Each year, approximately thirteen cases of a notoriously drug-resistant Victorian-era superbug, tuberculosis (TB), are diagnosed in Somerset, prompting health experts to issue warnings about rising infection rates and unprecedented levels of drug resistance.
Recent data from the UK Health Security Agency (UKHSA) reveal a total of 5,490 TB notifications across England in 2024, marking a 13% increase—over 600 more reported cases—compared to 4,831 cases in 2023. This rise continues a troubling upward trend; drug-resistant TB has surged to its highest recorded level since tracking began in 2012, with 2.2% of confirmed cases showing resistance to multiple medications.
If left unchecked, UKHSA warns that England risks losing its “low-incidence” TB status, a classification it has maintained since 2017. According to the World Health Organization (WHO), a low-incidence country registers fewer than 10 TB cases per 100,000 people annually. England’s current rate stands at 9.4 per 100,000, up from 8.5 in 2023, though still below the historic peak of 15.6 per 100,000 in 2011.
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Within Somerset, TB rates are below the national average but are gradually increasing. Between 2021 and 2024, the county averaged 13 notifications annually, translating to 2.3 cases per 100,000 residents—well below both England’s average and the WHO low-incidence threshold—but slightly higher than the previous period’s 2.2 rate. In contrast, neighboring urban areas like Bristol and Bath and North East Somerset have recorded sharper rises, with Bristol’s rate climbing from 8.8 to 9.0 per 100,000 and Bath and North East Somerset increasing from 2.7 to 3.7. Meanwhile, North Somerset saw a small decline.
Historically known as “consumption,” TB devastated populations in the 18th and 19th centuries, causing an estimated four million deaths in England and Wales between 1851 and 1910. The disease featured prominently in the works of literary giants such as Charles Dickens and Elizabeth Gaskell. Globally, TB remains a leading infectious killer, with approximately 1.25 million deaths in 2023, surpassing fatalities from COVID-19. While final 2024 data have yet to be released, projections suggest similar numbers.
In England, 82% of reported TB cases last year were among individuals born outside the UK; however, increases have been observed in both UK-born and immigrant populations. The disease disproportionately affects deprived communities and is more prevalent in major urban centers. For UK-born patients, vulnerability is often linked to homelessness, substance misuse, and contact with the criminal justice system.
Dr. Esther Robinson, Head of the TB Unit at UKHSA, emphasized, “TB is preventable and curable, but with cases rising, it remains a significant public health challenge. Rapid detection and treatment are critical to breaking transmission chains.”
She added, “A persistent cough lasting longer than three weeks, especially when accompanied by mucus and fever, is not always flu or COVID-19—it could signal TB. Anyone at risk, especially those recently from countries with higher TB prevalence, should consult their GP promptly.”
TB primarily targets the lungs but can spread to other body parts, including glands, bones, and the brain. Common symptoms include a chronic cough, fever, chills, weight loss, fatigue, and coughing up blood. Individuals experiencing these symptoms or prolonged illness should seek urgent medical advice.
As the threat of TB resurges, communities are urged to remain vigilant, prioritize early diagnosis, and support efforts to contain this historic yet persistent disease.