Infectious Diseases on the Rise in England, UKHSA Reports

The UK Health Security Agency (UKHSA) has warned of a “re-emergence” and “re-establishment of some infectious diseases in England. A report highlighted a particular resurgence of endemic diseases and vaccine-preventable infections since 2022.

The UKHSA’s 2025 report is its first annual update on infectious disease trends. Publication followed the release this week of the agency’s high-threat pathogen watchlist, which identified 24 pathogen families posing the greatest potential threat to UK biosecurity.

The COVID-19 pandemic and associated social restrictions reduced transmission rates of many infections, However, alterations in healthcare delivery, including disruptions to routine vaccination programmes, have had long-lasting effects. Richard Pebody, director of epidemic and emerging infections at UKHSA, highlighted these changes. 

“It is clear that a number of factors altered the rates and impact of endemic and epidemic infectious diseases in England over recent years,” Pebody said. “The reductions in transmission related to the COVID-19 pandemic have been followed by a rise in a range of infections since 2022 to 2023, due to the return of social mixing, international travel, and migration.”

Rising Infections and Increased Healthcare Burden

The report noted that in 2023-2024, infectious diseases were primarily responsible for more than 20% of hospital bed usage, with an annual cost of £5.9 billion. 

Several diseases have seen notable increases in cases. 

A resurgence of measles, for example, saw 362 laboratory-confirmed cases in England in 2023. However, this surged to 2911 cases in 2024. Pertussis (whooping cough) also rose sharply, with laboratory-confirmed cases increasing from 856 in 2023 to a provisional 14,905 in 2024.

Pebody also noted a decline in vaccination uptake, particularly for measles and pertussis. Uptake of the flu vaccine had declined in some groups, including at-risk individuals under 65, pregnant women, and healthcare workers.

Rising Tuberculosis and Norovirus Cases

Tuberculosis (TB) cases rose by 11% in 2023 compared with 2022. Provisional data has suggested a further increase of 13% for 2024, potentially jeopardising the UK’s low-incidence status with the World Health Organization (WHO).

Norovirus had seen an earlier increase than usual in autumn 2024, with weekly data from February 2025 showing the highest levels since current reporting methods began in 2014. Experts warned last month of a potential second wave.

England has seen the largest number of gonorrhoea diagnoses since records began in 1918, as well as the highest number of syphilis cases since 1948. The rise in Legionella infections, with 604 cases reported in 2023, also marks the highest level since 2017. Additionally, cases of resistant bloodstream infections have been increasing since 2021.

Optimism Amidst the Challenges

Despite these concerning trends, there is some cause for optimism. E arly assessment of the respiratory syncytial virus (RSV) vaccine programme in older adults showed a 30% reduction in the confirmed RSV hospital admission rate in eligible 75-79 year olds. In addition, flu vaccine uptake in older adults exceeded the WHO target of 75% for the fourth consecutive season in 2023-2024.

Progress has also been made towards the goal of eliminating viral hepatitis C (HCV) by 2030. The number of people living with chronic HCV infection dropped by 57% from 2015 to the end of 2023. England is also meeting or exceeding WHO targets for hepatitis B virus (HBV) mortality, incidence, mother-to-child transmission, and vaccine coverage. COVID-19 transmission has declined, with the virus circulating at baseline levels of activity for much of the current winter season. 

While there has been progress, the UKHSA stressed that more action is needed to tackle the rise in infectious diseases. “We need to be bolder, as much of this harm and distress is preventable,” Dame Jenny Harries, UKHSA chief executive, said in a statement.

Dr Rob Hicks is a retired NHS doctor. A well-known TV and radio broadcaster, he has written three books and has regularly contributed to national newspapers, magazines, and online. He is based in the UK.