A continued rise in immigration from countries with high rates of tuberculosis could cause ‘hundreds of deaths’ over the next five years, health chiefs have warned.
The UK Health Security Agency (UKHSA) said an increase in migrants carrying TB could place ‘additional pressure on health services’ in the years to come.
The comments made up part of the UKHSA’s future pandemic threat assessment, where officials warned that respiratory diseases with pandemic potential pose the greatest threat to Britain’s health security.
In its ‘reasonable worst-case scenarios’ ranking, the government body identified an influenza pandemic as the UK’s most significant risk, followed by avian flu – which is found in animals but capable of evolving into an outbreak that can infect humans.
A novel coronavirus similar to COVID-19 was listed next, ahead of a resurgence of TB linked to a surge in migration.
Often described as a ‘Victorian-era’ disease due to it triggering an epidemic in the 18th and 19th centuries, TB is caused by a bacterium – mycobacterium tuberculosis – which is easily spread through coughs and sneezes.
Without treatment, TB remains one of the world’s deadliest infectious diseases, with estimates suggesting that more than half of untreated patients will die.
In their latest report, the UKHSA said: ‘People who are arriving from countries and regions where certain infections are more common, and health systems are less resourced, may be at higher risk of undiagnosed or partially treated infections. TB is one such infection that can be prevented and treated and can be active or latent.’
The UK Health Security Agency (UKHSA) said an increase in migrants carrying undiagnosed or untreated tuberculosis could place ‘additional pressure on health services’ in years to come
Latent TB means it is not infectious but it can develop into active TB, which can spread.
They added that migration to the UK from countries where TB cases are high ‘continues to increase steadily’.
According to World Health Organisation data for 2024, South-East Asia accounted for 34 per cent of global TB cases, followed by the Western Pacific region with 27 per cent and Africa with 25 per cent. Just 1.9 per cent of TB cases came from Europe, the statistics show.
Globally, TB kills more than 1.2million people per year.
Though annual TB diagnoses in Britain declined between 2011 and 2021, the UKHSA said that ‘trend has reversed’.
Cases increased during 2023 and 2024, with official figures showing infections rising from 4,850 in 2023 to 5,480 in 2024 – an increase of 13 per cent.
Early symptoms of TB include a persistent cough accompanied by blood, fatigue, loss of appetite, weight loss, fever and night sweats.
Later, they may also develop breathing difficulties and lung damage, which can be fatal. The disease may also spread to other organs, including the brain or spinal cord.
Treatment usually involves a course of antibiotics lasting at least six months, although drug-resistant strains are becoming an increasing concern. In severe cases affecting the brain or heart, steroid medication may be required.
The report noted that migrants are screened for TB according to their ‘route of migration’ – with some undergoing checks before arrival and others tested after reaching Britain.
Tuberculosis is caused by a bacteria – Mycobacterium tuberculosis – that is easily spread through coughs and sneezes
Under the UK’s ‘reasonable worst-case scenario’, the UKHSA projects that TB cases could reach 10,000 annually within the next five years if migration from countries where TB is common continues to rise.
They added: ‘As a result, there are hundreds of deaths, tens of these resulting from drug resistance.
‘The increase in TB cases places additional pressures on health services locally, with long treatment plans, increased need for specialist facilities and increased need for testing.’
To limit the impact, officials said ‘awareness and education campaigns’ would target migrants arriving from countries with high TB rates, as well as populations in prisons.
Screening for both active and non-infectious TB would continue and could potentially be expanded, including at prisons and at the UK border for asylum seekers.
According to the NHS, those most at risk of developing TB include people born in countries where the disease is more common, individuals with weakened immune systems – such as those living with HIV or undergoing chemotherapy – children under five, people living in overcrowded or deprived conditions, and those who regularly smoke, misuse alcohol or take drugs.
Close contact with someone who has TB, or a previous history of the disease, also increases the risk of infection.
The BCG vaccine remains the main form of protection against TB and is estimated to be around 70 to 80 per cent effective in preventing the disease.
Commenting on the wider report, Professor Steven Riley, chief data officer at the UKHSA, said: ‘As we continue to experience risks from a wide range of complex health security threats which disproportionately impact more vulnerable groups in our society, it is vital we continue to enhance our preparedness measures and resilience planning.’
