The Victorian disease making a comeback as a 'serious public health issue' (2025)

The disease still kills more people than any other infectious disease across the globe

The latest infectious disease data shows a concerning rise in cases of a Victorian-era disease, with health officials warning that Britain risks losing its "low level" status for the contagious infection.

The UK Health Security Agency (UKHSA) has revealed a five-year action plan to fight Tuberculosis after data for England showed a rise in cases of the disease.

Tuberculosis (TB) is an infection that typically affects the lungs, caused by a bacteria called Mycobacterium tuberculosis. The disease is contagious, spreading through the air when people with TB cough, sneeze or spit.

TB was the leading cause of death in Victorian England, killing around four million people between 1851 and 1910. Despite progress in containing Victorian-era diseases, the WHO says a total of 1.25 million people died from TB in 2023, making it the world’s leading cause of death from an infectious agent, surpassing Covid-19.

The UKHSA published its first annual report last week (March 25) which revealed that both endemic disease and vaccine-preventable infections are on the rise in England.

The report looked at health data from 2023 to early 2025 and found that rising cases of TB could see the UK lose its "low incidence status" of 10 cases per 100,000 population from the World Health Organisation (WHO).

The report revealed that TB cases increased by 11 per cent in 2023, with a further 13 per cent increase in 2024. Rates of infection rose from 8.5 per 100,000 population in 2023 to 9.5 per 100,000 in 2024.

Dr Esther Robinson, Head of the TB Unit at UKHSA, said: "TB is curable and preventable, but the disease remains a serious public health issue in England. While England is still considered a low-incidence country for TB, the rise in cases over recent years means that we are now just below that threshold."

The UKHSA has launched a call for evidence to help shape its Tuberculosis (TB) National Action Plan for England, which will run from 2026 to 2031, that aims to improve the detection, prevention and control of TB.

Dr Robinson added: "This call for evidence will help us develop an action plan that prioritises the most effective interventions to reverse this trend, focusing particularly on the needs of those most affected."

The call for evidence, which will build on progress made under the current Tuberculosis Action Plan for England, published in 2021, invites experts and those with lived experiences of TB to supply ideas and evidence to help shape the plan.

The call for evidence seeks insights from:

• Academics
• Health and social care professionals
• Public health experts
• Epidemiologists
• Data and surveillance scientists
• Civil society representatives
• Policymakers
• Politicians
• Those with lived experience of tuberculosis

Tuberculosis is both preventable and curable. While the BCG vaccine, developed more than a century ago, is still in use today, experts warn it offers limited protection, especially in the lung form of TB. The UK has also seen a drop in people getting the vaccine since 2005, when the BCG vaccination programme was changed to only target high-risk individuals.

The UKHSA report also highlights a “strong association” between the rise in TB cases in England and migration from “high or very high incidence countries”, with 80 per cent of cases in 2023 in people born outside of the UK.

In countries where TB is common, a test for the disease in the lungs is part of visa entry requirements for coming to the UK for six months or more. However, the bacteria that causes TB can often lie dormant for years, in a condition called latent TB, meaning it wouldn't show up on routine tests.

Symptoms of TB include a persistent cough lasting more than three weeks, a high temperature, night sweats, loss of appetite, and weight loss, according to the UKHSA.

The call for evidence opens on Wednesday (April 2) and will close on May 2, 2025.