The UK is seeing a surge in cases of a Victorian illness that can make patients cough up blood – view our interactive map to see how common infections rates of the disease are in your area
Worrying new data shows the UK is experiencing a surge in cases of a killer Victorian disease that makes patients cough up blood.
Tuberculosis (TB) “remains a serious public health issue in England”, experts say – with the UK now at risk of losing its status for having low instances of the disease due to soaring cases. The urgent warning comes as the UK Health Security Agency (UKHSA) published its first annual report on infectious diseases impacting England, using data spanning from 2023 to early 2025. It said the “reemergence, re-establishment, and resurgence” of several illnesses was down to the return of social mixing and international travel following the COVID-19 pandemic, as well as changing migration patterns.
The World Health Organisation (WHO) deems a country with a threshold of 10 TB cases per 100,000 people as low-incidence. But according to UKHSA figures, notifications of the bacterial infection rose by 11% – or almost 500 additional cases – in 2023, with provisional data for 2024 showing a further 13% increase, or more than 600 additional cases.
The health agency says if these trends are not reversed, the UK could lose its WHO low incidence status, which it has held since 2017. England currently has a rate of 8.5 cases per 100,000 people, but in some parts of the nation, the figure is far higher. In the three years to 2023, Leicester had an average of 40.7 TB notifications per 100,000 people, the highest rate in England and four times the WHO low instance threshold.
TB notifications are statutory requirements for GPs to report suspected or confirmed cases to the National Tuberculosis Surveillance System. Another local authority district, Newham in East London, had a rate above 40 TB notifications per 100,000 of the population (40.6), while four had a rate above 30, Brent (39.1), Ealing (31.6), Harrow (31.1), and Slough (31.1).
Sixty local authority areas had a notification rate above the WHO low instance threshold. You can see how it compares to where you live using our interactive map.
TB – which used to be known as “consumption” – caused the deaths of an estimated four million people between 1851 and 1910 in England and Wales. It was the scourge of the 18th and 19th centuries and featured heavily in the literature of the time, with authors Charles Dickens, Elizabeth Gaskell, and Samuel Richardson all referencing the disease.
Worldwide, TB killed an estimated 1.25 million people in 2023, making it the leading infectious disease killer in the world, surpassing COVID-19. This week, 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 on Tuesday, she said: “Data shows reported notifications having increased by 11% in 2023, and a further 13% 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”. It added that some 80% of reported cases in 2023 were people born outside the UK, despite the number of people being screened for infection before entry doubling between 2021 and 2023.
A test for TB in the lungs is a 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 sometimes lie dormant for years, which is known as latent TB. A testing and treatment programme is in place for people in areas of England with higher rates or those coming from high-risk countries. The universal BCG vaccine programme 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.
TB is a serious long-term condition, but it is now curable. It usually affects the lungs but can spread to other parts of the body, such as your glands, bones, and brain. Symptoms include a chronic cough, fever, chills, loss of appetite, weight loss, fatigue, and coughing up blood. See a GP if you’ve had a cough for more than three weeks if you’re tired and not sure why, have a high temperature or night sweats that don’t go away, or have lost weight without changing your diet or exercise routine, or if you’ve spent a lot of time with someone who has TB.
Ask for an urgent GP appointment or get help from NHS 111 if you cough up blood.