The ‘White Plague’ is Making a Chilling Return Across America

A disease many people think belongs to the distant past is making an unsettling comeback in the US.

Tuberculosis, once known as the “white plague,” has quietly reclaimed its place as the world’s deadliest infectious disease, overtaking COVID-19 after the pandemic years. And while the US still has a relatively low rate compared with many other countries, the numbers are moving in the wrong direction. Cases have been climbing since 2020, reversing a decades-long decline and putting health experts on edge.

According to provisional CDC data, 10,260 tuberculosis cases were reported nationwide in 2025. New York alone accounted for 967 of them. That sharp rise is fueling concern that this ancient disease is far from gone — and in some cases, it is becoming even harder to treat because of antibiotic resistance.

The renewed spotlight on TB intensified this week after the man accused of killing Loyola University student Sheridan Gorman missed a detention hearing because he is reportedly being treated for tuberculosis. The case became a grim reminder that this infection is not some relic of history books. It is still here, still spreading, and still deadly.

Tuberculosis is a bacterial infection that most often attacks the lungs, though it can also spread to the brain, spine, kidneys, and other parts of the body. It spreads through the air when a person with active TB coughs, sneezes, talks, or sings, releasing tiny droplets that others can breathe in.

What makes TB especially tricky is that not everyone who carries it looks or feels sick. There are two forms of the disease: active TB and latent TB. Active TB causes symptoms and can spread to others. Latent TB means the bacteria are in the body but lying dormant, with no symptoms and no immediate risk of transmission.

But latent TB can become active if the immune system weakens. That is where the danger rises. The CDC estimates that up to 13 million people in the US may be living with latent TB, and more than 80% of active TB cases in the country are believed to come from old, untreated latent infections waking up.

The symptoms can also be easy to brush off at first. Active TB in the lungs often starts with a cough that lingers and slowly worsens. Some people also develop chest pain, cough up blood or mucus, or struggle with fever, chills, night sweats, exhaustion, weight loss, and loss of appetite.

If the infection spreads beyond the lungs, the warning signs can look very different. TB in the kidneys can cause blood in the urine. TB in the spine may trigger back pain. In the brain, it can lead to headaches or confusion. In the lymph nodes, it may show up as swollen, discolored lumps under the skin. That wide range of symptoms can make the disease easy to miss, especially when it resembles more common illnesses like the flu or RSV.

That delay can be dangerous. The longer TB goes undiagnosed, the more time it has to spread. It also gives the bacteria more opportunity to develop resistance to the drugs used to treat it, turning a serious disease into an even more stubborn one.

Treating tuberculosis is not simple. Unlike many common infections that can be knocked out with a short course of antibiotics, TB treatment usually requires multiple medications taken for six to nine months, sometimes longer. That long road can be physically and emotionally draining.

Doctors say one of the biggest challenges is that patients with active TB often start feeling better before the bacteria are fully gone. At the same time, the medications can cause side effects that make staying on treatment difficult. For people with latent TB, that challenge can feel even more frustrating, since they are taking strong medications to prevent a disease they may not feel at all.

When treatment is cut short or not completed properly, the consequences can be serious. The infection may not fully clear, and the bacteria can become resistant to medicine. In 2023, 589 TB cases in the US were resistant to at least one front-line drug, according to CDC data.

And yes, tuberculosis can absolutely be deadly.

Globally, about half of people with untreated active TB die from the disease. Around the world, TB kills an estimated 1.6 million people each year, more than HIV/AIDS and malaria combined. Left untreated, it can destroy the lungs, ravage the body, and cause patients to waste away.

There is a vaccine for TB, known as Bacille Calmette-Guérin, or BCG, but it is not routinely used in the US. It is more commonly given in countries where tuberculosis remains widespread. That means America’s strongest defense is not mass vaccination but early detection, fast treatment, and close monitoring of people at risk.

Health experts say the key is catching infections before they turn into something worse. That means getting tested if you have symptoms, if your immune system is weakened, or if you have recently been in close contact with someone who has active TB. If you are exposed, wearing a mask, improving ventilation, and avoiding prolonged close contact can help lower the risk.

For many Americans, tuberculosis sounds like something out of another century. But the latest numbers tell a much more unsettling story. This old killer never really disappeared — and now it is creeping back into the spotlight.