Tuberculosis in Switzerland and the Principality of Liechtenstein in 2025

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Published on September 17, 2026

Tuberculosis in Switzerland and the Principality of Liechtenstein in 2025​

In 2025, 544 cases of tuberculosis were reported in Switzerland and the Principality of Liechtenstein, the highest level since 2018. The resurgence observed since 2022 has thus continued, primarily affecting people of foreign origin. The number of infections has increased particularly among adolescents and young adults. This trend reflects the growing influence of refugees and migrants on the epidemiology of tuberculosis in European countries with low incidence. Overall, the resistance situation has remained stable. These results underscore the importance of continuous epidemiological surveillance, early diagnosis, and targeted prevention within particularly affected population groups.

Introduction​

Tuberculosis is an infectious disease caused by bacteria of the Mycobacterium tuberculosis complex . Most infected individuals do not experience symptoms. Only a small proportion develop the disease, with the risk being highest in the two years following infection or for those with immunodeficiency.
Tuberculosis most often affects the lungs, but can also affect other organs. Diagnosis is made when tuberculosis bacteria are detected through culture or molecular biology methods, such as polymerase chain reaction (PCR). Because pulmonary tuberculosis is transmitted through inhalation, early detection of infections and contact tracing remain central to disease control.
Tuberculosis is among the most widespread infectious diseases in the world. Although Switzerland is among the countries with a low incidence, international migration, the movement of refugees, and international epidemiological developments are increasingly influencing the epidemiology in these countries. Continuous epidemiological surveillance therefore remains the essential foundation for prevention and control measures.

Obligation to declare​

In Switzerland, tuberculosis is subject to mandatory reporting. For epidemiological surveillance purposes, clinical reports from treating physicians, laboratory reports, and supplementary reports relating to treatment outcomes are compiled.
Treating physicians report confirmed cases and those for which treatment with at least three antituberculosis drugs has been initiated. Demographic data are collected, as well as information on the location of the disease, medical history, diagnosis, and treatment.
Laboratories report bacteria identified by microscopy, PCR, or culture. They also transmit data on the pathogen species and on resistance or mutations in resistance genes. If rifampicin resistance is detected, the National Reference Centre for Mycobacteria at the University of Zurich conducts further investigations.

When treatment is completed, the physician submits a new report, which includes information on the patient's recovery, the end, failure or interruption of treatment, death, transfer to another facility, or the fact that the treatment outcome is unknown (e.g., in case of loss of contact). This data is used to assess the success of the treatment and the control of the disease.
To assess the epidemiological situation, the FOPH (Federal Office of Public Health) compiles clinical reports, laboratory results, and treatment outcomes for each case. The assessments in this report are based on clinical and laboratory reports from 2025 and treatment outcomes from 2024.

Epidemiology​

Number of cases​

In Switzerland and the Principality of Liechtenstein, the number of reported tuberculosis cases declined steadily for many years, reaching 350 in 2021, the lowest level since surveillance began in 1988 due to the pandemic (Figure 1, Table 1). Since 2022, cases have been rising again. This increase accelerated in 2025 with 544 reported cases. Consequently, the reporting rate rose from 4.8 to 6.0 cases per 100,000 inhabitants. Despite this trend, Switzerland remains a country with a low incidence of tuberculosis, still below the European average (8.4 cases per 100,000 inhabitants in 2024 [1] ).

Illustration 1: Tuberculosis in Switzerland and the Principality of Liechtenstein from 2005 to 2025, number of cases according to the origin of the people affected and the year

• Data relating to illustration 1: Tuberculosis in Switzerland and the Principality of Liechtenstein from 2005 to 2025, number of cases according to the origin of the people affected and the year​

  XLSX 12.30 kB September 10, 2026

The increase in cases is explained almost exclusively by their higher number among foreign-born individuals, while it remains stable among people originating from Switzerland and has even slightly decreased among those from Liechtenstein. Thus, the current trend seems to reflect more the movements of refugees and migrants, as well as changes in the epidemiology of tuberculosis in their countries of origin, rather than an increase in local transmission. These observations are consistent with findings in other European countries with low incidence. Studies show that tuberculosis affects more people from regions with high prevalence [2, 3] . Refugees, migration, and international mobility are having an increasingly significant impact on the epidemiology of tuberculosis.
Global trends confirm this interpretation. According to the WHO's Global Tuberculosis Report , approximately 10.7 million people contracted a new tuberculosis infection in 2024 [4] . A total of 8.3 million cases were diagnosed and reported worldwide, the highest number ever recorded. After the declines observed in 2020 and 2021 due to the pandemic, the resumption of diagnoses, treatments, and international travel has led to a resurgence in many regions. Furthermore, the COVID-19 pandemic and armed conflicts in various high-prevalence countries have hampered tuberculosis control, including preventive measures such as vaccination programs.
The situation in Switzerland therefore aligns with international trends and underscores the importance of ongoing surveillance, even in low-prevalence countries.
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Demography​

