HomeMy WebLinkAbouttb-factsheet-2025-remediatedFigure 2. Percent of TB Cases, by Place of Birth,
Alameda County, 2025
Tuberculosis in Alameda County, 2025
Background
During 2025, 122 tuberculosis (TB) cases
were reported to Alameda County
(excluding the City of Berkeley, which has
its own local health department). The 2025
TB case rate in Alameda County was 7.9
cases per 100,000 residents. The 2025
rate ranks fourth among all jurisdictions in
California and is 1.4x times higher than the
California state rate (5.4 per 100,000) and
2.6 times higher than the national rate (3.0
per 100,000).
The 2025 rate for Alameda County is
higher than some other Bay Area counties,
including San Mateo (6.8 per 100,000) and
Contra Costa (4.5 per 100,000) counties;
however, the 2025 rate is lower than Santa
Clara (8.4 per 100,000) and San Francisco
(9.3 per 100,000) counties.
Figure 1. Number of TB Cases and Rate per
100,000, Alameda County, 2016-2025
Demographics of TB Cases, 2025
Similar to previous years, the majority of TB cases
were male (59%). During 2025, the largest proportion
of TB cases occurred among adults aged 65 years
old and older (44%). The majority (2/3) of TB cases
occurred among Asian residents, and 1/5 of TB cases
occurred among Hispanic/Latino/a/x/e residents
(Table 1).
Ninety-five percent of cases were born outside the
U.S. (Figure 2). Of the 2025 cases born outside of the
U.S., 59% resided in the U.S. for ten or more years
before being diagnosed with TB, and 73% resided in
the U.S. for five or more years before diagnosis.
The largest proportions of 2025 TB cases occurred
among residents of Oakland (30%), Fremont (22%),
and Hayward (11%) (Figure 3). Fifty five percent of
the TB patients lived in zip codes that were in the two
lower quartiles of the Healthy Places Index in
Alameda County—a measurement in which higher
values indicate greater presence of health-promoting
social, environmental, and economic factors.
Philippines: 22%
India: 17%
China: 11%Mexico: 10%
Vietnam: 7%
USA: 5%
Other
Countries:
28%
Philippines India
China Mexico
Vietnam USA
Other Countries
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Sputum Smear Result
Percentage by NAAT
Result
100%
53%
0%
29%
18%
NAAT Positive NAAT Negative
NAAT Not Done
Positive (N =
37)
Negative (N=51)
0%
50%
100%
For questions or additional information, contact:
Alameda County Public Health Department
Tuberculosis Control Section
1100 San Leandro Blvd, San Leandro, CA 94577
Phone: (510) 667-3096 | Fax: (510) 273-3916
https://health.alamedacountyca.gov/program
/tuberculosis-tb/
Last updated March 30th, 2026
77%
9.6%
48%
Tuberculosis in Alameda County, 2025
Figure 3. Average Annual TB Rates per 100,000, by Zip
Code, Alameda County, 2021-2025
Clinical Characteristics
Of all 2025 TB cases, 77% had pulmonary
involvement and 23% were extrapulmonary
only (Table 2). Of all pulmonary cases, 40%
were acid-fast bacilli (AFB) smear-positive and
64% had evidence of cavitary disease on chest
radiography.
Risk Factors
Almost half (48%) of TB patients had a
comorbidity, as seen in Table 2. Eight (7%) were
HIV positive. Ninety-five patients (78%)
reported having a usual source of care in the
past two years, which was defined as a place
where the patient usually went when sick or
needing health advice. 27% of patients
reported being current or former smokers.
Drug Resistance
A smaller proportion of drug-resistant isolates
were identified among culture-positive cases in
2025 than 2024 (9.6% and 12%, respectively).
During 2025, two cases were multidrug
resistant TB (Table 2). Six cases were mono-
resistant to Isoniazid, and one case was mono-
resistant to Pyrazinamide.
