Tuberculosis　

Tuberculous: not a disease of the past

Tuberculosis (TB) is a potentially serious infectious disease that caused a public health crisis in Japan from the Meiji period until the mid-forties. It was the number one cause of death in Japan until 1950, killing more than 100,000 people every year.

With medical advancements and improved living standards, TB can now be treated and cured with medication. However, in Japan, TB is a grave infectious disease with an average of 28 people diagnosed with TB every day, and five people losing their life every day to the disease. In Hiroshima City as welll, there are approximately 90 new TB patients per year (91 in 2022), making TB not a disease of the past, but of the present.

In 2022, there were 10,235 people registered as new TB patients across Japan with an incidence rate of 8.2* and the country continues to be ranked as a low-burden TB country.** However, the reduction in newly-registered patients and incidence rate is thought to be due to COVID-19 and it will be necessary to closely watch the numbers in the years to come. In addtion, we face pressing issues with TB, inlcuding the the aging of TB patients and an increase in TB in young international residents.

*Expressed as the ratio per 100,000 inhabitants based on the number of newly-registered TB patients in Japan during one year.
**Countries with 10 or less newly registered patients per 100,000 inhabitants.

What is tuberculosis?

TB is a disease caused by Mycobacterium tuberculosis and causes inflammation primarily in the lungs. It can also cause inflammation in other organs (lymph nodes, kidneys, intestines, bones, skin, eyes, etc.) by travelling through lymph nodes or the bloodstream. This is known as extrapulmonary tuberculosis.  

It is an infectious disease transmitted through the air when an infected person coughs or sneezes. Despite contracting TB, many people live their entire lives without presenting any symptoms (latent TB). However, if their immune system becomes compromised due to aging or sickness, latent TB can become active.

Common symptoms of active TB include cold-like symptoms such as coughing, phlegm, a low-grade fever, and fatigue. If left untreated, the disease will get worse and can become life-threatening, and there is a high risk of infecting others.

Increased cases in the eldery and in foreign-born residents

In 2022, approximately 70% of those newly-diagnosed with TB were 65 or older. It is thought that many of these patients were infected in the past when TB was more widespread, and as they age and their immune systems weaken, they present symptoms.

The City of Hiroshima offers free TB examinations (chest x-rays) to those 65 and over. We recommend that you take this examination once a year, even if you have no noticeable symptoms, such as coughing.

• For more details about the TB examination, click here (Japanese).

In addition, the number of young foreign-born TB patients is on the rise. In 2022, approximately 70% of new TB patients in their 20s in Hiroshima City were born overseas. It is believed that cases are increasing as those who immigrated to Japan from countries where TB is widespread begin to show symptoms in Japan.

If you have a cold that lingers for a long time, don’t do nothing: go and get checked out by a medical institution. For those whose schools or workplaces offer regular health check-ups: be sure to get a chest x-ray once per year. (Multilingual TB awareness leaflets)

Age groups of newly diagnosed tuberculosis patients in Hiroshima City in 2022

If you are diagnosed with TB

When is it deemed necessary to take actions to prevent the spread of TB, health centers will, in accordance with the law*, advise those who have been diagnosed with TB to be hospitalized and for their attendance at work to be restricted. Moreover, when there is a chance family, friends, and those around the patient maybe have been infected, they will be asked to take a TB examination (chest x-rays, blood tests, etc).

*Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases

Financial aid for TB treatment

Tuberculosis patients or their guardians can apply for the medical expenses involved in treating TB to be covered by public funds.

When these costs are covered by public funds, treatment must follow the standard TB treatment regimen stipulated by the Ministry of Health, Labor, and Welfare.

Please note that the amount of financial aid will vary according to income, course of treatment, and whether treatment was received as an inpatient or outpatient. For further details, please contact your local ward health center.

• Financial Aid for Tuberculosis Treatment (Japanese)

Treating TB

Treatment for TB involves a 6-9 month course of anti-tuberculosis drugs (medicine that kills Mycobacterium tuberculosis (M. tuberculosis)). The pathogen M. tuberculosis is very hard to kill and thus treatment is a lengthy process. Patients that stop taking their medication before completing the full course of treatment because symptoms have subsided run the risk of reinfection and remaining sick. There is also a risk that the bacteria will become resistant to one or more of the drugs involved in treatment (drug-resistant TB). Treating drug-resistant TB is very difficult, resulting in a treatment regimen that lasts even longer than standard treatment.

If you contract TB, it is important to take your medications exactly as prescribed by your physician for the duration of the 6-9 month treatment regimen. If you experience side-effects from the anti-tuberculosis drugs, always consult with your doctor before stopping your medication.

In addition, even if you haven't contracted/presented symptoms for TB, you can prevent developing TB by taking anti-tuberculosis drugs for six months (for latent TB).

Preventing TB

Tuberculosis bacteria can infect the body but does not always cause any symptoms. In most cases, the immune system will stop the bacteria multiplying. A healthy immune system can help prevent the spread of TB and the onset of active TB.

Five tips for a healthy lifestyle and strong immune system:

1. Get appropriate exercise
2. Eat balanced meals
3. Get plenty of rest
4. Don't smoke
5. Get tested reguarly, even if you don't have symptoms

Infants have weak immune systems and often become seriously ill if they contract TB. The Bacillus Calmette–Guérin (BCG)* vaccine is an effective measure of prevention.

*Infants should be vaccinated before their first birthday. The recommended inoculation period is 5-8 months old.

• Vaccinations for Children

Tuberculosis Prevention Week and World Tuberculosis Day

The Ministry of Health, Labor, and Welfare designates September 24-30 as Tuberculosis Prevention Week in an effort to raise public awareness about TB and disseminate accurate information about the disease.

In FY2023, the Japanese government adopted the following slogan for TB Prevention Week:

Even today, 28 people on average are diagnosed with TB every day

In addition, at the World Health Organization’s 1997 World Health Assembly, March 24 was designated World Tuberculosis Day. This date marks the day on which German bacteriologist Robert Koch announced in 1882 that he had discovered the bacterium M. tuberculosis that causes TB. On this day, countries around the world are called upon to scale up and strengthen measures against TB.

Information for medical institutions

Under the provisions of Article 12, paragraph 1 of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, when a physician has diagnosed a patient with TB, the physician must file a notification with the nearest public health center immediately.

Additionally, under the provisions of Article 53-11 of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, when a TB patient is hospitalized or a TB patient who has been hospitalized is discharged, the administrator of the hospital must notify the nearest public health center within seven days.

• Information for Medical Institutions (Japanese)

Ward Office Health Centers

Useful links 

• The Japan Anti-Tuberculosis Association Website＜外部リンク＞ (Japanese)
• The Japan Anti-Tuberculosis Association Research Institute of Tuberculosis Website＜外部リンク＞
• Facts and Figures About Tuberculosis in Japan 2022 Report (Ministry of Health, Labor, and Welfare Website)＜外部リンク＞ (Japanese)

Multilingual TB awareness leaflets

• English
• Chinese
• Tagalog
• Vietnamese
• Simplified Japanese

Inquiries regarding this page

Preventative Medical Services Section, Health Promotion Division, Health Department, Health and Welfare Bureau
1-6-34 Kokutaiji-machi, Naka-ku, Hiroshima
Tel: 082-504-2882 // Fax: 082-504-2258
Email: k-suishin@city.hiroshima.lg.jp