Tuberculosis (TB), a bacterial infection primarily affecting the lungs, is experiencing a resurgence in England, with cases rising by 13% in 2024 compared to the previous year. This upward trend raises concerns, despite England being considered a low-incidence country for TB. The UK Health Security Agency (UKHSA) reported 5,480 cases in 2024, a significant increase from the 4,850 cases in 2023. While the majority of cases (81.5%) occurred in individuals born outside the UK, the rise is evident in both UK-born and non-UK-born populations. TB is often linked to socioeconomic deprivation and is more prevalent in large urban areas like London and the West Midlands, which saw the largest increases in 2024. Among UK-born individuals, risk factors include homelessness, substance abuse, and involvement with the criminal justice system.
Health officials emphasize that TB, while a serious public health concern, is both preventable and curable. Dr. Esther Robinson, head of the TB unit at UKHSA, urges individuals, especially those who have migrated from high-incidence countries, to be vigilant about potential symptoms. These include a persistent cough lasting longer than three weeks, often accompanied by mucus, fever, and night sweats. It’s crucial to differentiate these symptoms from common illnesses like flu or COVID-19 and seek medical attention if any concerns arise. Early diagnosis and treatment are vital for preventing further transmission and potentially serious complications.
TB is transmitted through close contact with individuals who have active TB, primarily through the inhalation of bacteria-containing droplets released during coughing, sneezing, or spitting. The infection can also affect other parts of the body, manifesting as swollen glands or joints. Untreated TB can lead to severe health issues, including lung damage, bone and joint damage, and even infections of the brain and spinal cord. The recommended treatment involves a prolonged course of antibiotics.
As the leading cause of death from a single infectious agent, surpassing even COVID-19, TB requires proactive measures to control its spread. The UKHSA advises individuals at risk to seek testing and treatment, particularly those arriving from countries with high TB prevalence. Visa requirements for individuals staying in the UK for six months or longer from certain high-incidence countries include a TB test. Furthermore, a testing and treatment program is in place for new arrivals from these countries in higher incidence areas within England to detect latent TB infection, a dormant form of the bacteria that can reactivate later.
A vaccine for TB, known as the BCG vaccine, is available and recommended for specific groups at higher risk. This includes babies living in high-incidence areas of the UK or those living with someone who has TB, babies and children born or living in high-incidence countries, and individuals aged 35 and under spending more than three months in a high-incidence country. Healthcare workers who may be exposed to TB through their work are also eligible. However, as a live vaccine containing a weakened form of the TB bacteria, the BCG vaccine is not suitable for everyone. Individuals who believe they may be eligible should consult their GP for advice.
The UKHSA is committed to raising awareness about TB and its symptoms to curtail its spread. Public health campaigns emphasize the importance of early diagnosis and treatment, as well as preventative measures like the BCG vaccine for at-risk groups. By promoting awareness and encouraging individuals to seek medical advice promptly, health authorities aim to combat the resurgence of TB and protect public health. The ongoing monitoring of TB cases, coupled with targeted interventions and public health messaging, is crucial to controlling the spread of this potentially life-threatening infection. Collaboration between healthcare providers, public health agencies, and community organizations will be essential in addressing the challenges posed by the rising incidence of TB in England.
