Rise of Dickensian disease that killed millions – as Manchester faces more infections than almost anywhere else

A Dickensian disease responsible for killing millions in Victorian Britain is making a post-pandemic comeback – with more infections identified in Manchester than almost anywhere else in the country. Tuberculosis or TB – also known as “consumption” – caused the deaths of an estimated four million people between 1851 and 1910.

It was the scourge of the 18th and 19th centuries and featured heavily in the literature of the time, with Charles Dickens, Elizabeth Gaskell, and Samuel Richardson among the authors writing about the disease. TB is thought to be one of the illnesses afflicting Tiny Tim in Dickens’ A Christmas Carol.




Although it is now curable, TB is still the second leading infectious killer globally, behind Covid-19. In the UK, cases and infection rates had been falling since 2011, as the health authorities work toward the elimination of the disease.

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However, the UK Health Security Agency (UKHSA) says that progress has now stalled. Cases went up during the pandemic in 2021 and then remained stable last year. So far this year the UKHSA has received notifications of 4,813 cases of TB in England and Wales – a seven per cent increase on the 4,480 cases over the same period during the previous year. It is also higher than in 2021 (4,557).

And, authorities have received notifications of 368 TB infections identified in Greater Manchester, with 150 cases in the city of Manchester alone. Of all local authority areas in England and Wales, only Birmingham had more cases of TB than Manchester.

TB is often linked to areas with high levels of deprivation and Manchester has the sixth highest proportion of neighbourhoods ranked among the 10 per cent most deprived in England. Birmingham has the fifth highest proportion of the most deprived neighbourhoods.

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