TB Is Rising In The UK, Should We Be Worried?

Symptoms of tuberculosis can be confused for Covid. Here's what to look out for.
A consistent cough can be a sign of TB.
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A consistent cough can be a sign of TB.

Peaky Blinders fans will have watched the devastating scenes relating to tuberculosis this series, but TB isn’t a disease that ended in the 1930s. While we don’t often hear about it now, case numbers are rising.

In 2021, TB diagnoses rose by 7.4% compared to 2020 (4,430 compared to 4,125 cases in 2020), according to provisional data for England by the UK Health Security Agency (UKHSA).

And the bacteria are getting more complex. There were more cases of drug-resistant tuberculosis in 2020 than any year since enhanced monitoring began. 11.6% of cases were resistant to any drug and 2.4% were multi-drug resistant (compared to 1.8% in 2019).

Cases are also more prevalent in socio-economically deprived and underserved groups. UKHSA warns the public, particularly those in high risk groups, not to dismiss a persistent cough with a fever as Covid-19, and contact their GP if they think they could be at risk so they can access effective treatment.

What is tuberculosis?

Tuberculosis is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person. It mainly affects the lungs, but it can affect any part of the body, including the tummy (abdomen), glands, bones and nervous system.

TB is a potentially serious condition, but it can be cured if it’s treated with the right antibiotics.

The risk factors for tuberculosis include close contact with a person with infectious TB disease, migration from countries with high rates of TB, homelessness, substance misuse, a weakened immune system and imprisonment.

What are the numbers saying?

Incidences of TB in England had been falling significantly since 2011, when it was among the highest in western Europe with a total of 8,280 cases recorded.

However, in 2019 the rate of decline reversed, with cases increasing by 2.4% (from 4,615 in 2018 to 4,725 in 2019).

While diagnosed TB cases appeared to fall in 2020 (to 4,125), this most likely reflected healthcare access and provisions during the pandemic and provisional data indicate that cases of the infection rose by 7.4% in 2021 compared to 2020.

According to the NHS, symptoms of TB include:

  • A persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody

  • Breathlessness that gradually gets worse

  • Lack of appetite and weight loss

  • A high temperature

  • Night sweats

  • Extreme tiredness or fatigue

Should we be worried?

Though case numbers have risen, TB is treatable and can be managed, so the earlier you catch it, the better.

Dr Jenny Harries, CEO of the UK Health Security Agency, said: “TB is curable and preventable and now is the time to get our elimination efforts back on track. Despite significant progress towards elimination in recent years, tuberculosis remains a serious public health issue in the UK. With treatment, most people will make a full recovery, but delayed diagnosis and treatment, particularly during the pandemic, will have increased the number of undetected tuberculosis cases in the country.

“It is important to remember that not every persistent cough, along with a fever, is Covid-19. A cough that usually has mucus and lasts longer than three weeks can be caused by a range of other issues, including tuberculosis. Tuberculosis develops slowly, and it may take several weeks, months or even years after you were infected before you notice you’re unwell. Contact your GP if you think you could be at risk so you can get tested and treated.”

What is being done to tackle TB?

There is a vaccine, the BCG, which protects against tuberculosis. Many of us will remember having the injection as a teenager, but in 2005, the jab was stopped in schools as evidence suggested it has little impact on control of the disease.

Today, it is given on the NHS only when a child or adult is thought to have an increased risk of coming into contact with TB.

The BCG vaccine is made from a weakened strain of TB bacteria. Because the bacteria in the vaccine is weak, it triggers the immune system to protect against the infection but does not give you TB. It provides consistent protection against the most severe forms of TB, such as TB meningitis in children.

It’s less effective in preventing TB that affects the lungs in adults, so has limited impact on the spread of TB. The BCG vaccine should only be given once in a lifetime.

If you do have persistent symptoms mentioned above, then contact your GP.