TB rates in Ireland are alarmingly high among migrants and pose a serious risk to the native Irish population. HSE-linked data reported that in 2024, TB incidence among people born outside Ireland was 12 times higher than among Irish-born people. This is a real public health problem that the Irish health system is facing. A Lancet study found that, despite overall declines, TB incidence among migrants in Ireland remained about five times higher than among non-migrants. Another 2025 study found migrants in Ireland with TB were more likely to have HIV, drug-resistant TB, and live in congregated settings.
TB Screening for Migrants
Ireland’s TB screening is targeted and voluntary rather than mandatory leaving no barrier against its importation. Migrants from high-incidence countries are not screened before arriving in Ireland unlike the UK which is one of only 5 countries consisting of Australia, Canada, New Zealand and the USA that have mandatory pre-entry screening.
The HPSC (Health Protection Surveillance Centre) recommends screening for TB in high-risk populations, including migrants from countries where TB is common, where there is close contacts with patients with active TB and with people with social risk factors such as the homeless, drug/alcohol problems and prisoners.
Screening Methods
Chest X-ray for people aged 16+ years that are not pregnant, tuberculin skin test (TST) for latent TB detection, IGRA blood test for latent TB infection and sputum testing if chest X-ray is abnormal. Contact tracing takes place when someone is diagnosed with TB and people who had prolonged close contact are offered screening tests. This includes family members, those living with an infected person and those in close contact.
The Bottom Line
Since TB incidence among people born outside Ireland is 12 times higher than among Irish-born people that poses a significant public health problem that could reasonably be described as a surge or flood of a disease that previous to the migrant influx was nearly eradicated in Ireland.
The actual numbers (2024):
- Foreign-born: 20.4 cases per 100,000 population
- Irish-born: 1.7 cases per 100,000 population
Imported TB Poses a Real Threat to Irish People
Multiple sources show that TB poses a real threat to Irish people because of the risk of spreading from migrants to the native population, especially in certain conditions. TB passes from person to person after prolonged close contact, like living in cramped accommodation with high numbers of residents; This is exactly what happens in many IPAS Centres where there is excessive over-capacity and crowding
Risk to the native population
In the Leinster House Dáil, Deputy Nolan said she is “deeply alarmed by the overall picture” and that we have a “growing public health threat.” She warned that “whatever measures are being taken to reduce the incidence rate here is not working” She further stated: “This increase is being driven by population groups coming from countries of origin that have exceptionally high rates of disease”
The actual risk
72% of TB cases are foreign-born (208 out of 277 total cases)
Foreign-born rate is 20.4 per 100,000 vs Irish-born 1.7 per 100,000 (12 times higher). In 2024, TB incidence increased to pre-pandemic levels. For migrants, the decline in TB rates stopped being significant between 2017-2021, making elimination targets harder to achieve.
The threat to the Irish population is growing because migrants with TB are younger (less likely to be elderly with other health issues). They have higher odds of living with HIV (OR 3.8). They have higher odds of drug-resistant strains (OR 2.30) They have higher odds of living in congested settings (OR 2.00)
The bottom line is that this poses a significant threat to Irish people because:
- TB is increasing againto pre-pandemic levels
- Foreign-born people have rates 12 times higher
- TB spreads easily in crowded conditionslike IPAS centres
- The decline in migrant TB rates has stopped
- Migrants with TB have higher rates of drug-resistant strains
Deputy Nolan is right to call this a “major resurgence of TB” that threatens Ireland’s health system.
Comparison:
| Category | Ireland | EU/EEA Average |
| Overall rate | 5.6 per 100k | 8.4 per 100k |
| Irish-born rate | 1.4 per 100k | Not available |
| Foreign-born rate | 18.0 per 100k | Not available |
Ireland has a lower overall TB rate than the EU average (5.6 vs 8.4 per 100k) making it a low TB incidence country with Irish-born rates below 6 per 100k since 2011. The foreign-born rate is 13 times higher than the Irish-born rate in Ireland (18.0 vs 1.4 per 100k). 66% of cases in 2023 were foreign-born (189 out of 287 cases). While Ireland’s overall TB rate is lower than the EU average, the foreign-born rate is extremely high (13 times higher than Irish-born), and the decline has stalled, making Ireland’s elimination targets harder to achieve while posing a serious threat to the health of Irish people. We must stop importing TB as a first step to its control and eradication where it was prior to mass uncontrolled migration.