KUALA LUMPUR, Feb 10 — Once widely regarded as a “death sentence”, tuberculosis (TB) has drawn renewed attention in Malaysia following a recent outbreak in Johor.
Health officials have said the two current TB incidents reported in the state are unrelated, despite occurring within the same state.
The latest case was announced on Monday and involves a male primary school student in Pontian, Johor, who tested positive for TB last week, prompting the screening of his close contacts.
The announcement came just a week after the Health Ministry, on Saturday, reported a TB outbreak in Kota Tinggi, Johor, where 33 people — including six students — tested positive for the respiratory disease. The number has since grown to 37.
More than 800 close contacts were screened between January 25 and February 5 in the Kota Tinggi cluster, which also recorded one death that health officials said was not caused by TB.
The two locations are about 125 kilometres apart, with the earlier case reported in the Sungai Mas area of Kota Tinggi and the latest involving Sekolah Kebangsaan Bandar Pontian in Pontian town.
TB is an ancient disease — often likened to leprosy and the plague — and while it is treatable today, outbreaks remain a cause for concern.
Health authorities have stressed that the situation in Malaysia remains under control.
What is TB?
TB is an infectious respiratory disease caused by the bacterium Mycobacterium tuberculosis.
If left unchecked, it can cause serious lung infections such as pneumonia, and remains one of the deadliest infectious diseases worldwide.
Those who contract TB usually experience symptoms such as persistent coughing, fever, night sweats and weight loss over time.
In more severe cases, TB can spread beyond the lungs, affecting other parts of the body — including the brain, where it can cause meningitis — or disseminate through the bloodstream.
Across much of Asia, TB came to be seen as a “death sentence”, shaped by stigma, widespread misconceptions and severe symptoms that often became apparent when the disease went untreated.
However, TB is curable with antibiotics.
Those infected typically require long courses of antibiotics for effective treatment, which generally last about six months, according to Health Ministry guidelines.
TB is caused by bacteria that exist in several strains, some of which are more aggressive or resistant to standard treatments.
How does it spread?
Malaysia is considered a country with an intermediate burden of tuberculosis (TB), with cases rising in recent years.
This means the disease remains endemic and continues to pose a public health concern, even though TB is curable and preventable.
TB is an airborne infectious disease that can be transmitted through microscopic droplets released when an infected person coughs, sneezes or even talks.
It is primarily transmitted through prolonged close contact with someone who has active pulmonary TB, such as people living in the same household.
TB also tends to spread easily in dense, overcrowded environments such as workers’ quarters and small rooms.
Children, as well as those with serious immune problems such as HIV infection or cancer chemotherapy, are at higher risk of infection if exposed.
This year, 10 TB clusters have been recorded nationwide, all of which are currently active.
Selangor recorded four clusters involving 10 cases, Johor reported one cluster with 37 cases, Kedah and Kelantan each recorded one cluster with two cases, Pahang reported one cluster with four cases, Perlis one cluster with two cases, and Sabah one cluster involving five cases.
As of February this year, 35 TB clusters reported last year remain active.
In 2025, a total of 88 TB clusters involving 254 cases were reported nationwide.
In 2024, Malaysia recorded 26,183 TB cases, representing a marginal increase of 34 cases compared with the 26,149 cases reported in 2023.
Latent TB
After exposure to TB, many people with a normal immune system do not fall ill, but instead keep the TB bacteria in a dormant state known as latent TB infection.
People with latent TB may never develop symptoms, but they carry a risk of progressing to active TB at some point in their lives.
Those with latent TB cannot infect others, but the condition can be detected through blood or skin tests.
Antibiotic treatment is available for latent TB and can significantly reduce the risk of developing active disease in the future.
How prepared are we?
When TB cases occur, state and federal public health authorities are responsible for ensuring infected individuals receive appropriate treatment, including antibiotics and hospital care where necessary.
Contact tracing, as well as isolation and quarantine measures, are part of the standard public health response to TB cases and clusters.
Public health authorities also conduct investigations to identify individuals who may have been in close contact with infectious patients.
Public education and access to accurate information are among the measures used by health authorities to address TB transmission.
At the policy level, the Health Ministry has set a target to achieve TB-free status for Malaysia by 2035.
This target is outlined under the “End TB Strategy” developed by the World Health Organisation (WHO).
According to the Health Ministry, the strategy includes measures such as active contact tracing, early case detection, laboratory testing, and the use of a national TB database.
Is there a TB vaccine?
Yes. The Bacille Calmette-Guérin (BCG) vaccine is used to protect against tuberculosis (TB).
It has been part of Malaysia’s immunisation programme for decades and is effective in preventing severe forms of TB in young children.
