Tuberculosis, the bacterial infection once called the white plague, infected 5,449 people in England in 2025, according to new figures released by the UK Health Security Agency (UKHSA) on 30 October. The number barely moved from the 5,485 cases recorded the year before, and health officials now describe the disease as a serious public health issue that is not going away on its own.
The Mirror reported the warning, in which Dr Esther Robinson, head of the TB Unit at UKHSA, urged people to learn the symptoms and get tested quickly, noting that not every persistent cough is flu or COVID-19
What the new TB figures actually show
The headline number conceals a sharply unequal geography. TB notifications were highest in urban areas, with London recording 20.2 cases per 100,000 people, the worst rate in England. People living in the most deprived areas were 6.9 times more likely to be diagnosed with TB than those in the least deprived areas in 2025.
Some 82.3% of notifications were in people born outside the UK, a figure that will be weaponised by a hostile media environment even though it reflects global health inequality, not individual behaviour. Tuberculosis remains the world's leading cause of death from a single infectious agent, and it concentrates wherever poverty, overcrowded housing, and rationed healthcare converge.
Multi-drug resistant TB accounted for 2.1% of cases in 2025, compared with 2.2% in 2024. UKHSA said this form of the disease requires longer and more complex treatment, placing additional burdens on health services that a decade of funding cuts has already hollowed out.
Why a Victorian disease is thriving in 2026
TB earned its Victorian label honestly. It peaked in the 19th century in rapidly industrialising British cities, where workers lived in damp, overcrowded slums and died in numbers that made the disease a byword for industrial cruelty. The pallor of its victims, drained by anaemia, gave it the name white death.
The comparison is not decorative. Then as now, the disease mapped onto class. It killed the people that the industrial economy treated as disposable, and it retreated only when housing, nutrition, and wages improved, long before antibiotics arrived. Its return to 21st-century England tracks the same coordinates: temporary accommodation, food insecurity, zero-hours contracts, and a GP system that migrants often struggle to register with for fear of immigration enforcement.
Dr Robinson was direct about who needs to hear the message.
If you have moved to England from a country where TB is more common, please make sure you know the symptoms of TB so you can get promptly tested and treated through your GP surgery.
That plea lands in a context where the NHS charges some migrants for care and where data-sharing arrangements with the Home Office have taught migrant communities, with good reason, to avoid contact with state institutions. Public health messaging cannot outrun a hostile environment policy that treats healthcare as a border checkpoint.
Symptoms to know, and why early testing matters
According to the Mirror, UKHSA stressed that a cough lasting longer than three weeks, especially with mucus, deserves medical attention rather than assumptions about colds or COVID-19. The NHS lists the symptoms of active pulmonary TB as:
- A persistent cough lasting more than three weeks, sometimes with blood in the mucus
- Chest pain or pain when breathing or coughing
- High temperature, fever and night sweats
- Extreme tiredness, loss of appetite and unexplained weight loss
Dr Robinson's full warning was blunt about the stakes.
While notifications haven't increased in the past year, TB remains a serious public health issue. It's important that everyone is aware of the symptoms to ensure prompt testing and treatment, so that we can bring TB levels down significantly.
Antibiotic resistance is a structural problem, not a personal one
TB treatment involves prolonged courses of antibiotics, and in recent decades the bacteria has grown increasingly resistant to them. That resistance is not an accident of nature. It is the harvest of decades in which pharmaceutical companies deprioritised new TB drugs because the people dying were mostly poor, mostly Black and brown, and mostly outside the markets that shareholders answer to.
UKHSA maintains a data dashboard covering antimicrobial resistance and respiratory infections that informs public health decisions in England. The data shows the problem is being monitored. Whether it is being resourced is another question, one that the coming TB National Action Plan, which UKHSA says will focus on improving prevention, detection and control in England, will have to answer.
Respiratory infections more broadly are straining the same creaking system. As Wikipedia's overview of whooping cough notes, antibiotics only work well within the first weeks of symptoms, which is exactly why delayed access to GPs, a crisis rooted in appointment shortages and clinic closures, converts treatable infections into dangerous ones.
Whose health counts?
The politics of this outbreak are hard to miss. When a disease concentrates in migrant communities, in deprived boroughs, in overcrowded housing, the response reveals what a state believes its institutions are for. The current answer, a warning to see your GP, is necessary but radically insufficient. Nobody coughing blood in a tower block in Newham needs a press release; they need a GP appointment this week, secure housing, and a guarantee that a clinic visit will not end in an immigration file.
Abolitionist and health justice organisers have long argued that public health and border regimes cannot be separated. The 2025 TB figures prove the point with brutal clarity. You cannot exclude people from care, housing and income and then act surprised when a disease of poverty takes root among them.
UKHSA says it wants to bring TB levels down significantly. That will require more than awareness campaigns. It will require treating the conditions the Victorians were forced to eliminate through struggle: housing, food, income, and care that reaches everyone, regardless of passport, postcode, or papers.
Frequently asked questions
How many TB cases were recorded in England in 2025?
UKHSA recorded 5,449 TB notifications in England in 2025, compared with 5,485 in 2024, according to figures reported by the Mirror.
Who is most at risk of tuberculosis in England?
UKHSA data shows people in the most deprived areas were 6.9 times more likely to be diagnosed with TB, and 82.3% of notifications were in people born outside the UK, with the highest rates in London.
What are the main symptoms of TB?
A cough lasting more than three weeks, possibly with mucus or blood, plus fever, night sweats, fatigue and weight loss. UKHSA urges anyone at risk to speak to their GP.
Is TB resistant to antibiotics?
Partially. Multi-drug resistant TB affected 2.1% of people notified in 2025, and UKHSA says it requires longer, more complex treatment that places extra burdens on health services.