Tuberculosis warning as cases of disease rise for first time in decades in Europe

Pandemic has ‘jeopardised’ the ‘remarkable progress’ made in tackling illness in recent years, WHO warns

Tuberculosis deaths have risen in Europe for the first time in decades, according to a World Health Organisation report (Getty Images/iStockphoto)

Disruption caused by the coronavirus pandemic is being blamed for the first recorded rise in tuberculosis (TB) cases and deaths in Europe for two decades.

Some 27,300 people died from TB in the World Health Organisation’s Europe region in 2021, up from 27,000 deaths the previous year, according to a new surveillance report by the WHO and European Union’s disease prevention agency.

The rate of new cases and relapses in the region is also estimated to have increased by 1.2 per cent compared to 2020, in a reversal analysts said “reflects the impact of disruption to TB services caused by the Covid-19 pandemic”.

The diversion of TB resources towards battling coronavirus in 2020, and difficulties patients experienced in accessing services, may have resulted in delayed diagnoses and reduced contact tracing, which could have enabled cases to become more severe and transmission to increase, the report states.

“As such, it is hypothesised that there may be an increase in the number and clinical severity of cases in the coming years,” according to the report.

While the authors warned that the pandemic’s impact on TB detection meant that their figures should be treated with caution, they said that the pandemic had “jeopardised” the “remarkable progress” made in containing the infection in Europe since 2015.

Looking ahead to the United Nations’ target of an 80 per cent reduction in new TB cases between 2015 and 2030, the report warned that “there is still considerable work to be done to achieve” this.

Following the disruption, “it is now critical that TB services are prioritised and appropriately resourced to support intensified public health measures against TB”, the authors said.

The report comes days after the UK Health Security Agency (UKHSA) reported a 7.3 per cent rise in cases in England in 2021, a year that saw new 4,425 cases.

Echoing the overall European findings, the UKHSA said that “despite an overall downward trend” in TB cases in England over the past decade, this has slowed in the last four years – warning that, without “immediate action”, England will fall short of achieving the UN’s target of a 90 per cent reduction by 2035.

“Tuberculosis remains a risk to some of the most vulnerable people in our society and this data highlights that progress towards elimination has stalled,” said Dr Esther Robinson, head of the agency’s TB unit.

“It is vital that we ensure that everyone has access to a timely diagnosis and effective treatment. This will also help us to get on course to eliminating TB in our communities through strengthening the prevention, detection and treatment of active TB in higher risk groups.”

How does TB spread and who is most at risk?

TB is spread through inhaling small droplets from the coughs or sneezes of an infected person. While nearly anyone can get TB, the most at risk include those who live in, come from, or have spent time in a country or area with high levels of TB, according to the UKHSA.

Other particuarly at-risk groups include: those in close contact with an infected person; people who have a condition or are receiving treatments that weaken their immune system; the very young and elderly; and those in poor health due to factors such as heavy substance use or homelessness.

What are the symptoms?

It mainly affects the lungs, but it can affect any part of the body, including lymph nodes (glands), bones and the brain causing meningitis, according to the UKHSA, which lists symptoms including:

• a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody
• breathlessness that gradually gets worse
• lack of appetite and weight loss
• a high temperature
• night sweats
• extreme tiredness or fatigue

What to do if diagnosed with TB

With treatment, TB can almost always be cured, and a course of antibiotics will usually need to be taken for six months, according to the NHS website.

Those infected with a drug-resistant form of TB may require treatment with six or more different medications.

While those infected with TB will not typically need to isolate, the NHS advises taking basic precautions to stop it from spreading to others, such as staying away from work or school, covering your mouth when coughing or laughing, opening windows where possible, and avoiding sleeping in the same room as others.