TB Risks During International Travel

Posted on Wed, June 01, 2005

By Charles M. Crane M.D., MPH

YOU CAN BRING back an ailment more serious than diarrhea when you travel out of the United States. Tuberculosis (TB) is among the risks of international travel, especially to countries that have a high TB rate.

TB is a serious, contagious disease in which the infected person may feel fine for years, but eventually may become quite ill.

If you plan to spend your vacation in such an area, you might consider taking a TB skin test prior to leaving, and again three months after you return.

If this test is negative prior to your vacation, then positive after, it means you have been infected with the TB germ, and you need treatment. Early treatment can help avoid serious illness.

Most infected people never get sick from TB and are not infectious. However, once infected, you are at risk of developing active TB (cough or other symptoms) and unknowingly spreading it to others, including your family.

Treatment of latent TB infection (i.e., the germ is in your body, but you have no cough or other symptoms yet) is often recommended because it reduces that risk of developing active TB.

Tuberculosis kills two million people annually worldwide. The disease is transmitted through the air when a person with active TB disease coughs, shouts, sings, sneezes, or even just speaks.

If diagnosed early, TB is curable, although the treatment lasts six to nine months. An exception is if you have multi-drug resistant (MDR) TB, a more deadly strain that is much more difficult to cure.

Casual contact with an infectious person is not likely to lead to TB infection, but there is a risk from traveling in countries with very high TB rates like sub-Saharan Africa, India and China. Russia and other former Soviet states not only have high rates of TB, but also of the more resistant strain.

TB rates are also high in South America, Central America, Asia, Eastern Europe, Southeast Asia and the Pacific Islands.

The level of risk also depends on what you do abroad. In order to get infected, you generally have to spend an extended period of time near a person with active TB.

I once had a patient who got TB infection from traveling for a few weeks on a bus in the Amazon. On the other hand, a 15-minute bus ride isn't likely to do it.

There have been cases of airplane passengers getting TB from an infectious passenger during flights of eight-hours. The risk of infection while outdoors is lower because air dissipates the germ.

If you notice someone with a serious and persistent cough, and you're in a bus or a building, move away or open a window if possible.

Symptoms of active TB disease include a cough with phlegm lasting at least three weeks, accompanied by fever, night sweats, and/or weight loss. If you have these symptoms, see a medical provider right away, or call 800-495-8885 to speak with a financial counselor and make an appointment with one of our health providers.

People without a regular doctor can call the Contra Costa Public Health toll-free at 877-405-8573 for information on where to get a TB skin test. For more TB information, visit Contra Costa Health Services' Web site.

Charles M. Crane, M.D., MPH, is the Medical Director for Contra Costa Health Services' Tuberculosis Program.