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Tuberculosis or TB is caused by a slow growing bacterium called Mycobacterium tuberculosis. Most individuals infected with M.tuberculosis remain asymptomatic, but a small proportion of infected individuals develop a clinical illness, sometimes many years after the original infection. TB is primarily a disease of the lungs, with common symptoms being cough, coughing up blood, fever, sweats and weight loss. However, the infection can spread via the blood from the lungs to all organs in the body. Infants, the elderly and people with impaired immunity are more prone to rapidly progressive or generalised infection.^7,51,52

Transmission
Transmission is usually by direct person-to-person mainly by airborne droplets from coughs of infected persons.^7,51 There is virtually no danger of it being spread by dishes, linens, and items that are touched, or by most food products.⁵² However, it can be transmitted through unpasteurised milk or milk products obtained from infected cattle.⁵²

Geographical distribution⁵¹
Worldwide. The risk of infection differs between countries.⁵¹

See tuberculosis distribution map

Risk to travellers⁵¹
Low for most travellers. Long-term travellers (over 3 months) to a country with a higher incidence of tuberculosis than their own may have a risk of infection comparable to that for local residents. As well as the duration of the visit, living conditions are important in determining the risk of infection; high-risk settings include health facilities, shelters for the homeless, and prisons.

Precautions and prevention

• BCG vaccine is of limited use for travellers but may be advised for infants and young children in some situations (see your doctor).⁵¹
• Avoid close contact or exposure to known tuberculosis patients in crowded environments (e.g. hospitals, prisons, or homeless shelters).⁵²
• For travellers from low-incidence countries who may be exposed to infection in relatively high-incidence countries (e.g. health professionals, humanitarian relief workers, missionaries), a baseline tuberculin skin test is advised in order to compare with retesting after return.⁵¹

(Please read the Disclaimer before using the ABC Guide to Travel Health).

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