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What is tuberculosis and its symptoms and what happened to the BCG jab for teenagers?

Cases of tuberculosis are rising in England and the UK Health Security Agency says progress towards eliminating the infection has now ‘stalled’.

Up until 2005, all teenagers were vaccinated against TB before the programme was scrapped in favour of offering jabs to those deemed most at risk.

The UKHSA says progress to eliminate TB has ‘stalled’. Image: iStock.
The UKHSA says progress to eliminate TB has ‘stalled’. Image: iStock.

But NHS figures for the first half of 2023 show that when compared with the same time-frame last year, cases are now up by around 7%.

What is TB?

Tuberculosis is a bacterial infection spread through tiny droplets in the coughs or sneezes of an infected person. It is a serious condition mainly affecting the lungs, but is curable with proper treatment.

While TB is not as contagious as the common cold or flu, it is usually passed between family members or those living in the same home because prolonged contact with an infected person helps to spread the bacteria.

TB mainly affects the lungs. Image: iStock.
TB mainly affects the lungs. Image: iStock.

During the first six months of 2022 there were 2,251 cases of TB in England – rising to 2,408 by June this year.

While England is still classified as a ‘low incidence country’ - says the UKHSA - it cautions that TB isn’t any longer just a problem for people in other countries and it is now impacting ‘increasing numbers’ of people at home.

Mass BCG vaccinations were scrapped in 2005. Image: iStock.
Mass BCG vaccinations were scrapped in 2005. Image: iStock.

BCG injections

When the BCG injection was scrapped almost two decades ago for all teenagers, it was replaced with a ‘targeted’ programme which immunises babies, children and young adults felt to be at a higher risk of developing tuberculosis.

TB notification rates in England remain highest among people from large urban areas of England associated with higher levels of deprivation alongside those who are originally from other parts of he world where TB remains more common.

Inclusion health groups – a term used to describe people who are socially excluded and who have multiple overlapping risk factors that contribute to their poor health are also at greater risk. This includes those experiencing homelessness or people in contact with the criminal justice system.

Those with a prolonged cough are being reminded to see a GP. Image: iStock.
Those with a prolonged cough are being reminded to see a GP. Image: iStock.

Dr Esther Robinson, Head of the TB Unit at UKHSA, appealed for anyone with a prolonged cough this winter to get themselves checked.

She explained: “It is very important that those with relevant symptoms are tested for TB and appropriate treatment is started promptly, both for the individual and for the prevention of onward transmission.

“As we head into winter, it is important to remember that not every persistent cough, along with a fever, is caused by flu or Covid-19. A cough that usually has mucus and lasts longer than three weeks can be caused by a range of other issues, including TB.

“Tuberculosis develops slowly, and it may take several weeks, months or even years after you were infected before you notice you’re unwell. Contact your GP if you think you could be at risk so you can get tested and treated.”

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