Cases of a Victorian superbug are on the rise as healthcare professionals observe escalating levels of a concerning drug-resistant strain – and you can track the proximity of these cases to your location. Data released by the UK Health Security Agency (UKHSA) reveals 5,490 notifications of tuberculosis (TB) in England during 2024.
This marked a 13% surge – equating to over 600 additional cases – from the 4,831 notifications recorded in 2023, which itself displayed an 11% increase from the previous year. The percentage of drug-resistant TB cases has reached its peak since enhanced monitoring commenced in 2012, with 2.2% of all confirmed cases exhibiting resistance to multiple medications.
UKHSA has issued a caution that unless the upward trend in cases is reversed, the UK might forfeit its “low-incidence” classification for TB, a status maintained since 2017. According to the World Health Organization (WHO), countries with a threshold of 10 TB cases per 100,000 individuals are considered low-incidence.
Presently, England reports a notification rate of 9.4 cases per 100,000 people, slightly below the low-incidence benchmark and up from 8.5 per 100,000 individuals in 2023. Nonetheless, this figure remains notably below the peak of 15.6 notifications per 100,000 in 2011.
Certain regions within the country display considerably higher rates. For instance, Leicester recorded an annual average of 161 TB notifications over the three years leading up to 2024, resulting in a rate of 42.1 TB notifications per 100,000 residents, surpassing the WHO low incidence threshold by more than four times.
Notification of TB cases is a legal requirement for general practitioners to report suspected or confirmed instances to the National Tuberculosis Surveillance System.
In addition, Newham in London exhibited a rate exceeding 40 TB notifications per 100,000 inhabitants (41.4), while Brent (39.1), Harrow (35.0), Ealing (33.6), Slough (32.8), and Hounslow (31.5) all had rates surpassing 30.
Sixty-one local authority areas reported notification rates exceeding the WHO low incidence threshold. Historically known as “consumption,” TB led to the demise of approximately four million individuals in England and Wales between 1851 and 1910. It was prevalent in the 18th and 19th centuries and prominently featured in the literature of that era, with notable authors such as Charles Dickens, Elizabeth Gaskell, and Samuel Richardson referencing the disease.
Globally, TB claimed an estimated 1.25 million lives in 2023, making it the primary infectious disease killer worldwide, surpassing COVID-19. While final figures for 2024 are pending, a similar number of deaths are anticipated due to TB.
In England last year, 82% of TB notifications were attributed to individuals born outside the UK, although there was an increase in both UK-born and non-UK-born populations. TB remains associated with poverty and is more prevalent in densely populated urban areas.
For UK-born individuals, TB is more prevalent among those experiencing homelessness, substance abuse issues, and involvement with the criminal justice system.
Dr. Esther Robinson, Head of the TB Unit at UKHSA, emphasized the preventable and curable nature of TB but highlighted its ongoing status as a significant public health concern. Swift action is imperative to disrupt transmission chains through prompt identification and treatment.
Persistent symptoms such as a chronic cough, fever, chills, weight loss, fatigue, and coughing up blood may indicate TB. Individuals experiencing such symptoms for an extended period should consult a GP promptly, particularly if they have a history of residing in regions with higher TB prevalence.
TB, a serious but curable long-term condition, primarily impacts the lungs but can also affect other body parts like glands, bones, and the brain.
If you notice symptoms such as a persistent cough, unexplained fatigue, prolonged high temperature, or significant weight loss, or if you suspect exposure to TB, seek urgent medical attention. In cases of coughing up blood, immediate consultation is recommended.
Various areas in England exhibit varying rates of TB notifications, with Leicester (42.1), Newham (41.4), Brent (39.1), Harrow (35), Ealing (33.6), Slough (32.8), Hounslow (31.5), Redbridge (29.9), Manchester (25.3), Hillingdon (24.4), Luton (22.6), Wolverhampton (22.3), and other regions reporting notification rates above the WHO low incidence threshold.