Cases of a potentially fatal stomach bug have surged across England over the last five years, analysis suggests.
Figures show that infections of Clostridioides difficile (C. diff) increased by more than 50 per cent between 2020 and 2025, to around 19,000 a year.
Data shows the North West, which includes Liverpool and Manchester, saw a rise of around 64 per cent over that period – and the region now has around two and a half times the infection rate of London.
C. diff, which is highly infectious, spreads through tiny spores found in people’s faeces, which can survive on surfaces for long periods.
People can become infected if they accidentally swallow the spores after touching contaminated surfaces and then touch their mouths, or by eating contaminated food.
It can cause debilitating diarrhoea more than 15 times a day alongside fever, loss of appetite, stomach pain and sickness.
In roughly one in seven cases the bug can trigger dangerous complications such as peritonitis – a life-threatening infection of the abdomen’s inner lining.
Analysts from clinical research company TrialMed have examined five years of data from the UK Health Security Agency.
Using the latest available figures, from 2024/25, the Daily Mail’s interactive graphics reveal the regions with the highest number of infections per 100,000 people.
Topping the list was the North West, with 46.5 cases per 100,000 residents.
In 2020/21 that figure stood at just 28.4 per 100,000 people, representing a 64 per cent rise in five years.
It’s followed by the South West, including Devon and Cornwall, with 37.6 cases per 100,000 – up from 25.6 five years before.
Next highest is the Midlands, including cities like Birmingham and Nottingham, with 36.6 infections per 100,000 last year, in a rise from 21.5 in 2020/21.
Meanwhile, the North East and Yorkshire recorded 34.1 cases per 100,000 between 2024 and 2025, up from 25.5 at the start of the decade.
Infections remained high at 33.1 per 100,000 in the East of England last year – a rise of around 53 per cent from 21.7 in 2020/21.
Levels dropped below 30 to 29.4 per 100,000 in the South East, where the infection rate was just 20.4 five years prior.
The lowest rate last year was in London, at 18.8 per 100,000. But even there, the figure was up by 25 per cent since 2020/21.
Across England, the total number of C. diff infections rose by almost 52 per cent over five years, from 12,500 in 2020/21 to 18,957 in 2024/25.
‘Cases are increasing across every NHS England region, which could be for a number of reasons,’ says Dr Marianne Viljoen, a clinical research physician at Trialmed.
‘Regional differences do not necessarily mean infection prevention is better or worse in one area compared to another.
‘They are more likely to reflect a combination of demographics, antibiotic prescribing patterns, population health, healthcare usage and the number of higher-risk patients living within those communities.’
Experts say infections of Clostridioides difficile – highly contagious bacteria known as C. diff – increased by more than 50 per cent since 2020
C. diff is also the leading cause of hospital-acquired diarrhoea.
The bacteria can generally live in the bowel without causing any harm, but those taking antibiotics may be at higher risk.
This is because antibiotics can kill some of the healthier bacteria in the gut – allowing C. diff to multiply and potentially cause infection.
Over-65s are most at risk, as they tend to have weakened immune systems and become ill, therefore making it more likely that they would be prescribed antibiotics.
The infection can also lead to sepsis, which around 48,000 Britons every year.
Furthermore, C. diff spores are highly resistant to heat and many disinfectants – making them easy to spread in hospitals.
Worryingly, a survey of more than 1,000 NHS staff this year found that nearly 80 per cent did not know the hygiene steps they needed to take to protect patients from it.
One in five staff also said they did not routinely test for C. diff if a patient developed diarrhoea in hospital.
Experts told the Mail previously that healthcare professionals must be aware of the potentially deadly risks of C. diff for patients.
‘The key to treating C. diff is getting a diagnosis with the right test,’ said Dr Jane Freeman, secretary of the C. diff Trust and an associate professor in clinical microbiology.
‘That relies on our healthcare professionals knowing the risk factors and making sure the patient is tested.
‘We need to make sure [they] have the right skills and awareness of C. diff, and that the NHS has the right systems and guidance in place to ensure that patients get the tests they need at the right time wherever they are.’
She also warns that failing to tackle infections can have long-term consequences for many patients.
‘Having C. diff can delay the treatments they need for those other conditions until they get better.
‘C. diff comes back in about 25 to 30 per cent of people, which leaves many patients worried about whether their recovery will last and fearing every tummy twinge.’
Official NHS guidance states there are several ways to reduce the risk of infection.
These include staying at home until 48 hours after diarrhoea has stopped to avoid spreading the bug, as well as washing hands regularly with soap and water.
Toilets should also be cleaned and disinfected after each use, and clothes and bedding that may be soiled with infected stool should be washed separately from other laundry.
