A disease which ravaged Europe in the Middle Ages is on the way back according to worrying figures released today by health experts. The UK Health Security Agency (UKHSA) said cases of Tuberculosis (T)B in England increased by 7% in the first half of 2023 compared to the same timeframe in 2022, with 2,408 notifications compared to 2,251 in the first 2 quarters of 2022.
TB that affects the lungs is the most contagious type, but it usually only spreads after prolonged exposure to someone with the illness. For example, it often spreads within a family who live in the same house. In most healthy people, the immune system (the body’s natural defence against infection and illness) kills the bacteria, and you have no symptoms.
UKHSA is reminding people that TB is not just a problem for other countries – it is impacting increasing numbers of people at home.
Symptoms of TB according to NHS
Typical symptoms of TB include:
- a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody
- weight loss
- night sweats
- high temperature (fever)
- tiredness and fatigue
- loss of appetite
- new swellings that haven’t gone away after a few weeks
You should see a GP if you have a cough that lasts more than three weeks or if you cough up blood.
Sometimes the immune system cannot kill the bacteria, but manages to prevent it spreading in the body. This means you will not have any symptoms, but the bacteria will remain in your body. This is known as “latent TB”. If the immune system fails to kill or contain the infection, it can spread within the lungs or other parts of the body and symptoms will develop within a few weeks or months. This is known as “active TB”.
Latent TB could develop into an active TB infection at a later date, particularly if your immune system becomes weakened.
TB notification rates in England remain highest in people who are originally from parts of the world where TB is more common and those in large urban areas in England which are associated with higher levels of deprivation, and in inclusion health groups – a term used to describe people who are socially excluded and typically experience multiple overlapping risk factors for poor health. This includes those experiencing homelessness or contact with the criminal justice system.
TB disproportionately impacts certain people, in part, due to the barriers they may face in accessing the interventions designed to identify clinical onset of TB; access to diagnostic and treatment services; ability to self-administer treatment and attendance at follow-ups.
Dr Esther Robinson, Head of the TB Unit at UKHSA, said: “TB is curable and preventable, but despite significant progress towards elimination in recent years, the disease remains a serious public health issue in the UK.
“With treatment, most people will make a full recovery. It is very important that those with relevant symptoms are tested for TB and appropriate treatment is started promptly, both for the individual and for the prevention of onward transmission.
“As we head into winter, it is important to remember that not every persistent cough, along with a fever, is caused by flu or COVID-19. A cough that usually has mucus and lasts longer than 3 weeks can be caused by a range of other issues, including TB. 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.
“Multi-drug resistance remains a major concern for TB treatment, but the latest data indicates that the proportion of people with a multi-drug resistant form of the TB bacteria has remained relatively stable in recent years.”
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