Health officials have issued a warning as cases of a once-deadly Victorian-era illness are climbing again — and its symptoms can easily be mistaken for flu or Covid.
Though preventable and treatable, the illness requires quick detection and medical care to avoid serious outcomes.
A lingering cough doesn’t always point to flu or Covid — it could also signal tuberculosis (TB).
According to new figures from the UK Health Security Agency (UKHSA), TB infections in England increased by 13.6 per cent in 2024 compared to the year before.
There were 5,490 reported cases in 2024, up from 4,831 in 2023.
Tuberculosis is a contagious bacterial infection that mainly attacks the lungs but can spread to other parts of the body.
It is transmitted through airborne droplets when an infected person coughs or sneezes.
While the disease can be deadly if untreated, it can usually be cured with antibiotics.
During the Victorian period, TB was widespread, accounting for about one in four deaths across Europe and the United States.
Although the introduction of antibiotics and better living conditions during the mid-1900s dramatically reduced cases in developed countries, progress has slowed, and millions remain affected worldwide.
Dr Esther Robinson, head of the TB Unit at UKHSA, said that even though TB remains preventable and curable, the rising numbers make it an ongoing public health concern.
She emphasized, “We must move quickly to stop transmission by identifying and treating infections without delay.”
A cough that produces mucus and lasts more than three weeks can be linked to several conditions, such as flu, Covid, or TB.
One woman who initially believed she had caught the flu after attending a concert later discovered she had contracted tuberculosis — a disease that devastated families in the 19th century.
Covid infections have also been increasing in the UK since late September, with a 22.2 per cent weekly rise recorded up to September 24.
Experts attribute this jump to two emerging Covid variants known as Stratus and Nimbus.
However, Dr Robinson cautioned that not every long-lasting cough is due to Covid or flu.
She explained, “A cough lasting over three weeks, particularly one that brings up mucus, could stem from other causes, including TB.
If you suspect you’re at risk — especially if you’ve recently lived in or arrived from a country where TB is common — please contact your GP.”
Six Common Symptoms of Tuberculosis
According to the NHS, TB symptoms often appear gradually.
Typical signs include:
- A cough lasting more than three weeks (sometimes with mucus or blood)
- Fatigue and tiredness
- Fever or night sweats
- Loss of appetite
- Weight loss
- General feeling of illness or weakness
Children with TB may also struggle to gain weight or grow normally.
If TB spreads beyond the lungs — for instance, to the lymph nodes, bones, or brain — additional symptoms can occur, such as:
- Swollen glands
- Joint pain or swelling
- Abdominal or pelvic pain
- Constipation
- Cloudy or dark urine
- Headache
- Vomiting
- Confusion
- Stiff neck
- Skin rash on the face, legs, or other areas
Some individuals can carry TB bacteria without any symptoms, a condition known as latent TB.
When symptoms are present, it is referred to as active TB.
England currently records 9.4 TB notifications per 100,000 people, lower than the century’s peak of 15.6 per 100,000 in 2011.
In 2024, 82 per cent of reported TB cases occurred in people born outside the UK, though increases were noted in both UK-born and non-UK-born groups.
The infection remains linked to poverty and is more frequent in densely populated cities.
Following previous trends, London had the highest regional rate (20.6 per 100,000), followed by the West Midlands (11.5 per 100,000).
Among UK-born residents, TB is more likely to affect those experiencing homelessness, substance or alcohol dependence, or involvement with the criminal justice system.
Although total numbers are still relatively small, drug-resistant TB has reached its highest level since detailed monitoring began in 2012.
Laboratory results showed 2.2 per cent of cases were resistant to multiple antibiotics, requiring longer and more complex treatment that strains healthcare services.
Prevention and Vaccination
The BCG vaccine against TB is available in the UK, though it is not part of the standard NHS vaccination program.
It is offered to those at higher risk, such as babies born to parents from countries with high TB rates, certain healthcare workers, and travellers to those regions.
Key prevention measures include:
- Vaccinating at-risk children
- Ensuring good ventilation
- Maintaining proper hygiene and covering your mouth when coughing
- Getting tested and treated promptly if you may be at risk or show symptoms
When to Seek Emergency Help
TB can be life-threatening. Without proper treatment, two-thirds of patients may die from the disease.
It remains the world’s most fatal infectious illness, causing about 1.3 million deaths in 2022 and 1.25 million in 2023, surpassing both HIV/AIDS and malaria.
Severe cases can lead to serious complications such as extensive lung damage, fluid buildup in the lungs, or infection spreading to the brain.
The NHS advises calling 999 or going straight to A&E if you experience any of the following:
- Severe headache with a stiff neck
- Sensitivity to bright light
- Seizures or fits
- Sudden confusion or changes in behavior
- Weakness or loss of movement in parts of the body
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