Diagnostic Testing
Among 2025 TB cases with any pulmonary
disease that had a sputum smear performed,
90% received a nucleic acid amplification
(NAA) test at diagnosis, 5% less than in 2024.
More cases with positive sputum AFB smears
received NAA tests compared to patients with
negative sputum AFB smears (Figure 4).
Figure 4. NAAT Results by Sputum Smear
Summary
TB remains an important public health
problem in Alameda County. While the
case rate reported in 2025 was similar to
the 2024 case rate, Alameda County
remains a high-TB-burden county with a
rate 2.5x higher than the national average.
Reports have indicated that 80%-86% of
all TB cases are due to LTBI reactivation,
and 78% of Alameda County TB patients
reported engaging with a usual source of
care. Therefore, it is important for
providers to screen for and treat LTBI to
prevent the reactivation and spread of TB.
Alameda County TB Control continues to
encourage early diagnosis through the
use of NAA tests regardless of sputum
smear results, as this practice may
facilitate earlier TB treatment initiation
and reduce disease transmission.
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Tuberculosis in Alameda County, 2025
Table 1. Demographics of TB Cases, 2025
Demographic Category 2025
Case
Counts
Percent Rate per
100,000
Sex at Birth Male 72 59%9.2
Female 50 41%6.4
Age
0-14 yrs < 10 --*
15-24 yrs 12 9.8%6.2
25-44 yrs 30 24.6%6.4
45-64 yrs 22 18%6.3
65-74 yrs 22 18%17.6
75+ yrs 32 26.2%28.2
Race/Ethnicity
American Indian/Alaska Native 0 0%*
Middle Eastern or North African 0 0%*
Pacific Islander < 10 --*
Multiracial < 10 --*
White < 10 --*
African American/Black < 10 --*
Hispanic/Latino/a/x/e 25 20.5%6.8
Asian 81 66.4%14.7
Detailed Asian
Race
N = 81
Filipino 28 34.6%--
Asian Indian 22 27.2%--
Chinese 15 18.5%--
Other Asian**16 19.80%--
Place of Birth United States < 10 4.9%*
Outside United States 116 95.1%20.5
* Categories with <10 average annual cases have unstable rates and are not presented
**Includes Vietnamese, Burmese, Korean, Cambodian, Nepalese, Pakistani, and Multiracial
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Tuberculosis in Alameda County, 2025
Table 2. Clinical Characteristics of TB Cases, 2025
Clinical Characteristic Category 2025
Case
Counts
Percent
Site of Disease Non-Pulmonary Only 28 23%
Pulmonary + Other 9 7.4%
Pulmonary Only 85 69.7%
Pulmonary Disease
Characteristics (n = 95)
Sputum Smear Positive 37 39.4%
Sputum Smear Negative 51 54.3%
Sputum Smear Not Done 6 6.4%
Cavitary Disease Absent*60 63.8%
Cavitary Disease Present*34 36.2%
Comorbidities HIV/AIDS 8 6.6%
Diabetes 32 26.0%
End-stage renal disease 9 7.4%
Other immunosuppression**4 3.3%
Hepatitis B 6 4.9%
No TB-related Comorbidities***64 52.5%
Other Risk Factors Usual Source of Care 95 77.9%
Current or former smoker 33 27.0%
Drug resistance among
culture positive cases (N=
94)
Resistance to any TB medications 9 9.6%
Resistance to INH only 6 6.4%
Resistance to PZA only 1 1.1%
Resistance to RIF Only 0 0%
Multidrug Resistance 2 2.1%
* Per X-ray, CT, or other chest imaging;
** Due to a medical condition, such as hematologic or reticuloendothelial malignancies or immunosuppressive
therapy, such as prolonged use of high-dose adrenocorticosteroids;
***TB-related comorbidities include those listed in the table in addition to Hepatitis C, organ transplant, and being
a TNF antagonist recipient;
****pncA mutation testing was conducted on 40 cases, one case had a mutation detected
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