Travel Guard Health Advisory: Tuberculosis (TB)

An individual contracts bacteria, and the body is unable to fight it. The bacteria continues to grow and multiply. Symptoms include:

• Bad cough that lasts 3 weeks or more
• Coughing up blood or sputum
• Weakness or fatigue
• Weight loss
• Chills
• Fever
• Night sweats

This individual may spread TB bacteria to others, may have abnormal chest x-rays, positive sputum smear or culture, and usually has a skin test or blood test indicating infection.

An individual contracts bacteria but does not get sick because the body is able to fight the bacteria and stop it from growing. This individual has no symptoms and does not feel sick, cannot spread TB bacteria to others, but usually has a positive TB skin test reaction or blood test. TB Disease may develop if treatment is not received.

TB is treatable and curable. Active, drug-sensitive TB is treated with a standard six-month course of four antimicrobial drugs that are provided with information, supervision and support to the patient by a healthcare worker or trained volunteer. Bacille Calmette-Guérin (BCG) is a vaccine for TB. It is often given to infants and small children in countries where TB is common. It does not always protect people from getting TB.

Travellers should avoid close contact or prolonged time with known TB patients in crowded, enclosed environments, such as clinics, hospitals, prisons, or homeless shelters.

Air travel itself carries a relatively low risk of infection with TB of any kind. Travellers who will be working in clinics, hospitals, or other health care settings where TB patients are likely to be encountered should consult infection control or occupational health experts. Ask about administrative and environmental procedures for preventing exposure to TB. Once those procedures are implemented, additional measures could include using personal respiratory protective devices.

Travellers who anticipate possible prolonged exposure to people with TB should have a TB skin test or a TB blood test. If the test reaction is negative, they should have a repeat test 8 to 10 weeks after returning to their countries.

Annual testing may be recommended for those who anticipate repeated or prolonged exposure to TB or an extended stay over a period of years in a location where TB is prevalent. Because people with HIV infection are more likely to have an impaired response to TB tests, travellers who are HIV positive should tell their physicians about their HIV infection status.