UK risks losing 'low level' status of Victorian disease as it makes comeback (2025)

The latest infectious disease data shows a concerning rise in cases of a Victorian-era disease

Officials have warned that Britain risks losing its low status for a contagious infection that experts warn kills more people than any other infectious disease.

The UK Health Security Agency (UKHSA) has published its first annual report, which revealed 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 Tuberculosis could see the UK lose its "low incidence status" from the World Health Organisation (WHO).

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.

Tuberculosis 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 infection “remains a serious public health issue in England," warned Dame Jenny Harries, chief executive of UKHSA.

The report revealed that TB cases increased by 11 per cent in 2023, with a further 13 per cent increase in 2024. The UKHSA warns that, if not reversed, this trajectory would see the UK lose its low level status of 10 cases per 100,000 population.

A testing and treatment programme is in place for areas of England with higher rates of TB, or those coming from high-risk countries. "UKHSA continues to work with NHSE and other partners on the TB action plan, which sets out steps to improve the prevention and detection of TB," the health agency wrote in a blog post about the report.

The UKHSA report 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.

The report said the return of social mixing and international travel following the Covid-19 pandemic, as well as international travel and migration patterns, has led to the “reemergence, reestablishment and resurgence” of a number of illnesses.

Richard Pebody, Director of Epidemic and Emerging infections at UKHSA, said: "It is clear that a number of factors altered the rates and impact of endemic and epidemic infectious diseases in England over recent years, and the reductions in transmission related to the COVID-19 pandemic have been followed by a rise in a range of infections since 2022 to 2023 due to the return of social mixing, international travel and migration.

"We have also seen vaccine uptake decrease for a number of infectious diseases, including measles, whooping cough and in certain groups eligible for the flu vaccine, such as under 65 at risk, pregnant women and health care workers.

"This winter has demonstrated that rises in rates of infectious diseases can cause significant strain, not only on the individuals directly affected, but also on the NHS. It is vital that we are not complacent about infections where we can reduce the burden of disease via interventions such as our world-class vaccination programmes."