TB cases in England spike by 10.7% in 2023

Figures published today by the UK Health Security Agency (UKHSA) in its TB annual report, show that tuberculosis cases in England in 2022 were stable compared to 2021 (4,380 in 2022 compared to 4,411 in 2021).

However, additional provisional data indicate that cases of tuberculosis (TB) in England rose by 10.7% in 2023 compared to 2022 (4,850 compared to 4,380). The rise signals a rebound of TB cases to above the pre-COVID-19-pandemic numbers.

While England remains a low incidence country for TB, the current trajectory takes the UK further from the pathway to meet World Health Organization (WHO) 2035 elimination targets. UKHSA is working with partners to investigate the reasons behind the increase in TB.

TB is a bacterial infection that most frequently affects the lungs, which is when it is infectious. Symptoms include:

• a cough that lasts more than 3 weeks
• high temperature
• drenching night sweats
• loss of appetite
• weight loss

It can be treated with a prolonged course of antibiotics but can be serious, particularly if not treated.

The proportion of TB notifications accounted for by people born outside the UK has been steadily rising for a number of years. However, the increase in TB in 2023 has now been seen in both UK born and non-UK born populations in England. The largest rises in cases have been in the urban centres of London, the North West and West Midlands. However, there has also been increases in the South West and North East regions where TB incidence is low.

Tuberculosis continues to be associated with deprivation and is more common in large urban areas. People born outside the UK, especially in countries in South Asia (India, Pakistan, Bangladesh), Africa (Eritrea, Nigeria) and Eastern Europe (Romania) experience the highest number of cases.  For those born in the UK, TB is more common among those who experience homelessness, drug and alcohol dependence and have had contact with the criminal justice system. TB rates are much higher in UK born individuals from ethnic groups other than white.

We need collective action to tackle TB and we are working with partners across the health system to understand how we can best refocus efforts to stamp out this preventable and treatable infection. 

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. Please speak to your GP if you think you could be at risk.

Dr Esther Robinson, Head of the TB Unit at UKHSA

UKHSA continues to work with NHSE and other partners on the TB action plan, which sets out steps to improve the prevention and detection of TB, along with increasing capacity in the TB workforce.