The number of tuberculosis cases in the UK topped 9,000 last year, the highest for nearly 30 years, figures show.
Diagnoses have been rising almost continuously since the 1980s, with many of the new cases thought to be among people who caught the disease abroad.
There has also been a sharp rise in drug-resistant TB cases: figures have nearly doubled since 2000 to 389.
The Health Protection Agency, which released the figures, said more efforts must be made to curb the problem.
TB can be fatal if not diagnosed early enough and there are around 350 deaths in England every year.
Tuberculosis
The majority of cases occur in London and other urban areas, and it is particularly common among the homeless and drug users.
The disease, caused by bacteria, infects the lungs and typical symptoms include cough, fever, tiredness, lack of appetite and weight loss.
But people can have the illness for several years without feeling at all unwell – which is one of the reasons it spreads so quickly.
Health Protection Agency officials also warn that the bacteria are becoming resistant to the treatment because patients are stopping taking the drugs too soon.
Dr Paul Cosford, executive director of health protection services at the HPA, said: ‘Although drug-resistant and multi-drug resistant cases of infection represent only a small proportion of TB cases overall, each resistant case requires careful and often prolonged treatment and care.
‘Drug resistance is increasingly an issue in a wide range of infections.
‘Patients must ensure they take their full prescription as instructed and, most importantly, they must finish any course of treatment that has been prescribed.’ Dr Ibrahim Abubakar, who is head of TB surveillance at the HPA, added: ‘We are concerned to see that cases of TB are at their highest levels since the 1970s.
Tuberculosis
‘Tuberculosis is a preventable and treatable condition.
‘But, if left untreated, it can be life threatening.
‘The key to reducing levels of TB is early diagnosis and appropriate treatment.
‘Efforts to improve early diagnosis and control the spread of this infection must remain a priority and be increased in areas where prevalence is high.’
Figures show that London had 3,440 cases of TB last year – which is 38 per cent of the total number of infections.
Up to 1,018 cases were recorded in the West Midlands, followed by 816 cases in the North West.
Most TB sufferers can be treated with a six-month course of multiple antibiotics.
However, those with drug-resistant TB may need to be treated for 18 months or longer.
In 2009, almost 7 per cent of new TB cases were resistant to the first-line antibiotic treatment, isoniazid.
Office for National Statistics figures for 2008 showed there were 334 deaths in England and Wales where TB was the underlying cause.
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Q. Why is it on the rise?
A. ATB was common in the UK in Victorian days. During the 20th Century it became rarer due to improvements in public health, living conditions, nutrition, treatment and vaccination. Now it is being seen again due to the ageing population, an increase in poverty and immigration from areas where TB is endemic.
Q. What about vaccinations?
A. Since 2005 the blanket policy of vaccinating all UK schoolchildren has changed. This is because the patterns of TB have changed and there are parts of the country where TB rates are so low that it is deemed unnecessary. The vaccines are now targeted at highrisk groups, including healthcare workers and immigrants from endemic areas, and those in highrisk areas.
Q. What are the symptoms?
A. The main symptom is a persistant cough that can cause sufferers to bring up blood. Sweating, fever and weight loss are common. TB sufferers also feel tired, lose their appetite and experience shortness of breath.
Q. Can my GP diagnose it?
A. If you have a catalogue of symptoms suggestive of TB, your GP can organise tests to definitively diagnose it. Commonly, a chest Xray is needed as well as sputum tests to check whether the bacteria can be seen in the laboratory. If these tests prove positive, you will be referred to a TB clinic.
Is it becoming harder to treat?
A. In the past decade some TB has become resistant to standard treatment. Experts say this is because patients do not take their TB drugs and do not finish the course. Normal TB requires six months of treatment; drug-resistant TB can need 18 months.
Q. Why does TB treatment take six months if a normal antibiotic course is a week?
A. Commonly used antibiotics are not effective with TB – a combination of special antibiotics is needed. TB is caused by a bacterium that is much harder for the body to get rid of than normal bacteria, so only a long course can clear them. Sufferers usually feel better after a few weeks but treatment must continue for the full course.