Infectious Lung Disease on the Rise Again

Tuberculosis cases are beginning to rise again in Belgium after years of decline, according to new data from the Flemish Association for Respiratory Health Care and Tuberculosis Control (VRGT). Based on the 2024 tuberculosis register, 950 new cases were identified in Belgium last year.

This figure represents an incidence rate of 8.1 cases per 100,000 inhabitants. While Belgium maintains a relatively low incidence of the disease, health officials note that the numbers remain higher than those seen in several neighboring countries.

Regional Trends and Distribution

The recent upward trend is not uniform across the country. The increase is most prominent in Flanders, with a less pronounced rise observed in the Brussels-Capital Region. In contrast, Wallonia has seen a slight decrease in cases for the time being.

Data indicates that the disease is currently concentrated in urban environments and among specific vulnerable populations. The VRGT report highlights that those disproportionately affected include asylum seekers, homeless individuals and undocumented migrants. Statistically, individuals with non-Belgian nationalities also show a higher incidence rate, although experts emphasize that tuberculosis is not exclusively an imported disease.

Understanding Tuberculosis

Tuberculosis, or tbc, is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis. While the infection primarily targets the lungs in approximately two-thirds of patients, it can also affect other parts of the body, including the kidneys, bones, lymph nodes, and the brain.

Because the lungs are the primary site of infection, the disease is highly transmissible through the air. Bacteria are released into the air in small droplets when an infected person coughs, sneezes, or speaks loudly. While brief encounters rarely lead to infection, the risk increases significantly in the following conditions:

• Prolonged close contact with an infected individual.
• Poorly ventilated indoor spaces.
• Crowded living environments, such as reception centers or dense housing.
• Within family households.

Latent vs. Active Infection

Medical experts distinguish between latent and active tuberculosis. In many cases, the bacteria can remain dormant in the body for years without causing any symptoms; What we have is known as latent tuberculosis. The disease typically becomes active only when the patient’s immune system is weakened, which often leads to delayed discovery.

When the disease becomes active, symptoms often emerge gradually and may initially seem unremarkable. Common indicators of active tuberculosis include:

• A persistent, long-term cough.
• Coughing up mucus or blood.
• Fever and night sweats.
• Unexplained weight loss and fatigue.
• Chest pain.

Because these symptoms overlap with many other respiratory conditions, tuberculosis is not always immediately recognized by patients or healthcare providers.

Causes of the Recent Increase

Experts suggest that the return to pre-pandemic levels is partly a result of the disruptions caused by COVID-19. During the pandemic, healthcare resources were heavily diverted toward managing the virus, leading to fewer tuberculosis tests and delayed diagnoses.

international screenings and contact tracing efforts were hindered during the pandemic years. As healthcare systems return to normal operations, more cases are being identified and recorded, contributing to the rise in official statistics.