The UK Health Security Agency has issued a significant health warning following the confirmation of 5,424 tuberculosis cases across England during 2025. This figure represents a slight decrease from the 5,487 cases recorded in 2024, maintaining a concerning notification rate of 9.4 per 100,000 population.
Understanding the Tuberculosis Landscape in England
Dr Esther Robinson, Head of the TB Unit at UKHSA, emphasised the ongoing seriousness of this public health challenge. "TB remains a serious public health issue in England," she stated. "The infection is preventable and curable. If you have moved to England from a country where TB is more common, please be aware of the symptoms of TB so you can get promptly tested and treated through your GP surgery."
Demographic Patterns and Regional Variations
The data reveals consistent patterns with previous years, with 81.6% of all TB notifications occurring in individuals born outside the United Kingdom. Tuberculosis continues to demonstrate strong associations with deprivation and is more prevalent within large urban centres.
Regional analysis shows notable variations across England:
- The North East recorded the largest percentage increase with 42 additional notifications, representing a 34.1% rise
- The West Midlands experienced the most significant decrease with 74 fewer notifications, a 10.4% reduction
- Five of the nine UKHSA regions maintained stable TB notification rates
Among UK-born individuals, tuberculosis remains more common in those experiencing homelessness, struggling with drug or alcohol dependency, or having contact with the criminal justice system.
Recognising Tuberculosis Symptoms
Health authorities stress the importance of symptom recognition, as tuberculosis manifestations can easily be mistaken for less serious conditions. "Not every persistent cough, along with a fever, is caused by flu or COVID-19," Dr Robinson cautioned. "A cough that usually has mucus and lasts longer than 3 weeks can be caused by a range of other issues, including TB. Please speak to your GP if you think you could be at risk."
The primary symptoms of tuberculosis include:
- A persistent cough lasting more than three weeks
- High temperature or fever
- Night sweats
- Loss of appetite
- Unexplained weight loss
Transmission and Treatment Considerations
Tuberculosis, the world's leading cause of death from a single infectious agent having surpassed coronavirus, is a bacterial infection that most frequently affects the lungs. The disease spreads through close contact with symptomatic individuals who have active TB. When infected persons cough, they release small droplets containing the bacteria, which can infect others through regular, prolonged inhalation.
While tuberculosis can be treated with extended antibiotic courses, it poses serious health risks if left untreated. The infection can also manifest in other body parts beyond the lungs, presenting symptoms such as swollen glands and joint problems.
Preventative Measures and Future Planning
Current preventative measures include tuberculosis testing as part of visa requirements for individuals arriving from high-incidence countries who plan to stay in the UK for six months or longer. However, the bacterium responsible for TB can remain dormant for extended periods in what's known as latent TB infection.
To address this challenge, testing and treatment programmes operate in higher incidence areas across England, specifically targeting new arrivals from countries with elevated tuberculosis rates.
Looking forward, development work is underway for a new Tuberculosis National Action Plan covering 2026 to 2031. This strategic framework will be informed by evidence gathered from experts and stakeholders earlier this year, focusing on improving prevention, detection, and control measures across England. The plan prioritises implementing the most effective interventions while addressing persistent health inequalities associated with tuberculosis incidence and outcomes.
