Tuberculosis: Why did Victorian disease make a comeback? Is it declining?

Tuberculosis (TB) was once rampant in 19th century England, when industrialisation was at its height.

Cramped conditions, poor public health and education were major factors in facilitating TB development.

However as the 20th century progressed, vaccines and public health were greatly improved, effectively eradicating it.

In the last 20 years or so, TB has resurged, and made a deadly return to the UK.

Tuberculosis is a serious condition characterised by coughs lasting over three weeks, weight loss, night sweating, high temperature (more than 38C), tiredness/fatigue, loss of appetite and neck swellings.

According to Public Health England (PHE), TB is a serious disease, and outbreaks are closely monitored by the Government.

According to PHE: “TB is one of the leading causes of death worldwide and England has one of the highest rates in Western Europe with just under 5,200 people affected by TB in 2017.”

Recent years have been characterised by a steady increase of about one percent every year, showing a clear comeback.

Why did Tuberculosis make a comeback?

According to a paper titled ‘Trends in tuberculosis in the UK’ by Philippe Glaziou, Katherine Floyd and Mario Raviglione, there are a host of reasons the disease returned.

Researchers said officials believed the disease was essentially eradicated, and as a result dismantled some TB control programmes.

Following the complacency, the spread of immune-compromising diseases like HIV, and diseases where TB is a risk factor, including diabetes and drug resistant TB are major health factors.

There were economic causes as well, as economic crises coupled with huge inequalities allowed the disease to breed.

Is Tuberculosis declining?

Modern times have seen Tuberculosis close to once again becoming a disease of the past, but it remains a public health risk.

According to researchers, it is declining but there is more work to be done.

They said: “After three consecutive decades of a relentless increase of the rate of incidence at an average of 1.9 percent/year between 1980 and 2012, TB resumed its secular decline in England in the past 5 years.

“The future trajectory of TB incidence is uncertain and maintenance of the current favourable trends will require strict adherence to the measures undertaken lately.

“To achieve these results and eliminate TB as a public health problem in England, 10 key areas for action were prioritised in the Collaborative TB Strategy for England 2015–2020.”

Eradicating Tuberculosis as a health threat is left up to addressing these key areas in public health.

According to the World Health Organisation (WHO), these include:

– Screening for TB in migrants arriving to the country

– Reducing time between symptoms and diagnosis via raising awareness and improving service accessibility

– Ensuring quality of TB treatments and services are continuing in high quality

– Addressing the social factors relating to TB, including education and poverty conditions which can allow it to breed