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One person a week dies with undiagnosed and therefore untreated tuberculosis in England, a study has found.

British-born, older men were among those most likely to have TB diagnosed only after death, researchers said, suggesting healthcare workers could be overlooking the possibility of the disease in these patients.

Being diagnosed with TB postmortem should be considered a “never event” that prompts urgent investigations, they said, describing it as “the ultimate diagnostic delay”.

Tuberculosis rates in England are at a 10-year high, with 9.4 cases per 100,000 people in 2024. The rate is only just below the World Health Organization’s “low incidence country” threshold of 10 cases per 100,000 – a level expected to be breached when 2025 figures are published.

Most TB cases are diagnosed in people born outside the UK, with an average age of 36. But research published in the journal Thorax found that was not the case in those diagnosed after death, who tended to be older and British-born.

“As TB rates continue to rise, we need to keep asking: ‘Could this be TB?’, even in people who do not fit the usual risk profiles,” said Dr Eleanor Morgan, the study’s co-author and a resident doctor at Liverpool University hospitals NHS foundation trust.

“If England is to eliminate TB, reducing delays in diagnosis will be essential so that fewer people miss the opportunity to receive effective treatment.”

The researchers also found children aged under four were at higher risk, which they said could be linked to underdeveloped immune systems, non-specific symptoms, and challenges in getting samples from very young children for testing.

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Source: The Guardian, 29 June 2026

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