A recent report from the UK Health Security Agency (UKHSA) has revealed a troubling resurgence of Tuberculosis (TB) in England, prompting health officials to declare the situation a serious public health issue. The data indicates an 11 per cent increase in TB cases in 2023, with projections suggesting a further 13 per cent rise in 2024. As a result, England stands on the brink of losing its "low incidence" status, as defined by the World Health Organisation (WHO), which states a threshold of 10 cases per 100,000 population. Current rates have escalated from 8.5 per 100,000 in 2023 to approximately 9.5 per 100,000 projected for 2024, according to the data published on March 25.
Tuberculosis is an infectious disease primarily affecting the lungs, caused by the bacterium Mycobacterium tuberculosis. Known historically for its devastating impact during the Victorian era, TB claimed the lives of around four million people in England between 1851 and 1910. In contemporary terms, it has emerged as the world's leading cause of death from an infectious disease, with the WHO reporting 1.25 million fatalities globally in 2023, exceeding those attributed to Covid-19.
Dr Esther Robinson, Head of the TB Unit at UKHSA, stated, "TB is curable and preventable, but the disease remains a serious public health issue in England. While England is still considered a low-incidence country for TB, the rise in cases over recent years means that we are now just below that threshold." Her remarks underline the urgency of the situation, as health officials work to combat the uptick in infections.
To address this growing concern, the UKHSA has outlined a five-year action plan aimed at improving the detection, prevention, and control of TB across the country. This comprehensive strategy will culminate in the Tuberculosis (TB) National Action Plan for England, set to run from 2026 to 2031. In preparation for this initiative, health officials have issued a call for evidence, inviting input from a wide range of stakeholders, including academics, public health experts, policymakers, and individuals with lived experience of tuberculosis. Dr Robinson noted that the call for evidence "will help us develop an action plan that prioritises the most effective interventions to reverse this trend."
The UKHSA's report further highlights a significant correlation between the rise in TB cases and migration from countries with high or very high incidence of the disease. It is reported that 80 per cent of the cases in 2023 occurred in individuals born outside the UK. This trend underscores the need for enhanced screening measures, especially as those arriving from high-incidence regions are required to undergo TB testing only if they plan to reside in the UK for six months or longer. However, the bacteria responsible for TB can remain dormant for years in a state known as latent TB, complicating routine detection efforts.
Symptoms indicative of TB include a persistent cough lasting more than three weeks, fevers, night sweats, loss of appetite, and significant weight loss. The BCG vaccine, developed over a century ago, still provides some degree of protection against the disease; however, experts caution that its effectiveness, particularly against lung TB, is limited. Vaccination rates in the UK have declined since 2005 when the BCG programme was modified to target only high-risk groups.
The call for evidence is slated to commence on April 2, 2025, and will close on May 2, 2025, as part of efforts to gather insights that will inform the forthcoming National Action Plan.
Source: Noah Wire Services