Tuberculosis Crisis at California High School in 2026

Tuberculosis (TB) cases in the United States have risen steadily over the past few years, highlighting a reversal of the long-term decline in prior decades.

Over the past five years (2020–2024), reported TB cases have increased each year after the 2020 low, resulting in a cumulative rise of approximately 44%, with provisional data reporting 10,347 TB cases in 2024

According to the U.S. Centers for Disease Control and Prevention (CDC), in 2026, this unfortunate trend is linked to increased travel and migration and to localized outbreaks in several states, including California.

The California Department of Public Health notes that TB primarily affects foreign-born individuals, with higher rates in urban areas like the Bay Area.

On January 29, 2026, the San Francisco Department of Public Health (SFDPH) issued a health advisory about an ongoing TB outbreak linked to Archbishop Riordan High School (ARHS) in San Francisco.

The advisory outlines a large-scale contact investigation that followed the identification of three confirmed cases of active TB disease among individuals associated with the school since November 2025.

Additionally, over 50 cases of latent TB infection have been detected within the school community, and preventive treatment efforts are currently underway for those affected.

SFDPH emphasized the need for mandatory TB evaluations for all students and staff affiliated with ARHS. The response includes widespread testing, such as TB skin tests or blood tests like IGRA, as well as chest X-rays for those with positive results to rule out active disease.

Clinical evaluations by healthcare providers and mandatory reporting of suspected or confirmed cases are also required.

Notably, no Bacille Calmette-Guérin (BCG) vaccine is being offered as part of the San Francisco outbreak response.

The BCG vaccine is not routinely administered in the United States due to its variable effectiveness against pulmonary TB in adults. Public health authorities, including the CDC, do not recommend BCG for general use in the U.S., even during localized outbreaks like this one.

In 2026, various versions of the BCG vaccine are routinely offered in most countries with moderate to high TB incidence, as recommended by the World Health Organization (WHO).

According to data from sources such as the BCG World Atlas and WHO immunization reports, approximately 156 of 194 countries maintain a policy of universal BCG vaccination for newborns.