LOS ANGELES — Tuberculosis cases are rising again in California, and health officials are urging those at higher risk, as well as doctors, to be alert for the disease, which can lurk in people's bodies for years before becoming potentially deadly.

The number of tuberculosis cases in 2023 rose by 15% in California compared to the previous year, the state Department of Public Health said. That's the highest year-over-year increase since 1989, when it was tied to people co-infected with HIV.

There were 2,113 cases across California last year; that's about the same amount reported in 2019, before the COVID-19 pandemic began. Seniors 65 and older had the highest percentage increase in cases between 2022 and 2023.

Those at major risk for tuberculosis are people who have lived outside the U.S. where the TB rate is high, including most nations in Asia, the Middle East, Africa, Eastern Europe and Latin America.

Caused by bacteria mycobacterium tuberculosis, tuberculosis disease is spread through the air. Unlike COVID-19 — in which infection can occur in minutes — a person would typically need to be exposed for hours to inhale enough TB bacteria to get infected, said Dr. Julie Higashi, director of the L.A. County tuberculosis control program.

Most active cases in California are from people with latent TB who picked up the bacteria decades ago but weren't contagious or showing symptoms. "Then something happens. Either they age ... and their immune system actually becomes weaker ... and then they progress" to acute TB, Higashi said.

On the flip side, an estimated 18% of TB cases in L.A. County occur from recent transmission.

California officials said that 13% of people with tuberculosis died in 2020. That's up from 8% in 2010. Generally, more than 200 Californians die from tuberculosis every year, state officials say.

TB has afflicted humanity since before the dawn of recorded history, and at one point in the 17th and 18th centuries, caused one-quarter of all deaths in Europe.

It was only on March 24, 1882 — 142 years ago Sunday — that a scientist announced the discovery of the bacteria that causes TB. (Decades earlier, TB was thought to be hereditary, and in New England, inspired "vampire panics" because people thought the first family member to die of TB would come back as a vampire to infect the rest of them, according to the U.S. Centers for Disease Control and Prevention.)

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