Not every persistent cough will be Covid-19.

That's the warning from health officials concerned about rising cases of tuberculosis in England, where symptoms can be very similar to those associated with coronavirus.

Tuberculosis is a serious infectious disease and can show itself with a persistent cough, lasting longer than 3 weeks, and a fever. Those infected may also experience extreme tiredness, breathlessness and a lack of appetite.

While it can be life threatening without appropriate treatment, in the majority of cases it can be successfully treated with antibiotics if caught.

Rates of TB in England had fallen significantly since 2011 when the country had one of the highest incidences in Western Europe with more than 8,000 cases recorded.

However since the pandemic, which is thought to have kept cases artificially low because of lockdown and access to healthcare during that time, the rate of decline has been reversed and cases were up 7% in 2021 and are thought to still be rising.

TB, says the UK Health Security Agency, 'disproportionally' impacts under-served populations such as those who have been homeless, spent time in prison or misused drugs and other substances. But other risk factors that may increase someone's likelyhood of catching the disease include having been in close contact with a person with infectious TB, coming from a country which has a high rate of TB or having a weakened immune system.

Anyone with a cough, but particularly those who know they are in groups that are at a higher risk, are being urged not to dismiss their symptoms as coronavirus as they could be caused by a range of other health issues.

Dr Jenny Harries, the CEO of UKHSA, explained: "TB is curable and preventable and now is the time to get our elimination efforts back on track. Despite significant progress towards elimination in recent years, tuberculosis remains a serious public health issue in the UK.

"With treatment, most people will make a full recovery, but delayed diagnosis and treatment, particularly during the pandemic, will have increased the number of undetected TB cases in the country. It is important to remember that not every persistent cough, along with a fever, is Covid19.

"A cough that usually has mucus and lasts longer than 3 weeks can be caused by a range of other issues, including TB."

Tuberculosis, says the UKHSA can develop very slowly and it may take several weeks or months - possibly even years - after someone is infected before they may notice they are unwell.

The numbers and rates of cases with drug resistance also increased in both 2019 and 2020 - where 11.6% of cases were resistant to any drug - and so the advice is to contact a GP and request a test if you think you're at risk.

Health and Social Care Secretary Sajid Javid added: "Despite significant progress made in the last decade towards eliminating tuberculosis in England, it is very concerning to see an upward trend in cases. TB is a serious infectious disease, and without treatment it can be life-threatening.

"TB disproportionately affects people in deprived and underserved groups, so it is vital everyone has access to effective treatment so we can continue to level up health across the nation."