Tuberculosis cases in England hit lowest ever levels

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New cases of tuberculosis (TB) in England have fallen to the lowest levels since records began in 1960. The new data published by Public Health England (PHE) comes ahead of World TB Day on Sunday March 24 2019.

Following action by PHE, the NHS and others, there was a 44% drop in new diagnoses from the peak in 2011 to 2018 (from 8,280 to 4,672), with an 8.4% fall in diagnoses between 2017 and 2018 alone.

PHE is working towards the World Health Organisation (WHO) goal to halve TB incidence by 2025, and ultimately eliminate the disease.

TB is an infectious disease that usually affects the lungs. The most common symptoms of TB are a persistent cough for more than 3 weeks, unexplained weight loss, fever and night sweats. Although TB can be fatal if left untreated, it is curable for the majority with a course of antibiotics.

While huge strides have been made to reduce TB rates, further work needs to be done to eliminate the disease in England. The most deprived 10% of the population have a rate of TB more than 7 times higher than the least deprived 10%, and people born outside the UK have a rate 13 times higher than people born in the UK. People, especially those from these communities, should be aware of the symptoms and make sure they visit their GP if they are concerned.

PHE has played a key role in driving down the rates of TB in England, working with NHS England and other partner organisations to implement the Collaborative tuberculosis strategy for England: 2015 to 2020.

This includes raising awareness and tackling TB in vulnerable populations, ensuring patients successfully complete treatment, and strengthening surveillance of TB rates.

As well as encouraging those with ‘active’ TB infection to seek treatment, PHE has worked with partners to implement testing for latent TB in those arriving from countries with high rates of the disease. A latent TB infection occurs when an individual is carrying the TB bacteria but doesn’t have any symptoms. The bacteria can, however, go on to cause disease in the future.

Steve Brine, Public Health Minister said:

We should be proud that TB rates are now at the lowest levels ever recorded in this country – a true testament to the hard work of the NHS and public health staff in this country.

There is still more to do – people in deprived communities are still disproportionately more likely to contract this disease, so we must do more to tackle this injustice by raising awareness and ensuring early diagnosis and treatment.

Dr Sarah Anderson, Head of TB Strategy at Public Health England, said:

It is hugely encouraging to see a continued decline in TB cases in England, which shows that the interventions we are putting in place are having an impact.

However, TB still affects nearly 5,000 people a year in the UK and many people are simply unaware of the symptoms and impact of the disease.

This World TB Day we are calling for anyone who has possible TB symptoms, or thinks they may be at risk of having latent TB, to speak to their healthcare professional to get diagnosed and treated as soon as possible, to minimise the chance of long-term ill health and onward transmission.

Professor Mike Morgan, NHS England’s National Clinical Director for Respiratory Disease, said:

One of our priorities has been to drive improvements in the way TB is managed and it is excellent news that, thanks to the hard work of NHS staff, rates are now significantly lower. However, we must not rest on our laurels and with PHE we will continue to work hard towards the eradication of TB.

The risk factors for tuberculosis include a weakened immune system, poor quality housing, alcohol and substance misuse, or time spent in a country with high TB rates.

While cases are declining overall, still more needs to be done to reach those in under-served populations to ensure they are aware of symptoms and can access treatment.

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