Kuala Lumpur – Health officials in Malaysia are bracing for a potential surge in tuberculosis (TB) cases linked to increased social gatherings during the upcoming Chinese New Year, Ramadan, and Hari Raya Aidilfitri celebrations. The Galen Centre for Health and Social Policy issued a warning on Monday, February 16, 2026, citing the risk of heightened transmission in crowded indoor spaces and during communal activities.
The concern stems from the way TB spreads – through the air when individuals with active TB cough, sneeze, shout, or sing. Azrul Mohd Khalib, Chief Executive of the Galen Centre, described the situation as feeling like a “deja vu” moment, reminiscent of the early stages of the COVID-19 pandemic. He emphasized that the upcoming festive periods, characterized by travel, visiting, and large indoor gatherings, create ideal conditions for the disease to spread. “We’re definitely looking at a spike of incidence of cases related to TB in the next few months. It’s almost certain,” he said in a recent interview with the New Straits Times’ “Beyond the Headlines” podcast.
Recent data from the Ministry of Health (MOH) supports these concerns. As of February 7, 2026, a total of 2,571 active TB cases had been reported for the fifth epidemiological week of the year, representing a 9.8 percent increase – 229 cases – compared to the same period in 2025, which saw 2,342 cases. Outbreaks have been reported in every state and federal territory across Malaysia, with Sabah currently reporting the highest number of cases at 614, followed by Selangor with 476 and Sarawak with 257.
Regional Case Distribution
The spread of TB cases isn’t uniform across the country. Here’s a breakdown of reported cases as of February 7, 2026:
- Sabah: 614 cases
- Selangor: 476 cases
- Sarawak: 257 cases
- Johor: 233 cases
- Kuala Lumpur and Putrajaya: 202 cases
- Penang: 148 cases
- Kedah: 144 cases
- Perak: 127 cases
- Kelantan: 96 cases
- Pahang: 81 cases
- Terengganu: 60 cases
- Negeri Sembilan: 58 cases
- Melaka: 42 cases
- Perlis: 17 cases
- Labuan: 16 cases
The Challenge of TB Transmission and Treatment
TB is endemic in Malaysia, with approximately 85 percent of cases affecting Malaysian citizens and 15 percent affecting non-citizens. The Galen Centre highlights that the insidious nature of TB – its often-subtle symptoms and long incubation period – complicates prevention and control efforts. Symptoms like prolonged coughing, fatigue, and unexplained weight loss are often dismissed or attributed to other causes.
Whereas the BCG vaccine, administered in childhood, offers some protection, its effectiveness diminishes over time, leaving older adults particularly vulnerable. Azrul Mohd Khalib explained that the vaccine’s protection “won’t last forever” and individuals may become susceptible to infection later in life. The risk is amplified by the fact that TB can linger undetected, spreading through aerosol droplets that can remain airborne for hours, particularly in poorly ventilated spaces like workplaces, public transport, and places of worship.
Treating TB requires a lengthy course of antibiotics – typically six to nine months – and strict adherence to the prescribed regimen. Malaysia currently has a treatment default rate of around 24 percent, resulting in an 81.5 percent success rate for new cases, falling short of World Health Organization (WHO) targets. To ensure compliance, Malaysia employs Directly Observed Treatment (DOT), where healthcare workers directly observe patients taking their medication.
Concerns About Drug-Resistant TB
Adding to the complexity, the Galen Centre has expressed concern about the growing threat of drug-resistant TB, which occurs when TB strains develop resistance to antibiotics due to overuse or inconsistent leverage. “We don’t want an outbreak of drug-resistant TB,” Azrul Mohd Khalib stated. “That’s what I’m worried about.”
In 2024, Malaysia reported 2,580 TB-related deaths out of 26,183 cases, according to The Star. While the national mortality rate is around 7.6 deaths per 100,000 population, Sarawak has a significantly higher rate of 12.6 deaths per 100,000.
The Galen Centre recommends that individuals diagnosed with TB wear face masks to prevent further transmission. The organization also urges a return to precautionary measures adopted during the COVID-19 pandemic, particularly during congregational prayers in Ramadan, including the use of masks and improved ventilation.
Health officials will continue to monitor TB case numbers closely in the coming weeks and months, particularly as Malaysia enters the peak of the festive season. The Ministry of Health is expected to provide updated data and guidance as the situation evolves.
Disclaimer: This article provides information about tuberculosis and should not be considered medical advice. Consult with a healthcare professional for diagnosis and treatment.
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