In 2025, tuberculosis cases increasingly affected younger age groups. A total of 207 infections occurred in individuals aged 20 to 39, the patient group with the highest number of cases (Table 1). However, the most significant increase was observed among 15- to 19-year-olds. In this age group, the number of cases doubled, rising from 51 to 102. This group also had the highest morbidity rate among all age groups (22.3 cases per 100,000 inhabitants; Table 2). The increase primarily affected adolescents and young adults of foreign origin. In contrast, among individuals born in Switzerland or the Principality of Liechtenstein, tuberculosis cases continued to occur at an older age, most often as a reactivation of a previously contracted infection (Figure 2). In 2025, men were significantly more affected than women (366 cases, or 67.3%). The reporting rate for men was more than twice as high.
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Figure 2: Age distribution of tuberculosis cases in Switzerland and the Principality of Liechtenstein, from 2020 to 2025, number of cases according to origin and sex of patients

Origin​

Origin is determined using the country of birth. If this information is unavailable, nationality is used. In Switzerland, the epidemiology of tuberculosis remains primarily influenced by people originating from other countries. After people originating from Switzerland, most cases involved individuals from Eritrea, Somalia, and Afghanistan (Table 3). According to the World Health Organization, these countries have a much higher incidence of the disease than Switzerland and are among the main countries of origin for asylum seekers in Switzerland [4, 5] .
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Clinical manifestation​

Pulmonary tuberculosis remains by far the most common form of the disease. In 2025, 268 exclusively pulmonary cases were reported, compared to 238 cases of combined pulmonary and extrapulmonary infections. Overall, 94% of those infected had lung involvement (Table 1). Since pulmonary forms of tuberculosis are crucial for transmission, this observation underscores the importance of early diagnosis, systematic contact tracing, and contact tracing.

Laboratory analysis results​

Diagnostic evolution​

The diagnostic trends reported in this report sometimes differ from data in previous reports. These discrepancies are due to a correction in the assessment methodology. The results presented here are based on a revised calculation. In 2025, the quality of diagnoses remained high. Of the 544 reported cases of tuberculosis, 510 (93.8%) were laboratory-confirmed. Laboratory diagnoses are increasingly based on molecular biology methods. Alongside the rise in tuberculosis cases, the proportion of infections diagnosed by PCR increased, reaching its highest level since the start of the observation period in 2025. This diagnostic method allows for the rapid detection of pathogens of the Mycobacterium tuberculosis complex and relevant mutations in resistance genes, thus enabling the prompt initiation of appropriate treatments. However, culture remains the gold standard for confirming the diagnosis and for comprehensive resistance testing (Table 4). A decline in cases detected by microscopy has been observed (Figure 3). Concurrently, the proportion of cases analyzed by microscopy with indeterminate results has also increased significantly. This situation could indicate that microscopy has been used less frequently due to the increased reliance on molecular biology methods, or that the results were incompletely documented or reported. The observed decrease in positive cases detected by microscopy should therefore be interpreted with caution, as it could be explained, at least in part, by the increased proportion of indeterminate results. Regardless, a positive sputum smear detected by microscopy remains an important marker of bacterial load and high contagiousness.

Illustration 3: Share of results obtained by culture or microscopy, by year of laboratory-confirmed tuberculosis cases in Switzerland and the Principality of Liechtenstein, from 2020 to 2025.

• Data relating to illustration 3: Share of results obtained by culture or microscopy, according to the year of laboratory-confirmed tuberculosis cases in Switzerland and the Principality of Liechtenstein, from 2020 to 2025.​

  XLSX 15.03 kB September 11, 2026

Molecular testing of resistance genes detects mutations in the rpoB and katG genes and in the inhA gene promoter , which are associated with resistance to rifampicin or isoniazid. From 2020 to 2025, the proportion of detected resistance gene mutations remained low and largely stable. Mutations in the rpoB gene (rifampicin resistance) were detected annually in approximately 2% to 3% of laboratory-confirmed cases, those in the katG gene (isoniazid resistance) in 3% to 5% of cases, and those in the inhA gene promoter (isoniazid resistance) in approximately 2% of cases. Overall, there is no indication that resistance detected by molecular analyses has increased in Switzerland (Table 4).

Species​

The identified isolates are predominantly Mycobacterium tuberculosis or belong to the Mycobacterium tuberculosis complex . Other species, such as M. bovis or M. africanum , were rarely detected. The distribution by species therefore remained stable compared to previous years (Table 4).
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Resistance situation​

The resistance situation remained generally stable. In 2025, isoniazid resistance was detected in 29 isolates, and rifampicin resistance in seven cases. Five cases met the definition of multidrug-resistant tuberculosis (MDR-TB), i.e., resistance to at least isoniazid and rifampicin. The number of MDR-TB cases remained unchanged compared to the previous year. During the year under review, no cases of extensively drug-resistant tuberculosis (XDR-TB) were reported. Despite the net increase in tuberculosis cases, there is no indication that the overall resistance problem has increased (Table 5).

However, marked differences were observed between communities. Throughout the review period, cases originating from Ukraine, in particular, had a significantly higher proportion of rifampicin-resistant isolates. This observation is consistent with the known epidemiological situation in regions with a high prevalence of MDR-TB and suggests that drug-resistant tuberculosis in Switzerland is due more to people arriving in the country from abroad than to local transmission.

