Lethal Stomach Bug Cases Surge in England

Cases of the potentially fatal stomach bug Clostridioides difficile (C. diff) have seen a significant surge across England in the last five years, with infections increasing by more than 50 percent between 2020 and 2025, reaching approximately 19,000 annually. Analysis of data from the UK Health Security Agency by clinical research company TrialMed highlights a particularly sharp rise in the North West region, which includes Liverpool and Manchester.

Regional Trends and Infection Rates

The North West experienced a roughly 64 percent increase in C. diff cases during this period, with an infection rate of 46.5 cases per 100,000 residents in 2024/25, up from 28.4 per 100,000 in 2020/21. This rate is now approximately two and a half times higher than that of London. The South West followed with 37.6 cases per 100,000, an increase from 25.6 five years prior. The Midlands reported 36.6 infections per 100,000, up from 21.5 in 2020/21. The North East and Yorkshire recorded 34.1 cases per 100,000, an increase from 25.5, while the East of England saw a 53 percent rise to 33.1 per 100,000. The South East saw a 25 percent rise to 29.4 per 100,000, and London, with the lowest rate at 18.8 per 100,000, still experienced a 25 percent increase.

Across England, the total number of C. diff infections rose by nearly 52 percent, from 12,500 in 2020/21 to 18,957 in 2024/25. Dr. Marianne Viljoen, a clinical research physician at Trialmed, noted that cases are increasing in every NHS England region and suggested that regional differences likely reflect a combination of factors including demographics, antibiotic prescribing patterns, population health, healthcare usage, and the prevalence of high-risk patients.

Understanding C. diff

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

C. diff is also a leading cause of diarrhea acquired in hospitals. While the bacteria can naturally reside in the bowel without causing harm, individuals taking antibiotics are at higher risk. Antibiotics can disrupt the balance of healthy gut bacteria, allowing C. diff to multiply. Those over 65 are particularly vulnerable due to potentially weakened immune systems, often leading to higher rates of antibiotic prescriptions. The infection can also contribute to sepsis, which affects an estimated 48,000 Britons annually.

Challenges in Prevention and Diagnosis

C. diff spores are highly resistant to heat and many disinfectants, facilitating their spread in healthcare settings. A recent survey of over 1,000 NHS staff indicated that nearly 80 percent were unaware of the necessary hygiene protocols to protect patients from C. diff, and one in five staff reported not routinely testing for the infection in patients with diarrhea.

Dr. Jane Freeman, secretary of the C. diff Trust, emphasized the critical need for healthcare professionals to recognize the risks and ensure timely diagnosis through appropriate testing. She warned that delays in tackling infections can have long-term consequences for patients, potentially postponing essential treatments for other conditions. For many, C. diff can recur, with estimates suggesting it returns in 25 to 30 percent of cases, leading to ongoing anxiety about recovery.

Official NHS guidance for reducing infection risk includes staying home for 48 hours after diarrhea subsides, regular hand washing with soap and water, disinfecting toilets after each use, and washing soiled laundry separately.Experts say infections of Clostridioides difficile – highly contagious bacteria known as C. diff – increased by more than 50 per cent since 2020.