Tuberculosis Notifications Increased 8.1% in England

Tuberculosis (TB) is an ancient disease impacting modern cities in 2023, such as London, England. 

Over the last two years, the 5% annual rate increase goal outlined in the joint UK Health Security Agency (UKHSA) and NHS England TB action plan for England, 2021 to 2026 has not been achieved.

The UKHSA announced on October 26, 2023, there was an 8.1% increase in TB notifications this year compared with the same period in 2022 (3,628 versus 3,402).

In quarter three of 2023, the areas with the most notifications continued to be London in the North East, Yorkshire, the Humber, and West Midlands.  

Increases were reported in London (6.5%), North East (23.8%), North West (10.6%), West Midlands (11.4%), and Yorkshire and the Humber (15.5%).

In the UK, like many other countries, a version of the 100-year-old Bacille Calmette-Guerin (BCG) vaccine is offered to children who are likely to spend time with someone with TB.

This includes babies who live in an area with high rates of TB or babies with parents or grandparents from a country with increased rates of TB.

The UKHSA stated in April 2023 that the BCG vaccination is particularly effective in protecting young children against the rarer severe forms of TB, such as TB meningitis.

BCG vaccines contain a weakened form of the bacteria that causes TB. Because it is weakened, it doesn't cause TB, but it helps children develop TB immunity.

A version of the BCG vaccine is no longer offered in secondary schools in the UK. 

In the United States, the USAID leads the government's global TB Strategy 2023–2030 efforts.

The incidence of reported TB decreased gradually from 1993 to 2019, reaching 2.7 cases per 100,000 persons in 2019. Incidence substantially declined in 2020 to 2.2, coinciding with the recent pandemic.

However, the U.S. CDC reported on March 23, 2023, that TB cases increased by 5% in 2022, with 60 states, the District of Columbia, and territories provisionally reporting 8,248 TB cases.

In 2022, 73% of TB cases occurred among non–U.S.-born persons, compared with 72% in 2021.

California and Texas lead the U.S. in reporting TB cases.

Recent data indicates TB rates are accelerating in certain Texas cities (Dallas, Ft. Worth, Hidalgo County, Houston, San Antonio) in 2023.

In 2022, 1,097 TB cases were reported in Texas, a 9.9% increase, with Harris Country (Houston) reporting the most TB cases (267).

In 2022, 50 Texans died of TB.

As of October 30, 2023, there are over 16 BCG vaccine versions offered globally, with about 17 vaccine candidates in development. When authorized, the TICE® BCG version is administered in the U.S.