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TB is a public health issue because it is a very dangerious disease and very infectious, and as there is a cure it can be prevented.

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Tackling Tuberculosis (TB) is one of seven key priorities for Public Health England and it's a public health problem that we absolutely have to overcome.

Our incidence of TB is four times higher than in the US and if current trends continue, England will have more TB cases than the whole of the US within two years. This is not acceptable.

To get on top of this problem we've been working closely with NHS England and a coalition of key stakeholders to develop a collaborative TB strategy for England which we launched this week (19 Jan 2015). Our ambition is to achieve a year on year reduction with the ultimate aim of eradicating TB across England.

What's the scale of the problem?
Following major declines in the incidence of TB during most of the 20th century, the incidence of TB in England increased steadily from the late 1980s to 2005, and has remained at relatively high levels ever since.

Let me give you some worrying stats: in 2013 there were 7,290 cases of tuberculosis reported in England, which is a rate of 13.5 cases per 100,000 population. A total of 2,985 cases occurred in London alone, a rate of 35.5 cases per 100,000 population, nearly three times higher than the national average.

This is mirrored by rates in Leicester (53.1), Birmingham (38.0), Luton (41.3), Manchester (37.0) and Coventry (36.2), demonstrating that tuberculosis is predominantly concentrated in large urban areas (2011-2013 average rate).

London is widely cited as being the tuberculosis capital of Western Europe, with examples of outbreaks in other countries originating in the UK. Other comparable countries have seen sustained declines in rates over the past decades, mainly due to improved control.

Failure to prevent, diagnose and adequately treat tuberculosis cases is also leading to the development of drug resistance, onward transmission and outbreaks, including outbreaks of multidrug resistant tuberculosis.

Our recent TB in the UK report includes more information and statistics (also see graphic below).

Why are the incidence rates a concern?
Tuberculosis is a preventable and treatable disease that disproportionately affects vulnerable and disadvantaged populations. We have the means and knowledge to substantially decrease the incidence of tuberculosis through our new strategy.

What measures can be taken to improve TB control?
Tuberculosis control requires a combination of medical and social interventions to address its underlying determinants. Our strategy contains ten key areas of action including the prompt identification of individuals who are infectious and ensuring that they are placed on appropriate treatment.

Communities where tuberculosis is common and services that support individuals in these communities all need to be aware of the symptoms of tuberculosis so that they can seek care.

Other measures include vaccination of high risk groups, maintaining our excellent diagnostic services, tackling drug resistant TB, identifying and treating those with latent TB who are at high risk of progressing to active disease, ensuring contact tracing happens when a new case is diagnosed and planning the workforce required to deliver these interventions.

Who is contributing to beating TB?
We have received considerable input in the development of the strategy from colleagues across local government which has helped improve our approach. The implementation of the strategy will include a significant role for local government in ensuring that the wider social determinants of TB are addressed and that people affected by TB are supported to take their treatment. PHE and NHS England together with local government and a range of partners must work together to make sure all aspects are implemented.

We are lucky to have an All Party Parliamentary Group on Global TB which is very supportive of domestic TB work. We also worked closely with the APPG on TB to develop the strategy.

The TB drugs and vaccine For the first time in several decades, two new antibiotics Bedaquiline and Delamanid have received approval for the treatment of drug resistant tuberculosis. This is fantastic news especially for very severe forms of drug resistant tuberculosis where almost no antibiotic is effective. This is no time for complacency as we have far fewer candidates in the pipeline for new drugs. More needs to be done to identify shorter treatment regimen for tuberculosis from the current six months required for drug sensitive TB and longer for drug resistant TB. This will help tackle the global TB problem. The UK MRC and DFID continue to support projects that are evaluating new and innovative regimen for tuberculosis.

Unfortunately, there are no new effective vaccines available for tuberculosis that improve on BCG. Further research is ongoing on a range of candidate vaccines, including several projects that colleagues at PHE are leading.

