Tuberculosis (TB)

TB is spread from person to person through the air when someone with active disease in the lungs coughs or sneezes. It is not highly contagious. It usually takes close, prolonged or regular contact to spread this disease. 

There are two types of TB: TB infection or TB disease. Someone with TB infection has TB germs in the body but is not sick, has no symptoms, and cannot spread TB to others. If TB infection is not treated, it can develop into TB disease, which does make a person sick and can be spread.” 

TB Infection

Most people who breathe in TB germs are able to stop them from growing. Their immune system traps the TB germs and keeps them inactive. This is called TB infection. 

People with TB infection: 

• Cannot spread TB germs to others 

• Do not feel sick or have TB symptoms 

• Have a positive skin test (people with weak immune systems may have a negative skin test even though they are infected with TB – speak with your doctor or nurse) 

• May develop active TB disease later in life 

TB Disease

TB germs become active when the body’s immune system cannot stop the germs from growing. The active TB germs begin to grow and cause damage to the body. This is called TB disease. TB disease of the lungs and throat can be spread to other people. 

People who have TB infection do not have symptoms and are not sick. People with TB disease can feel sick and have the following symptoms:

• Fever / chills / night sweats
• Coughing (more than 3 weeks)
• Tiredness
• Loss of appetite / unexplained weight loss

If the TB disease is in another part of the body it is called extra-pulmonary disease.  The symptoms will depend on where the TB is growing, for example swollen lymph node or joint pain. Extra-pulmonary TB is not infectious to others.

When to contact a Health-Care Professional

It is good to seek medical attention if you are experiencing any signs or symptoms that are not getting better on its own because TB signs and symptoms can often mimic other sicknesses.

Anyone can get TB but some people who are at higher risk of getting it include:

• People who are in close contact with someone who is ill with infectious TB disease
• People who have lived or travelled to countries where TB is common
• People who live in congregate settings with increase rates of TB disease

Learn what tests are used to identify TB infection and TB disease, and what the TB screening recommendations are for different workplace settings. 

• Screening for TB Disease
• Testing for TB Infection – TB skin and IGRA-QFT blood tests
• TB Screening Recommendations for Workplaces
  • Non-Health Care Settings (child care, shelters, detention)
  • Health Care Settings (long-term care, primary care, home care)

Learn more about the different treatments and medications available for tuberculosis.

TB Treatment

• Treatment for TB Disease
• Treatment for TB Infection
• TB Medication Fact Sheets
  • Isoniazid
  • Rifampin
  • Pyrazinamide
  • Ethambutol
  • Moxifloxacin
• Home Isolation

Learn more about the TB program and services available for anyone affected by tuberculosis.

Toronto Public Health TB Programs and Services

• Case Management Teams
• Directly Observed Therapy (DOT)
• Drug Order Team
• Homeless and Corrections Team
• TB Immigration Medical Surveillance 
• Social Work for TB Clients
• TB Prevention Team
• TB Stop Drop-In

Other TB services in Toronto

• TB Clinics in Toronto

• Information about TB Immigration Medical Surveillance and How to Report

Learn more about TB in Canada, including how it’s monitored, and the work of national partners committed to ending TB 

• Public Health Agency of Canada (PHAC)
• STOP TB Canada

March 24 is World Tuberculosis (TB) Day. This annual event commemorates the day in 1882 when Dr. Robert Koch announced his discovery of the TB bacterium, paving the way for the diagnosis and cure of this disease. It is an important day to raise awareness about the health, social, and economic impacts of TB.

Learn more about World TB Day.

Overall Trends for TB Disease:

• The 2025 TB incidence rate in Toronto was 9.6 cases per 100,000 population. There were 313 confirmed TB disease cases, higher than reported in pre-pandemic years, but lower than the 10-year peak of 369 cases in 2024.
• 70.3% of people with TB had pulmonary involvement. This has remained relatively stable.
• Toronto accounted for 33.3% of the TB cases reported in Ontario. The provincial TB incidence rate was 5.7 per 100,000 population.

Demographics:

• The average age at TB diagnosis has steadily decreased from the pre-pandemic average age of 49 years old, to 47 years old for Toronto residents diagnosed in 2025.
• Nearly all people with TB (95.0%) were born outside of Canada. The top three countries of birth among foreign born people with TB were Philippines, India and China (45.7% of all people with TB).
• The TB incidence rate by sex was higher for males (11.5 per 100,000 population) than females (7.6 per 100,000 population), consistent with previous years and provincial trends. By age group, the 65+ age group had the highest incidence rate (14.2 per 100,000), followed by the 20–24-year-old age group (13.0 per 100,000).
• The fatality rate among people with TB was 5.8%, comparable to the pre-pandemic rate.

Treatment:

• The proportion of TB cases with resistance to one or more drugs was 9.0%. Similar to previous years, it was driven by INH mono- resistance, at 7.2% of cases with sensitivity results available.
• The mean length of treatment for all people with TB starting treatment in 2025 was 222 days (range 177-408, median 187.5), approximately 7.4 months of treatment.
• 98.7% of all people with TB diagnosed and residing in Toronto in 2025 completed adequate treatment according to the Canadian TB Standards. More than half of individuals with TB (55.3%) had medical or social complexities, or a complex contact investigation requiring enhanced case management.

TB Contacts:

• There were 1,320 contacts identified in 2025, an average of 4.2 contacts per Toronto case. During the January 1 to June 31, 2025, cohort period, 17 site-based screenings were conducted, and 310 household contacts were followed up.

TB Immigration Medical Surveillance:

• 2,261 TBIMS referrals were received for Toronto residents in 2025.
• 1,371 medical surveillance clients completed follow-up as recommended and of these, 8 clients (0.6%) were diagnosed with TB disease.

This information is also available in the following languages. To request a copy, email us at targettb@toronto.ca or call 416-338-7600 and ask for the TB program.