Tuberculosis (TB) cases in Colorado rose sharply in 2025, with state health officials reporting a 32% increase compared to the previous year. According to the Colorado Department of Public Health and Environment (CDPHE), there were 103 confirmed TB cases in 2025, up from 78 in 2024.
This rise follows a period when TB cases had been declining. Data from CDPHE shows that Colorado recorded 52 cases in 2020, 58 in 2021, and 57 in 2022. However, numbers increased to 89 cases in 2023, during which at least two people died from the disease.
Dr. Michelle Barron, senior medical director of infection prevention and control at UCHealth and professor at the University of Colorado School of Medicine, explained that TB can be difficult to diagnose because its most common symptom—a persistent cough—resembles other respiratory illnesses such as flu or COVID-19. “TB investigations require a lot of detective work,” said Barron. “People have this smoker’s cough that can come from a lot of causes, and TB can get missed when people come to an ER or urgent care.”
Barron outlined several challenges associated with detecting and treating TB:
– Many infected individuals are unaware they have it.
– Some may become “super spreaders,” unknowingly transmitting the disease.
– Treatment is lengthy and not always accessible.
Common symptoms include a persistent cough, low-grade fever, night sweats, coughing up blood, unintentional weight loss, and sometimes cavitary lesions visible on chest X-rays. Barron described these lesions as “a walled-off area of your lungs” formed by the immune system’s response.
Despite its severity, TB is curable with antibiotics taken over six months to a year. Barron noted: “Yes. This is a curable disease. But it requires very long treatments… There’s a cocktail (of medications) that you have to take.”
Globally, TB remains one of the deadliest infectious diseases—killing more than 4,300 people daily—and infects over ten million annually.
The recent increase in Colorado has affected ethnic and racial minority groups disproportionately; CDPHE reported that among new patients with TB in recent years:
– About 88% identified as members of an ethnic or racial minority group.
– In one report year: roughly 40% were Hispanic; about one-fifth were Asian; others included white and Black residents.
Diabetes was cited as the strongest medical risk factor for developing active tuberculosis.
Risk factors also include being born in countries where TB rates are high or experiencing homelessness. Dr. Barron advised: “If you’re from a country where rates of tuberculosis in the community are high, you should be aware of potential exposures.”
TB is endemic worldwide but especially prevalent across Mexico, South America, Africa, East Asia, Russia and India.
In the United States—where overall incidence remains low—higher-risk populations include those who have lived or traveled abroad to regions where TB is common; people living or working in crowded settings like jails; those experiencing homelessness; healthcare workers; older adults; young children; and individuals diagnosed with diabetes.
Without treatment,“it destroys your lungs… You stop eating…and your body stops functioning,” said Barron.
Public health protocols require reporting positive tests to authorities followed by contact tracing within households or workplaces.“Sometimes we can have super spreaders,” said Barron.”Other times,a person won’t transmit it…There’s a lot of variability.”
A vaccine exists but does not provide strong protection against adult pulmonary forms common outside high-incidence areas.“It’s airborne,and it can be very infectious,” said Barron.TB bacteria may remain dormant without causing symptoms but still test positive through blood tests or sputum analysis under microscopy.
If untreated after exposure,someone could develop active infection later.Dr.Barron recommends anyone exposed—or with symptoms such as chronic cough,nightsweats,and unexplained weight loss—to seek testing promptly:“Anybody who had a persistent cough that hasn’t gone away for months…should be tested.”
Historically,Tuberculosis played an important role shaping Colorado’s population growth through so-called ‘cure chasers’ seeking fresh air therapies before effective medicines existed.The state’s tourism industry grew alongside sanatoriums established for patient care,but altitude alone did not cure the disease according to modern understanding.
Barron emphasized awareness rather than alarm:”We don’t want to alarm anyone,but we want to raise awareness.”