What are the next steps?
The Launch of the Collaborative TB Strategy is just the first step in achieving our objective of effective tuberculosis control - we now need to work with partners to implement all the measures we've outlined. The £11.5 million new funding announced will ensure that latent TB screening and tuberculosis in under-served populations is tackled. Our progress will be monitored using the published set of indicators.

(Click on graphic to enlarge)

Image at top of page: CDC

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Tackling Tuberculosis (TB) is one of seven key priorities for Public Health England and it's a public health problem that we absolutely have to overcome. Our incidence of TB is four times higher than in the US and if current trends continue, England will have more TB cases than the whole of the US within two years.

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New guidance on prevention and management of tuberculosis - Stewart - 2016 - Prescriber - Wiley Online Library

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New vaccination are becoming available as TB is becoming more drug resistant and although TB is becoming less common it is still quiet high and highly contagious.

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This guidences also want to promote education about TB so that early digonosise can happen.

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The guidelines states that the government is trying to "prevent, identify and manage latent and active tuberculosis in children, young people and adults. It aims to improve ways of finding people who have TB in the community and recommends that everyone under 65 with latent TB should be treated. it describes how TB services should be organised, including the role of the TB control board." (NICE, 2016).

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We work with health and care professionals, people who use services and carers to draft our recommendations. Find out how we choose our topics, draft and publish our guidelines.

Our guidelines can help you make decisions around prescribing medicines, what treatments to recommend and the promotion of safeguarding.

You can help draft our guidelines by registering as a stakeholder or joining a guideline committee.

Our guidelines support shared decision making between healthcare professionals and those receiving care and treatment.

We're changing how we manage and maintain our guidelines by prioritising which topics we monitor and update.

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NICE guidelines are evidence-based recommendations for health and care in England.

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In 2016, new guidelines were put into place to but in motion to get rid of TB in the UK.

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There are two different types of TB. Active TB and Latent TB.

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As TB is not completely cleared from the UK the government is still trying new ways to get rid of TB as it is a preventable and curable disease.

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London still has high rates of TB.

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The UK planned to get rid of TB from the country using the NHS service and the governments influences back in early 2015.

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"Tackling TB is one of seven key priorities for Public Health England."

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This was less TB cases than the previous years as rates have been declining since 2012.

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"In 2016, there were 5,664 cases of TB cases notified in England" (Public Health England, 2017).

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The screening process has three different steps. The first step is to have your history asked about. The second step is to have your chest x-ray. If your chest is clear then you can travel freely. If discrepancies are found then step three starts. The third step is giving a sample, these results can take up to two months to get the results (Public Health England, 2013).

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Measures that the UK government has in place to prevent a break out of TB in the UK is that screening is done then if a person does have TB then a person does have TB when screened they can have a course of medication.

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Some countries that have high rates of TB are Africa, southeast Asia, Russia, China and many other parts of the world.

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People that are at risk of getting TB are people that live in areas that have high rates of TB and people that are going to work/live in areas that has high rates of TB for more than three months.

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TB can be cured with antibiotics or antimicrobial drugs which are given over a 6 month course of treatments.

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TB mostly affects the lungs. But it can also affect the "abdomen, bones and nervous system" (NHS, 2016).

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Tuberculosis (TB) is an infection that usually affects the lungs. It can be treated with antibiotics but can be serious if not treated. There's a vaccine that helps protect some people who are at risk from TB.

Check if you have tuberculosis (TB)

Symptoms of tuberculosis (TB) usually come on gradually.

Common symptoms include:

a cough that lasts more than 3 weeks - you may cough up mucus (phlegm) or mucus with blood in it

feeling tired or exhausted

a high temperature or night sweats

loss of appetite

weight loss

feeling generally unwell

Children may also have difficulty gaining weight or growing.

If TB has spread to another part of your body such as your glands (lymph nodes), bones or brain, you may also have other symptoms, including:

swollen glands

body aches and pains

swollen joints or ankles

tummy or pelvic pain

constipation

dark or cloudy pee

a headache

being sick

feeling confused

a stiff neck

a rash on the legs, face or other part of the body

If you have TB and you have symptoms, it's called active TB.

