Cases of a Victorian superbug are on the rise as healthcare professionals document escalating levels of a concerning drug-resistant strain, with close proximity to residents highlighted. Data revealed by the UK Health Security Agency (UKHSA) indicates a total of 5,490 notifications of tuberculosis (TB) in England in 2024.
This marks a 13% surge, equating to over 600 additional cases compared to the 4,831 notifications in 2023, itself an 11% increase from the previous year. The prevalence of drug-resistant TB has peaked since enhanced monitoring commenced in 2012, with 2.2% of confirmed cases displaying resistance to multiple drugs.
UKHSA has cautioned that if the trend of escalating cases persists, the UK could forfeit its “low-incidence” status for TB, a designation held since 2017. According to the World Health Organization (WHO), countries recording 10 TB cases per 100,000 individuals are classified as low-incidence nations.
Although England currently reports a rate of 9.4 notifications per 100,000 people, slightly below the low-incidence threshold, this figure has climbed from 8.5 per 100,000 in 2023. Notably, this rate remains significantly lower than the peak of 15.6 notifications per 100,000 in 2011.
Certain regions in the country exhibit notably higher rates. For instance, over the three-year period leading to 2024, Leicester averaged 161 TB notifications annually, translating to a rate of 42.1 TB notifications per 100,000 individuals, surpassing the WHO low incidence threshold by more than fourfold.
TB notifications serve as a mandatory requirement for General Practitioners (GPs) to report any suspected or confirmed cases to the National Tuberculosis Surveillance System.
Furthermore, several local authorities, including Newham in London, reported rates exceeding 40 TB notifications per 100,000 individuals, with Brent, Harrow, Ealing, Slough, and Hounslow also recording rates above 30.
The historical impact of TB in England and Wales was significant, causing an estimated four million deaths between 1851 and 1910. Once known as “consumption,” TB was prevalent in the 18th and 19th centuries and prominently featured in literature by authors like Charles Dickens, Elizabeth Gaskell, and Samuel Richardson.
Globally, TB claimed an estimated 1.25 million lives in 2023, surpassing COVID-19 as the primary infectious disease killer worldwide. While final figures for 2024 are pending, it is anticipated that a similar number of deaths occurred due to TB.
In 2024, 82% of TB notifications in England were from individuals born outside the UK, albeit there was an increase in cases among both UK-born and non-UK-born populations. TB remains linked to socioeconomic deprivation, with higher prevalence in densely populated urban areas.
Individuals born in the UK facing homelessness, substance dependence, or involvement with the criminal justice system are at higher risk of contracting TB.
Dr. Esther Robinson, Head of the TB Unit at UKHSA, emphasized the preventability and curability of TB, underscoring the need for swift action to halt transmission through prompt identification and treatment. She urged individuals with persistent coughs lasting over three weeks, along with associated symptoms, to seek medical advice promptly, especially if they have recently relocated from regions where TB is more prevalent.
While TB is a serious, chronic condition, it is treatable. Although primarily affecting the lungs, TB can spread to other parts of the body, such as glands, bones, and the brain.
Common symptoms include a persistent cough, fever, chills, appetite loss, weight loss, fatigue, and coughing up blood. Individuals experiencing these symptoms for an extended period or with known exposure to TB patients should seek medical attention promptly.
Additionally, a range of regions across England reported varying TB notification rates, highlighting the need for continued vigilance and proactive healthcare measures to combat the spread of this infectious disease.
