Press release: Tuberculosis rates in England hit lowest recorded levels

New data published by Public Health England (PHE) reveal that the number of people in England diagnosed with tuberculosis (TB) is at its lowest level since 1990, raising the hope that it will soon be consigned to the history books.

Following action by PHE, the NHS and others, there was a 38% drop in new diagnoses from the peak in 2011 to 2017 (from 8,280 to 5,102), with a 9% fall in diagnoses between 2016 and 2017 alone.

The incidence rate of TB in England is now 9.2 per 100,000 population – taking England to below the World Health Organisation definition of a low incidence country (10 per 100,000 population) for the first time. TB is high on the global political agenda, as Heads of State gather in New York for the first UN High Level Meeting on tuberculosis, with the shared ambition of ending TB across the world.

Public Health England 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 underserved populations, implementing testing for latent TB in those arriving from countries with high rates of TB, and strengthening surveillance and monitoring.

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

It is hugely encouraging to see a continued decline in TB in England which shows that the interventions we are putting in place are having an impact and will hopefully one day soon consign TB to the history books. While these new figures are positive, challenges still exist.

The proportion of people who experience a delay between symptom onset and diagnosis remains stubbornly high. We are working across England to ensure that patients are diagnosed and treated as soon as possible to minimise the chance of long-term ill health and onward transmission.

The risk factors for tuberculosis – a bacterial infection that primarily affects the lungs and causes persistent cough, fever and weight loss – include homelessness, poor quality housing, alcohol and substance misuse.

The new data indicates that nearly 13% of people with TB have a ‘social risk factor’ and that they are more likely to have drug resistant infections and are less likely to complete treatment, prolonging the infection and increasing the risk of onward infection.

Steve Brine, Public Health Minister said:

We’re committed to keeping people healthy, and the steep decline of TB rates in this country is a testament to our world-leading approach. We are also helping other countries to go further in the fight against TB, with funding and research.

However, in the UK the poorest are still 7 times more likely to have TB than the most well off, and we have to drive down this inequality.

The UN High-Level Meeting on TB will be a prime opportunity to join forces with other countries and push further in the global effort to eliminate TB for good – in our country and around the world.

Background

1. TB in England, 2018 report, will be published on GOV.UK on 25 September 2018.
2. TB is an infectious disease that usually affects the lungs, but can affect other parts of the body such as the lymph nodes (glands), the bones and the brain and can lead to serious complications. The most common symptoms of TB are a persistent cough for more than 3 weeks, unexplained weight loss, fever and night sweats.
3. TB is difficult to catch, and you generally need to spend many hours in close contact with a person with infectious TB to be at risk of infection. Although TB can be fatal if left untreated, it is curable for the vast majority with appropriate antibiotic treatment.
4. Heads of State will gather in New York on 26 September 2018 at the United Nations General Assembly first-ever high-level meeting on tuberculosis to accelerate efforts in ending TB and reach all affected people with prevention and care. The theme of the meeting is ‘United to end tuberculosis: an urgent global response to a global epidemic’.
5. 2017 figures were the lowest number since 1990 (5,010). This is compared to 5,616 in 2016.
6. The incidence rate in 2017 was 9.2 per 100,000 population, our lowest recorded rate, which for the first time falls under the 10 per 100,000 WHO definition of a low incidence country.
7. In 2017, 71% of people (3,556) notified with TB were born outside the UK; this is a 13.1 decline from 2016 and at its lowest rate since 2000.
8. Nearly one-third (31%) of people with pulmonary TB continue to experience a delay of more than 4 months between symptom onset and treatment start.
9. In 2017, 12.6% of people notified with TB had a social risk factor (SRF), the highest proportion since data collection began in 2010.
10. The rate of TB in the most deprived 10% of the population was 18.4 per 100,000, more than 7 times higher than in the least deprived (2.5 per 100,000).