TRAVEL GUARD® HEALTH ADVISORY: TUBERCULOSIS

Tuberculosis is caused by bacteria called Mycobacterium tuberculosis. It most commonly affects the lungs (pulmonary Tuberculosis) but can also affect other parts of the body, such as the lymph nodes, bones, brain or kidneys.

Tuberculosis is generally treatable and curable with appropriate antibiotic treatment. However, if untreated it can become serious.

Malaysia continues to report cases of Tuberculosis each year (and is considered endemic there). Recent surveillance data indicates an increase of approximately 10% of cases in some regions. Public health authorities are actively monitoring the situation and strengthening case detection and treatment programmes.

Malaysia has established Tuberculosis-control programmes to diagnose, treat, and prevent transmission. Most travelers remain at a low risk of contracting the disease, particularly during short visits.

Tuberculosis spreads through the air when a person with active pulmonary Tuberculosis coughs, sneezes, speaks or sings. The bacteria can stay in the air for several hours, depending on the environment.

Tuberculosis bacteria are more likely to spread indoors or other places with poor air circulation (e.g. inside a car) than in outdoor areas. People nearby may breathe in these germs and then become infected.

Tuberculosis does not spread through casual contact such as handshakes, sharing food or touching surfaces.

Symptoms usually develop gradually over weeks or months and may include:

• Persistent cough, persistent generally meaning lasting more than three weeks
• Coughing up phlegm or blood
• Fever/chills and drenching night sweats
• Unexplained weight loss
• Fatigue or weakness
• Chest pain or shortness of breath

Some individuals may carry latent Tuberculosis infection, meaning the bacteria are present in the body but inactive and without symptoms. Latent Tuberculosis is not contagious but without treatment it can develop into active Tuberculosis at any time.

The risk of developing active Tuberculosis is higher for:

• People with weakened immune systems. This may include individuals with HIV infection, immune disorders or those on immunosuppressive therapy, such as chemotherapy.
• Individuals with certain chronic conditions (e.g., diabetes).
• Young children and the elderly.
• People with prolonged exposure to individuals with active Tuberculosis.
• Healthcare workers or those working in high-risk environments.

General precautions include:

• Avoid prolonged close contact with people who have symptoms of Tuberculosis.
• Ensure good ventilation in indoor environments.
• Practice good respiratory hygiene (covering mouth when coughing or sneezing).
• Seek medical advice if you develop symptoms suggestive of Tuberculosis.

For most travelers, no specific preventive measures are required beyond general health precautions.

If you develop symptoms such as a persistent cough, fever, night sweats or unexplained weight loss, you should:

• Seek medical advice promptly.
• Inform the healthcare provider about your recent travel history.
• Follow medical advice regarding testing and treatment.

Early diagnosis and treatment are important both for recovery and to prevent transmission to others.

Testing for Tuberculosis may include:

• Chest X-ray
• Sputum testing for Tuberculosis bacteria
• Molecular tests

Testing is generally recommended if a person has symptoms suggestive of Tuberculosis or has had significant exposure to a confirmed case.

Yes, the BCG (Bacillus Calmette-Guérin) vaccine protects young children against severe forms of Tuberculosis. BCG is part of routine childhood immunisation programmes in many countries, including Malaysia.

For most travelers, Tuberculosis does not significantly affect travel plans. The risk to short-term travelers remains low.

However, if you feel unwell with symptoms suggestive of Tuberculosis or another respiratory illness, it is advisable to seek medical advice and consider postponing travel until assessed by a healthcare professional.

• World Health Organization (WHO). Global Tuberculosis Report.
  https://www.who.int/teams/global-tuberculosis-programme/tb-reports
• World Health Organization (WHO). Tuberculosis Fact Sheet.
  https://www.who.int/news-room/fact-sheets/detail/tuberculosis
• Ministry of Health Malaysia (Kementerian Kesihatan Malaysia) – Tuberculosis Control Programme information and national surveillance updates.
  https://www.moh.gov.my
• MyTB – Malaysian Tuberculosis Information Portal, Ministry of Health Malaysia.
  https://mytb.moh.gov.my
• Centers for Disease Control and Prevention (CDC). Tuberculosis (TB).
  https://www.cdc.gov/tb