Health bosses have vowed to use pioneering DNA testing to tackle the growing threat from tuberculosis.
TB is overtaking Covid-19 as the most deadly infectious disease and experts fear mutant superstrains could be imported to Britain.
The NHS was the first health system in the world to start offering whole genome sequencing (WGS) at scale to predict which antibiotics will work in TB patients.
Writing for the Mirror, the head of the UK Security Agency says this pioneering DNA technology will be directed at the “growing threat” of antimicrobial resistance.
Dame Jenny Harries said: “Infectious diseases are making a comeback.
“Drug resistance is not helping our fight against TB. It is a growing problem. Some TB strains are no longer responding to some of our usual antibiotics.
“But our scientific progress using genome sequencing means we can now track down chains of transmission faster as well as look at each sample taken from a patient and predict which drug they will respond to and ensure the most effective treatment is provided.”
Latest data shows an overall TB rate of 7.8 cases per 100,000 of the population in 2021, an increase from 7.3 the previous year.
This compared to 4.7 in Germany and 2.4 in the US - which is on track to eradicate the disease in the coming years.
Multi drug resistant TB has a much higher mortality rate killing almost a third of patients.
While the percentage of infections that are drug resistant is still a small fraction of overall cases, this is growing.
WGS analyses the entire genome and has been introduced to the NHS from 2017 to identify patients with an infection resistant to a particular drug, so a different course of antibiotics can be offered.
Back then it was the first time that this has been used to diagnose and manage a disease at this scale anywhere in the world.
Drug resistant TB kills quickly so this rapid diagnosis following analysis the UKHSA lab in Birmingham is vital.
Previously it could take up to a month to confirm a diagnosis of TB and the treatment choices.
It comes a day after the Mirror reported from the frontline in the “hidden pandemic” from a South African slum with some of the highest rates of drug resistant TB globally.
Experts there revealed TB is now overtaking Covid-19 as the most deadly infectious disease in the world.
The UKHSA has said unless immediate action is taken England will fail to meet the World Health Organisation’s “End TB” target of a 90% reduction in cases by 2035.
Provisional data from 2022 indicates we remain off trajectory.
Prof Harries, who was awarded an OBE for her work during the Covid-19 pandemic, said: “The UK Health Security Agency is working with the NHS and partners across the country to get England back on track.”
She added: “While TB can be life threatening without appropriate treatment, in the vast majority of cases it can be successfully treated with antibiotics.
“Getting diagnosed early will help you receive treatment sooner – don’t put off a visit or call if you have concerns.”
Drug resistance to TB is increasing globally with latest World Health Organisation data identifying a 3% jump in 2021 - the first such increase since records began in 2004.
Latest data showed 1.7% of all TB cases had confirmed multi-drug resistance in 2020, up around 30% from 1.3% in 2019.
These years were impacted by isolation rules linked to the Covid-19 pandemic when fewer people were catching other infectious diseases and being treated for them.
Most UK cases have historically been imported via London from China, India, Pakistan and Africa.
TB rates are highest in England than other UK nations but numbers also crept up in Scotland and Wales last year. Wales recorded 2.8 cases per 100,000 of population in 2021, as did Northern Ireland, while Scotland reported 4.2 cases. The overall UK rate was 7.1 cases per 100,000.
The UKHSA told the Mirror it has carried out WGS on 11,000 TB patients since 2018to predict which antibiotics will be effective.
Early diagnosis can help - don't put off calling your doctor if you have concerns
By Professor Dame Jenny Harries, Chief Executive of the UK Health Security Agency
Infectious diseases are making a come-back. New pathogens are emerging globally, cases of measles are on the rise again in England and overseas and it is very clear that tuberculosis too is not an infection consigned to the history books in this country.
Cases of TB in England had been falling significantly since 2011, when incidence here was amongst the highest in western Europe - more than 8,280 cases recorded that year alone. But in 2019 that rate of decline reversed and latest data show TB is on the rise again post-pandemic. England is still classed as a ‘low incidence’ country, and rates are nearly half what they were in 2011, but it’s important that we – the public and healthcare professionals – don’t rule out the common signs and symptoms of TB.
A cough lasting longer than three weeks, unexplained weight loss, a high temperature, drenching night sweats, not wanting to eat, and feeling very tired or having no energy are among the most common symptoms - but they can vary from person to person.
If you have these symptoms, please contact your GP surgery or use NHS 111 Online so you can be assessed.
While TB can be life threatening without appropriate treatment, in the vast majority of cases it can be successfully treated with antibiotics. Getting diagnosed early will help you receive treatment sooner – don’t put off a visit or call if you have concerns.
As with many diseases some people are at greater risk of infection than others - those who have had contact with a person with infectious TB, those who have come to the UK from countries where TB is common and those with weakened immune systems.
TB remains a risk to some of the most vulnerable people in our society including those with certain social risk factors: homelessness, substance misuse or prison history. Our public health recommendations are designed to make sure those most at risk are offered TB screening and supported to get the diagnosis and treatment they need.
Drug resistance is not helping our fight against TB. It is a growing problem. Some TB strains are no longer responding to some of our usual antibiotics.
But our scientific progress using genome sequencing means we can now track down chains of transmission faster as well as look at each sample taken from a patient and predict which drug they will respond to and ensure the most effective treatment is provided.
Through our TB Action Plan, the UK Health Security Agency is working with the NHS and partners across the country to get England back on track and ensure that everyone has access to a timely diagnosis and treatment. And through the UKHSA’s work supporting countries to develop their own genome sequencing capabilities we are contributing to the WHO End TB goal worldwide.
