Soaring cases of TB have seen more than 5,000 people in England diagnosed with this Dickensian superbug that killed an estimated four million people in Victorian Britain. New data published by the UK Health Security Agency shows that reported notifications of Tuberculosis (TB) increased by 12.9% last year in England compared to 2023.
There were 5,480 notifications of the disease last year, compared to 4,850 in 2022. This means England has fallen even further behind in achieving the World Health Organisation’s TB elimination target, set in 2015, of a 90% reduction in cases by 2035.
Eight in 10 TB notifications in 2024 (81.5%) were in people born outside the UK, but there was an increase in both UK-born and non-UK-born populations.
TB continues to be associated with deprivation and is more common in large urban areas. Among people born in the UK, TB is more common in those experiencing homelessness, drug or alcohol dependency, and contact with the criminal justice system.
London (1,877) and the West Midlands (709) had the highest number of TB notifications in 2024. But TB cases are growing fastest in the West Midlands, where the number of notifications increased by 22.2%. Yorkshire and the Humber (up 18.2%) and the South West (a 15.1% increase) followed.
While England remains a low-incidence country for TB, the notification rate in England rose from 8.5 cases per 100,000 people in 2023 to 9.5 per 100,000 in 2024.
Dr Esther Robinson, Head of the TB Unit at UKHSA, said: “TB remains a serious public health issue in England. The infection is preventable and curable. If you have moved to England from a country where TB is more common, please be aware of the symptoms of TB so you can get promptly tested and treated through your GP surgery.
“Not every persistent cough, along with a fever, is caused by flu or COVID-19. A cough that usually has mucus and lasts longer than 3 weeks can be caused by a range of other issues, including TB. Please speak to your GP if you think you could be at risk.”
TB – which used to be known as “consumption” – caused the deaths of an estimated four million people between 1851 and 1910 in England and Wales. It was the scourge of the 18th and 19th centuries and featured heavily in the literature of the time, with authors Charles Dickens, Elizabeth Gaskell, and Samuel Richardson all referencing the disease.
In the 21st century it is the world’s leading cause of death from a single infectious agent, having surpassed COVID-19.
It is a bacterial infection that most frequently affects the lungs, which is when it is infectious.
Symptoms of TB include:
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A cough that lasts more than three weeks
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High temperature
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Night sweats
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Loss of appetite
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Weight loss
It can also be found in other parts of the body besides the lungs, with symptoms including swollen glands and joints. The infection can spread through close contact with people who have the infection and have symptoms.
When someone with active TB coughs, small droplets containing the bacteria are released. If you regularly breathe in these droplets over a long period of time, you can catch TB. TB can be treated with a long course of antibiotics – but it can be serious, particularly if not treated.
A TB test is part of the visa requirements for anyone coming to stay in the UK for six months or more if they are coming from certain countries where TB is common. However, the bacterium that causes TB can also lie dormant for many years. A testing and treatment programme is in place in higher-incidence areas of England for new arrivals from higher-incidence countries.