Quote from Alex bobby on April 20, 2025, 4:59 AM

Tuberculosis Cases Surge in England, Revealing Deeper Public Health Crisis

Tuberculosis (TB), long thought of as a relic from a bygone era, is making a troubling comeback in England. According to recent figures, TB cases rose by 13% in 2024, the largest annual increase recorded since at least 1971. The disease, often dubbed the "archetypal illness of poverty," is now affecting both immigrants and people born in the UK — a wake-up call for public health systems and a reminder that TB is far from defeated.

One of the more harrowing personal accounts comes from Anja Madhvani, an event manager from Leeds. In 2018, while participating in an ultramarathon in Morocco, she began experiencing symptoms: fever, vomiting, and eventually coughing up blood. “I had this physical feeling that I was dying,” she recalled. Doctors initially misdiagnosed her with the flu and then a chest infection. Only after more extensive testing did she learn she had TB.

Madhvani spent 11 days in hospital isolation and nearly a year on a strict regimen of daily pills. Even after her physical recovery, the psychological impact lingered. “Some of those things still linger a little bit,” she said, reflecting on the trauma of unknowingly walking around with a deadly disease — and infecting close contacts, including her mother.

TB: A Hidden Danger in the UK

TB is caused by the Mycobacterium tuberculosis bacteria, which can remain dormant in the body for years before becoming active, often attacking the lungs but also affecting other organs. It killed an estimated 1.25 million people globally in 2023 — more than HIV or malaria. Most cases occur in Southeast Asia, Africa, and the Western Pacific. However, wealthy nations like the UK are now seeing a resurgence.

In 2024, England recorded 5,480 TB cases, up from the previous year’s tally. Clinics in TB hotspots, like East London, are struggling to meet demand. One such clinic is opening a £4.63 million canter to handle rising cases — it treated nearly 300 patients in just one year.

Experts point to multiple reasons for the rise. Delays in diagnosis and treatment during the COVID-19 pandemic created a backlog of undetected infections. But they believe this explanation only scratches the surface. TB thrives in conditions of poverty, overcrowding, poor nutrition, and among people with limited access to healthcare — all indicators that have worsened in many communities in the UK.

“Because TB is the archetypal disease of poverty… it really is a sentinel for other conditions,” said Dr. Tom Wingfield of the Liverpool School of Tropical Medicine.

The Social Factor in TB Spread

TB is more common among individuals who are homeless, have a history of drug or alcohol misuse, are imprisoned, or suffer from undernutrition. As of late 2024, just 13.1% of England’s TB patients over 15 years old reported having at least one of these social risk factors — though public health experts suspect the true number is much higher due to underreporting and missing data.

Paul Sommerfield, executive trustee of TB Alert, a non-profit focused on the disease, says that while data shows where the increases are occurring, “the why is still a bit of a mystery.”

Part of the challenge lies in the outdated public perception of TB as a disease of the past. This lack of awareness leads to delays in diagnosis, incomplete treatment, and stigma — all of which perpetuate its spread.

What’s Being Done — and What’s Missing

Earlier this year, the UK Health Security Agency (UKHSA) launched a consultation for a new five-year TB action plan. Goals include improving early diagnosis, expanding testing, ensuring patients complete their treatments, and educating healthcare workers about TB symptoms. However, the agency has not yet confirmed how much funding will be allocated to the plan.

Dr. Esther Robinson, head of the TB unit at UKHSA, called TB a “serious public health issue” and encouraged anyone with persistent coughing or other symptoms to get tested. But advocates like Sommerfield and Dr. Wingfield argue that more aggressive measures are needed.

Among their recommendations: improved screening for immigrants from high-risk regions, more comprehensive support services for patients (including housing and food), and better collection of data on patients' social circumstances.

Dr. Wingfield highlighted the personal sacrifices many TB doctors have made, including using their own money to help patients afford food or transport. “They're just in a dire situation,” he said.

Meanwhile, Madhvani stressed the psychological toll TB takes on patients. Despite finishing treatment years ago, she still feels abandoned by the healthcare system. “There’s no more follow-up,” she said. “It’s like you’re just spat out into the world.”

Early Detection Is Key

One positive note is that most TB cases in the UK are not drug-resistant, which makes them easier and less costly to treat. But early diagnosis remains critical. Some people with latent TB never develop the disease, but those who do — like Madhvani’s mother — can face long-term health problems if not treated promptly.

Madhvani herself unknowingly spread the disease to several loved ones. One friend developed latent TB but failed to complete treatment. Years later, he was hospitalised with full-blown disease. “He looked more unwell than I ever was,” she said.

Her story underscores the urgent need for public awareness and stronger health policies. “It doesn’t matter how wealthy you are, whether you’ve travelled or not travelled,” she warned. “If you come into contact with it, you’re at risk.”

Conclusion

The alarming rise in tuberculosis cases across England is a stark reminder that this ancient disease is far from defeated. While TB is often associated with poverty and distant history, it is now resurfacing in one of the world's wealthiest nations, affecting both immigrants and native-born citizens alike. Factors like social deprivation, crowded living conditions, and weakened healthcare systems post-pandemic have created the perfect storm for its return.

Addressing TB will require more than updated action plans — it demands real investment in early detection, community outreach, social support services, and public education to break the cycle of infection. Stories like Anja Madhvani’s show just how invisible and devastating TB can be when left unchecked, impacting not only physical health but also mental well-being and social stability.

Without serious and sustained efforts, TB’s resurgence could signal broader public health failures in the years to come. As Madhvani warns, TB doesn't discriminate — anyone who comes into contact with it is at risk. It’s a call to action that the UK — and the world — cannot afford to ignore.