There were 5,480 reported cases of TB in 2024, up from 4,850 the year before and 25 per cent higher than in 2022, according to the UK Health Security Agency (UKHSA) – a number that remains relatively low but is the highest since 2016 and shows concerning signs of increasing, experts say.
The number of cases reported last year amounts to 9.5 people per 100,000 of the population – compared to 8.5 a year earlier.
Hitting this level wouldn’t trigger any additional requirements from the health service although experts said it would put a further spotlight on this growing problem that may lead to increased surveillance, contact tracing and monitoring to identify and address the drivers of the increase.
Where were the biggest increases?
Large urban centres are the major hotspots for TB because they have can have high levels of poverty, are densely populated and have more people born outside the UK, who are at higher risk.
They said growing poverty rates as a result of the cost of living crisis are likely to have played a significant role in rising TB cases – although there are many factors involved.
And separate figures show that the number of people living in poverty in the UK has risen by 18 per cent in three years, increasing from 13.6 million in 2020 to 16 million in 2023, according to a report by the Social Metrics Commission published in November.
Tuberculosis
Symptoms of TB usually come on gradually.
Common symptoms include:
a cough that lasts more than three weeks – you may cough up mucus (phlegm) or mucus with blood in it feeling tired or exhausted a high temperature or night sweats loss of appetite weight loss feeling generally unwellChildren may also have difficulty gaining weight or growing.
If TB has spread to another part of your body such as your glands (lymph nodes), bones or brain, you may also have other symptoms, including:
swollen glands body aches and pains swollen joints or ankles tummy or pelvic pain constipation dark or cloudy pee a headache being sick feeling confused a stiff neck a rash on the legs, face or other part of the body“I think that increasing levels of poverty and the cost of living crisis will be among the factors contributing towards increasing TB cases,” Tom Wingfield, of the Liverpool School of Tropical Medicine, told The i Paper – adding that its not possible to prove a definitive link.
“TB is associated with poverty through many intersecting elements including malnutrition, stress, other illnesses, unemployment, and overcrowded or inadequate housing.”
As in previous years, the vast majority of cases were reported in people who were born outside the UK, who accounted for 81.5 per cent of reported TB infections.
China, India, Nigeria and South Africa are among the countries with high levels of TB.
This can be activated upon arrival in a new country – or some time after – triggered by factors such as proverty, stress, or weakened immune system, coupled with potential barriers to accessing healthcare in their new environment.
“TB rates tend to be higher in urban areas – when large numbers of people live and mix within close quarters, infections spread more easily. London and Birmingham also have areas of high poverty and high concentrations of ethnic minority groups who are at higher risk of TB,” he added.
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Professor Steve Griffin added that the rising number of TB cases strengthens the case for broadening the number of children who have a TB jab.
Professor Griffin explains that the vaccine prevents severe forms of TB and contributed significantly to the reduction in prevalence since its introduction in the 1950s.
“TB is incredibly infectious – literally a handful of the bacteria can establish infection – and spreads via airborne aerosols when present in an infected persons’ lungs. So measures that improve indoor air quality including ventilation and filtration as well as well-fitted respirator masks will reduce transmission,” Professor Griffin added.
“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.
To help tackle TB cases the UKHSA and NHS England launched a five-year action plan in July 2021.
This included plans for a new National TB Surveillance System and the routine provision of whole genome sequencing data to TB services and to improve early detection of TB by identifying, investigating and acting on the components that contribute to patient delay.
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