Urgent warning over surge in killer Victorian disease that makes patients cough up blood - UK about to lose its 'low incidence' status
Rising migration has been blamed for a surge in the killer Victorian disease tuberculosis (TB) in Britain.
Officials say the increase in cases over recent years is now so large that the UK could lose its 'low incidence' status for the disease.
Experts said the return of social mixing and international travel following the Covid pandemic, as well as changing migration patterns, has led to the 'reemergence, reestablishment and resurgence' of TB.
Figures from a new UK Health Security Agency report recorded an 11 per cent rise for the disease in 2023, with data for last year suggesting a further 13 per cent increase in cases.
According to the UKHSA, these trends could result in the UK losing its 'low incidence status' for TB — which it has held since 2017 — if the trend is not reversed.
A country is only granted 'low incidence status' by the World Health Organisation as less an than 10 cases of TB per 100,000 population.
TB, known as consumption in the Victorian era, is spread by the coughs and sneezes of those infected and can cause symptoms like coughing up blood.
Dame Jenny Harries, chief executive of UKHSA, warned that TB 'remains a serious public health issue in England'.
Speaking at the UKHSA conference in Manchester today, she said: 'Data shows reported notifications having increased by 11 per cent in 2023, and a further 13 per cent increase in provisional data for 2024.
'This current rate of increase will soon see the UK lose its WHO low incidence status of 10 per 100,000 population.'
The UKHSA highlighted a 'strong association' between the rise in TB cases in England and migration from 'high or very high incidence countries'.
About four out of 10 reported cases in 2023 were people born outside of the UK, it added, despite the number of people being screened for infection before entry doubling between 2021 and 2023.
Previous data has suggested people originally from India, Pakistan, Nigeria, and Romania are biggest non-British born groups among TB patients.
A test for TB in the lungs is part of the visa requirement for people coming to the UK for six months or more from countries where the disease is common.
However, the bacteria that causes the illness can lie dormant for years before starting to cause symptoms and become contagious, making it undetectable.
A testing and treatment programme is in place for people in areas of England with higher rates, or those coming from high-risk countries.
TB is spread by the coughs and sneezes of those infected and most often emerges in the lungs, although it can get into other parts of the body. Pictured microscopic view of Mycobacterium tuberculosis bacilli, the organism responsible for causing the disease
The UK's universal BCG vaccine programme, which protects against TB, for school-aged children was stopped in 2005 and replaced by a targeted programme for babies and children at risk of exposure to the disease.
Previous official reports have estimated that roughly one in every 25,000 people in England has TB, though this rises to almost one in every 5,000 people in London.
Potential symptoms of TB include a cough that lasts more than three weeks and produces blood, a high temperature, night sweats, loss of appetite and unexplained weight loss.
TB is treated with antibiotics and as such is rarely deadly in countries like Britain.
However, globally it is estimated to kill one in six people it infects, with deaths typically occurring years after initial infection.
The infections kills by destroying the organs from the inside, causing them to bleed and fill with liquid.
Tuberculosis is spread by the coughs and sneezes of those infected and most often emerges in the lungs, although it can get into other parts of the body.
However, some studies have found it can also be spread passively by infected people simply breathing, even if they show no symptoms.
Tuberculosis is particularly dangerous for immunocompromised people, like those undergoing chemotherapy, as well those who are generally more vulnerable such as young children and the elderly.
Cases of the bacterial lung infection soared to record high of 8.2million in 2023 according to the World Health Organisation. Pictured a relative adjusts the oxygen mask of a tuberculosis patient at a TB hospital in Hyderabad, India, earlier this year
Officials have also raised concerns over declining vaccine uptake in England, particularly for childhood illnesses like measles and whooping cough.
In September it emerged that childhood vaccination coverage fell in 2023/24, with no vaccines meeting the 95 per target.
The uptake of some doses of the jab for measles, mumps and rubella (MMR) fell to levels not seen since 2009/2010.
The MMR was introduced in 1988 and prior to this notifications for measles cases were between 160,000 to 800,000 each year, according to Dame Jenny.
'Following the introduction of MMR we saw very few cases in the UK and in 2017 the World Health Organisation declared the UK to have eliminated measles,' she said.
'Sadly, as our report shows, we are in a different place now. In 2023 there were 362 confirmed measles cases. In 2024, 2,836.
'Those numbers sit alongside other data for childhood vaccine preventable illness.
'We saw pertussis – whooping cough – cases rise from the hundreds in 2023 to over 14,000 in 2024, tragically resulting in a small number of deaths in babies.'
Dame Jenny also warned many other diseases are 'out of step from the pandemic or moving in the wrong direction', including sexually transmitted infections.
Analysis by UKHSA found infectious diseases were the reason for more than 20 per cent of NHS hospital bed usage in 2023/2024, costing almost £6 billion.
Publication of the report comes as the health service emerges from the winter months, which saw a so-called 'quad-demic' of disease; flu, Covid-19, respiratory syncytial virus (RSV) and the vomiting bug norovirus.
Richard Pebody, director of epidemic and emerging infections at UKHSA, added: 'This winter has demonstrated that rises in rates of infectious diseases can cause significant strain, not only on the individuals directly affected, but also on the NHS.
'It is vital that we are not complacent about infections where we can reduce the burden of disease via interventions such as our world-class vaccination programmes.'
