TB and People Living in Correctional Facilities in the United States

Background

People living in congregate settings, including correctional facilities and detention centers, are at an increased risk of becoming infected with TB germs compared to the overall population.

By the Numbers

In 2021, U.S. state, local, and territorial health agencies reported a total of 7,882 TB cases to CDC.

In 2021, 179 cases of TB disease (2.3%) reported in the United States occurred among people 15 years of age or older who were current residents of correctional facilities.

The percentage of cases among persons aged 15 years or older who reported residing in a correctional facility at the time of TB diagnosis has been decreasing since 2010 (4.7%). In 2021, the percentage was 2.4% (n=179) compared with 2.6% (n=178) in 2020.

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Among the TB cases reported among residents of correctional facilities in 2021, the percentage in

Local jails increased from 23.0% in 2020 to 31.3% in 2021,
State prisons increased from 26.4% in 2020 to 27.9% in 2021,
Federal prisons increased from 10.7% in 2020 to 12.3% in 2021, and
Other correctional facilities decreased from 38.2% in 2020 to 27.4% in 2021.

In 2021, 179 TB cases were reported among persons aged 15 years or older who were residing in a correctional facility at the time of TB diagnosis. The percentage in local jails increased from 23.0% in 2020 to 31.3% in 2021, the percentage in state prisons increased from 26.4% in 2020 to 27.9% in 2021, the percentage in federal prisons increased from 10.7% in 2020 to 12.3%, and the percentage in other correctional facilities decreased from 38.2% in 2020 to 27.4% in 2021.

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TB cases among persons 15 or older residing in correctional facilities are shown in the maps in the figure below by state prisons, federal prisons, local jails, and other correctional facilities, including Immigration and Customs Enforcement (ICE) detention centers. The maps are color-coded so that as the number of TB cases increases, the color becomes darker.

This slide displays the number of TB cases diagnosed among residents of state prisons, federal prisons, local jails, and other facilities in 2021 as four separate maps. Each map is color-coded so that as the number of TB cases increases, the color becomes darker. Texas had the greatest number of cases among persons who resided in state prisons (n=28), local jails (n=15), and other facilities (n=21) at the time of diagnosis. California had the greatest number of TB cases (n=6) among persons who resided in federal prisons. Other facilities include Immigration and Customs Enforcement (ICE) detention centers, Indian reservation facilities (e.g., tribal jails), military stockades and jails, federal park police facilities, police lockups (i.e., temporary holding facilities for persons who have not been formally charged in court), or other correctional facilities that are not included in the other specific choices.

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TB Control in Correctional Facilities

Effective TB prevention and control measures in correctional facilities include:

Early identification of persons with TB disease through entry and periodic follow-up screening;
Successful treatment of TB disease and latent TB infection;
Appropriate use of airborne precautions (e.g., airborne infection isolation, environmental controls, and respiratory protection);
Comprehensive discharge planning; and
Thorough and efficient contact investigations when a TB case has been identified.

These measures should be instituted in close collaboration with local or state health department TB control programs and other key partners. Continuing education of people who are incarcerated and correctional facility staff is necessary to maximize cooperation and participation. To ensure TB prevention and control measures are effective, annual program evaluation should be conducted.

Resources on TB and Correctional Facilities

For additional CDC resources on TB, see Patient and General Public Materials and Health Care Providers and TB Program Materials.