TB every year. In 2022, 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 TB Unit recommends that health care providers stay current on TB testing recommendations and report TB to their local or regional health department as soon as TB is suspected.
 

How does TB impact young children?

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 deadlier form of TB such as TB meningitis, if exposed. In 2021, 311 children under the age of five were exposed to TB: In 2022, 24 children under the age of five developed active-TB: of those, 29.2 percent had TB meningitis, as compared to 1.9 percent of adult TB cases.  While TB meningitis can be treated, children can end up with permanent disability if not connected to care early enough. In 2022, there were no TB-related death in a child under the age of five.

Where in Texas is TB Found?

Texas counties with the most TB cases - 2022

• Harris: 267
• Dallas: 121
• Bexar: 62
• Tarrant: 52
• Hidalgo: 49
• Travis: 48
• Cameron: 46
• Frio: 46
• Collin: 35
• Webb: 32

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

In 2022, border counties represented 21.2 percent of TB cases in Texas, although only 9.5 percent of the Texas population live 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 are assisted living facilities and nursing homes, homeless shelters, and correctional facilities such as jails and prisons across the state.

• 60 people (5.5 percent) were diagnosed in the following congregate settings:
  • 12 in long-term care facilities
  • 6 in homeless shelters
  • 42 in various other congregate settings
• 23 people (2.1 percent) were diagnosed in a city or county jail
• 84 people (7.7 percent) were diagnosed in other correctional facilities:
  • 6 were diagnosed in a federal prison
  • 78 were diagnosed in other correctional facilities (detention facilities and Immigrations and Customs Enforcement [ICE] facilities)
• 14 people (1.3 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 2022 cases were reported from metropolitan areas. The counties with the highest number of TB cases are Harris, Dallas, Bexar, Tarrant, Hidalgo, Travis, Cameron, Frio, Collin, and Webb.
 

Who is at risk for TB?

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 (67.9 percent)
• living with diabetes (24.2 percent)
• current or past drug and alcohol use (12.1 percent)
• recent exposure to someone with TB disease of the lungs
• living or working in a congregate settings (including prisons or detention centers) (12.8 percent)
• experiencing homelessness (3.7 percent)

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

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

Does drug-resistant TB impact Texans?

Yes, drug resistant TB (DR-TB) was reported in Texas in 2022. In 2022, Texas reported 157 people diagnosed with TB to have drug resistance to at least one TB medication. Among those, 12 cases (1.1 percent) 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). 146 people were exposed to MDR-TB in 2021. While MDR-TB can be treated, the cost is much higher than the cost to treat drug-susceptible TB. DSHS works with TB clinics across the state to make sure patients with drug resistant TB have access to life-saving treatments.  *Source: Centers for Disease Control and Prevention’s 2020 estimates. Direct treatment cost includes inpatient care and the estimated outpatient costs.

Other Resources

• TB Case Counts and Rates by County, 2017-2021: A–B | C | D–F | G–H | I–L | M–P | R–S | T–Z | TDCJ | Texas
• Texas TB Slide Set, 2022
   

1. Source: DSHS TB Unit, 2022 data is provisional