Sometimes you can have TB in your body but have no symptoms. This is called latent TB.

you've had a cough for more than 3 weeks

you're feeling tired or exhausted and you're not sure why

you have a high temperature or night sweats that do not go away

you often do not feel hungry

you keep losing weight without changing your diet or exercise routine

you've spent a lot of time with someone who has tuberculosis (TB) and has symptoms (for example, you live with someone who has it)

Ask for an urgent GP appointment or get help from NHS 111 if:

you're coughing up blood or mucus (phlegm) with blood in it

You can call 111 or get help from 111 online.

you have a stiff neck and a severe headache

it's painful to look at bright lights

you've had a seizure or fit

you've had a change in behaviour - such as sudden confusion

you have weakness or loss of movement in part of the body

These could be signs that tuberculosis (TB) has spread to your brain (meningitis).

Tests to check for tuberculosis (TB)

If you have symptoms of tuberculosis (TB), tests you may have include:

an X-ray, ultrasound, echocardiogram or CT scan of your chest or the part of your body that may be affected

taking samples of your mucus (phlegm)

a biopsy to take a sample of tissue, cells or fluid from the affected area

If you have no symptoms but are at risk from TB (for example, you've been in close contact with someone who has TB) you may have a Mantoux test or blood tests to check if you have it.

A Mantoux test is a skin test where a small amount of liquid is injected under the skin in your arm. This liquid will cause a small reaction on your skin if you have TB.

Treatment for tuberculosis (TB)

The main treatment for tuberculosis (TB) is to take antibiotics for at least 6 months.

If TB has spread to your brain, spinal cord or the area around your heart, you may also need to take steroid medicine for a few weeks.

If you have TB but do not have symptoms (latent TB) you usually need to take antibiotics for 3 to 6 months.

Important

It's important to take your antibiotics correctly and until you've completed the course, even if you feel better. If you stop your treatment early, TB could come back.

Causes of tuberculosis (TB)

Tuberculosis (TB) is caused by bacteria. It can spread through close contact with people who have TB and have symptoms (active TB).

When someone with active TB coughs, they release small droplets containing the bacteria. You can catch TB if you regularly breathe in these droplets over a long period of time.

Some people have TB in their body but do not get ill or have any symptoms (latent TB). This type of TB cannot be spread to others, but it can turn into active TB in the future.

People who are more likely to get TB

Anyone can get TB, but some people are more likely to get it or get more seriously ill from it, including people who:

spend a lot of time with someone who has active TB, such as people living in the same house

were born in or lived in an area where TB is more common

have a weakened immune system, such as people with HIV, a kidney transplant or who are having certain treatment like chemotherapy

are under 5 years of age

live in overcrowded or unhealthy conditions, such as people who are homeless

regularly smoke, drink alcohol or take drugs

have had TB before and it was not treated properly

Tuberculosis (TB) vaccination

There is a vaccine for tuberculosis (TB) called the BCG vaccine.

It's recommended for some people who are at higher risk of catching TB or getting seriously ill from it, including:

babies who live in areas of the UK where TB is more common

babies and children who live with someone who has TB

babies and children who were born or lived in a country where TB is more common

babies and children whose parents or grandparents were born in a country where TB is more common

people aged 35 and under who are spending more than 3 months in a country where TB is more common

people at risk of getting TB through their work, such as healthcare workers who work with people who have TB

Find out more about the BCG vaccine for tuberculosis (TB)

Page last reviewed: 20 April 2023
Next review due: 20 April 2026

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NHS information about tuberculosis (TB), including symptoms, when to get medical help, treatments and causes.

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The bacteria that causes TB is Mycobacterium Tuberculosis. This bacteria is best spread through the air when people cough and sneeze.

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TB also known as Tuberculosis is a bacterial infection. It is most commonly found in developing countries.