Patients who had previously received treatment showed higher resistance rates over several years than newly diagnosed cases. However, these results should be interpreted with caution due to the small number of cases. This pattern is consistent with observations made abroad: prior tuberculosis treatment is a risk factor for drug-resistant tuberculosis, since incomplete or insufficiently effective treatments can promote the selection of resistant pathogens.
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Treatment results​

Since treatments last between six and twelve months, their results are always evaluated with a certain delay. Thus, those completed in 2024 were evaluated during the year under review.

In 2024, success rates were recorded for 70.6% of documented treatments and 72.7% of treatments for culture-confirmed pulmonary tuberculosis without rifampicin resistance. Success rates remain well below the levels achieved between 2019 and 2021 and are also below the WHO target of 90%. Treatment is considered successful when, at the end of therapy, tuberculosis bacteria are no longer detectable or the treatment has been completed. In 14.6% of cases, a supplementary report regarding treatment outcome was missing, and in 6.2% of cases, the treatment outcome was unknown. Therefore, the treatment success rate is likely underestimated. More comprehensive reporting of treatment outcomes by physicians is thus a crucial objective in the fight against tuberculosis.
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Quality of statements​

The quality of tuberculosis surveillance depends primarily on the completeness of reporting. In 2025, clinical data were available for 539 of the 544 reported cases (99.1%). The high data completeness thus remained stable compared to previous years. The number of follow-up reports can still be improved: in 2024, the return rate was 85.4% (369 out of 432 cases), a level slightly higher than the lowest recorded in 2022 (78.5%; Figure 4). No data are yet available for 2025, as treatments are ongoing. Missing data on treatment outcomes complicate the interpretation of results and likely lead to an underestimation of treatment success. According to feedback received from the reporting agencies, the high mobility of patients, particularly transfers within the asylum system, results in some follow-up reports being missing. A more comprehensive capture of treatment outcomes would improve the assessment of tuberculosis control and facilitate comparison with WHO targets.

Figure 4: Share of cases with clinical outcome reporting (COR) and supplementary reporting (SR), in Switzerland and the Principality of Liechtenstein, from 2020 to 2025

• Data relating to illustration 4: Share of cases with clinical outcome reporting (COR) and supplementary reporting (SR), in Switzerland and the Principality of Liechtenstein, from 2020 to 2025​

  XLSX 12.11 kB September 10, 2026

Conclusions​

After the dip observed in 2021 due to the pandemic, tuberculosis cases began to rise again in 2022; this trend continued in 2024 and 2025. The increase primarily affected people from outside Switzerland, especially adolescents and young adults. This development is consistent with observations in other European countries with low incidence rates and underscores the influence of international migration and refugee movements on the epidemiology of tuberculosis.

Over the past few years, the number of cases among people arriving from Switzerland and Liechtenstein has remained generally stable. Available data on reporting and the overall stable resistance situation suggest no major changes in local transmission.
In 2025, the quality of diagnoses and resistance monitoring remained at a high level. Areas for improvement still concern the completeness of supplementary reports on treatment outcomes, as gaps in this area complicate the assessment of treatment success. More comprehensive recording of treatment outcomes would improve the evaluation of tuberculosis control and facilitate comparison with WHO targets.

In the coming years, it will be important to focus on early diagnosis, comprehensive documentation of treatment outcomes, and rapid contact tracing and screening to detect further cases and infections. At the same time, prevention and management measures should continue to target particularly affected population groups. These findings demonstrate that even in a low-incidence country like Switzerland, continuous monitoring of epidemiological trends and adaptation of tuberculosis control to international developments remain essential.

Additional themes​

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References​

• European Centre for Disease Prevention and Control, WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2026: 2024 data. Stockholm: European Centre for Disease Prevention and Control; Copenhagen: WHO Regional Office for Europe; 2026.
• Dara M, Solovic I, Goletti D, Sotgiu G, Centis R, D'Ambrosio L, et al. Tuberculosis in migrants in low-incidence countries: epidemiology and intervention entry points. Int J Tuberc Lung Dis. 2017;21(6):624-636. doi:10.5588/ijtld.16.0845. PMID: 28482956.
• Greenaway C, Pareek M, Abou Chakra CN, Walji M, Makarenko I, Alabdulkarim B, et al. The effectiveness and cost-effectiveness of screening for latent tuberculosis among migrants in the EU/EEA: a systematic review. Euro Surveillance 2018;23(14):17-00543. doi:10.2807/1560-7917.ES.2018.23.14.17-00543. PMID: 29637889.
• World Health Organization. Global tuberculosis report 2025. Geneva: World Health Organization; 2025.
• State Secretariat for Migration (SEM). Asylum Statistics 2025. Bern-Wabern: Federal Department of Justice and Police; 2026. Available from: https://www.sem.admin.ch/sem/fr/home/publiservice/statistik/asylstatistik/archiv/2025.html (accessed 29.6.2026).

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