THE UK Health Security Agency (UKHSA) is calling on the public and healthcare professionals to help reverse an upward trend in TB cases.

The incidence of TB in England had been falling significantly since 2011, when it was among the highest in western Europe with a total of 8,280 cases recorded. However, in 2019 the rate of decline reversed, with cases increasing by 2.4% (from 4,615 in 2018 to 4,725 in 2019).

While TB incidence appeared to fall in 2020 (to 4,125 cases), this most likely reflected healthcare access and provisions during the pandemic and provisional data indicate that cases of the infection rose by 7.4% in 2021 compared to 2020.

Anyone with a cough, particularly those in groups that are at high risk for TB, are being urged not to dismiss their persistent cough and fever as COVID-19 as it could be caused by a range of other issues, including tuberculosis (TB).

Tuberculosis is a serious infectious disease and symptoms include a persistent cough (lasting longer than 3 weeks) and fever. While it can be life threatening without appropriate treatment, in the vast majority of cases it can be successfully treated with antibiotics. The risk factors for tuberculosis include close contact with a person with infectious TB disease, time spent in a country with a high TB rate, homelessness, substance misuse, a weakened immune system and imprisonment.

Bayad Nozad, UKHSA South West Consultant in Health Protection, said: “Generally, the South West has low TB incidence and we have made significant progress to bring the number of cases down. However, TB remains a serious public health threat and the COVID-19 pandemic and the recent global events has added another challenge and complexity in the fight against TB. Therefore, it is more important than ever to focus our collective efforts in controlling TB.

“It is important to remember that not every persistent cough, along with a fever, is COVID-19 – it could be Tuberculosis, which can be treated easily with antibiotics. As last week saw World TB Day we are calling for anyone who has possible TB symptoms to speak to their GP to get diagnosed and treated as soon as possible, to minimise the chance of long-term ill health and onward transmission.

“TB is curable and preventable and now is the time to get our elimination efforts back on track.”

Symptoms of TB include: A persistent cough that lasts more than 3 weeks and usually brings up phlegm, which may be bloody; breathlessness that gradually gets worse; lack of appetite and weight loss; a high temperature; night sweats; and extreme tiredness or fatigue.

Numbers and rates of cases with drug resistance increased in both 2019 and 2020. There were more cases of drug-resistant TB in 2020 than any year since enhanced surveillance began – 11.6% of cases were resistant to any drug and 2.4% were multidrug resistant (compared to 1.8% in 2019).

TB disproportionally impacts under-served populations such as those who have been homeless, spent time in prison or misused drugs and other substances. Ensuring that everyone has access to a timely diagnosis and effective treatment is therefore critical.