Rise in ‘world’s deadliest infection’ that could be mistaken for Covid

Health officials have issued a warning after new figures revealed that cases of tuberculosis (TB), dubbed the world’s deadliest infectious disease, are climbing rapidly across England.

Doctors say that while many people now dismiss a lingering cough as flu or Covid, it could in fact be TB—once thought largely consigned to history but now spreading again in parts of the country.

Data released today by the UK Health Security Agency (UKHSA) shows infections rose by 13.6 per cent in 2024, with 5,490 cases recorded compared with 4,831 the year before.

Although the risk to the general public remains low, experts warn TB spreads easily and can be deadly if not diagnosed and treated early.

Caused by the bacterium Mycobacterium tuberculosis, the infection most often attacks the lungs but can also spread to the brain, spine or kidneys.

Symptoms typically develop slowly over weeks or months and include a persistent cough lasting more than three weeks—sometimes producing blood—along with fever, night sweats, fatigue, weight loss and loss of appetite.

If left untreated, TB can cause lasting lung damage or spread through the bloodstream, leading to potentially fatal complications such as meningitis or organ failure.

It is often described as the world’s deadliest infectious disease because it kills more people each year than any other infection—around 1.25 million globally in 2023, according to the World Health Organization, surpassing deaths from HIV, malaria and Covid-19.

The illness is treatable with a course of antibiotics lasting at least six months, but patients must complete the full regimen to prevent drug resistance. 

TB spreads through prolonged close contact with an infected person when they cough, sneeze or speak, but it is not easily caught through casual contact.

The infection is both preventable and curable—with more than 84 per cent of patients completing treatment successfully within 12 months. 

However Dr Esther Robinson, head of the TB unit at UKHSA, said: ‘We must act fast to break transmission chains through rapid identification and treatment.

‘It’s important to remember that not every persistent cough, along with a fever, is caused by flu or Covid. A cough that usually has mucus and lasts longer than three 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—particularly if you have recently moved from a country where TB is more common.’

England now has a rate of 9.4 cases per 100,000 people—still below this century’s 2011 peak of 15.6 but moving steadily upwards.

The UKHSA said 82 per cent of last year’s cases were among people born outside the UK, though there was also a rise in infections among UK-born patients.

TB remains closely linked to deprivation and is more common in large cities—London recorded the highest regional rate at 20.6 per 100,000, followed by the West Midlands at 11.5 per 100,000.

Of growing concern is the spread of drug-resistant TB, which reached its highest level since records began in 2012.

Around 2.2 per cent of laboratory-confirmed cases showed resistance to multiple antibiotics—meaning longer, more complex treatment and greater strain on NHS services.

The government said it remains committed to improving prevention, detection and control of TB by focusing on the groups most at risk and tackling health inequalities.

UKHSA has also published new evidence from experts to inform the forthcoming National Action Plan for 2026–2031—which will aim to drive down transmission rates and improve access to testing and treatment.

The disease earned its ‘Victorian’ nickname because it was once the leading cause of death in 19th-century Britain—famously claiming the lives of figures such as the Brontë sisters—before public health measures and antibiotics saw cases plummet throughout the 20th century. 

In February, UKHSA warned that rising migration and the return of global travel following the pandemic had fuelled a ‘reemergence, re-establishment and resurgence’ of TB in Britain.  

Officials said the increase was so significant the UK risked losing its World Health Organisation ‘low-incidence’ status—granted only to countries with fewer than ten cases per 100,000 people.

Then, Dame Jenny Harries, the agency’s chief executive, told delegates at the UKHSA conference that, without intervention, the current rate of increase would soon see Britain lose that classification.

She described TB as a ‘serious public health issue’ and highlighted a strong association between rising infections and migration from countries with high TB rates.