Lethal Stomach Bug Cases Surge in England, Rise Over 50% Since 2020

Cases of the potentially fatal stomach bug Clostridioides difficile (C. diff) have surged across England, with infections increasing by more than 50 percent between 2020 and 2025. Analysis of data from the UK Health Security Agency by clinical research company TrialMed indicates that infections rose from approximately 12,500 a year in 2020/21 to around 19,000 in 2024/25.

The North West region, encompassing areas like Liverpool and Manchester, experienced a particularly sharp rise of approximately 64 percent over the same period. This region now has an infection rate of 46.5 cases per 100,000 residents, compared to 28.4 per 100,000 five years prior. In contrast, London recorded the lowest rate at 18.8 per 100,000, though this still represents a 25 percent increase.

C. diff is a highly infectious bacterium that spreads through spores found in feces. These spores can contaminate surfaces and food and survive for extended periods. Infection can occur through accidental ingestion of spores after touching contaminated surfaces or by consuming contaminated food. Symptoms include severe diarrhea, fever, loss of appetite, stomach pain, and sickness. In approximately one in seven cases, C. diff can lead to dangerous complications like peritonitis, a life-threatening infection of the abdomen's inner lining.

Experts attribute the rise to various factors, including regional demographic differences, antibiotic prescribing patterns, population health, healthcare usage, and the prevalence of high-risk patients. Antibiotics can disrupt the gut's natural balance of bacteria, allowing C. diff to multiply. Individuals over 65 are considered particularly at risk due to potentially weakened immune systems and a higher likelihood of receiving antibiotic prescriptions.

C. diff is also a leading cause of hospital-acquired diarrhea. Worryingly, a recent survey of over 1,000 NHS staff found that nearly 80 percent were unaware of the necessary hygiene steps to prevent patient transmission. Furthermore, one in five staff members reported not routinely testing for C. diff when a patient developed diarrhea in a hospital setting.

Dr. Jane Freeman, secretary of the C. diff Trust, emphasized the importance of accurate diagnosis and timely testing by healthcare professionals. She warned that failure to manage C. diff infections can have long-term consequences for patients, delaying treatment for other conditions and causing anxiety about recovery, as the infection can recur in 25 to 30 percent of individuals.

Official NHS guidance recommends measures to reduce the risk of spreading C. diff, including staying home for 48 hours after diarrhea subsides, regular handwashing with soap and water, cleaning and disinfecting toilets after each use, and washing soiled clothing and bedding separately. C. diff spores are highly resistant to heat and disinfectants, making them easily spreadable in healthcare environments.