Disease Information Sheets
Tuberculosis (TB) is a bacterial infection spread from person to person through the air. It usually affects the lungs, but can also affect other parts of the body. In most cases TB is treatable and curable. Multidrug-resistant TB (MDR TB) is TB that is not susceptible to at least two of the best anti-TB drugs that are commonly used to treat all TB patients. About 3.7% of new cases and 20% of previously-treated cases are MDR TB. Extensively drug resistant TB (XDR TB) is a rare type of MDR TB which is also resistant to additional drugs used to treat TB. Only about one in ten MDR TB cases is XDR TB.
How common is it?
TB is found around the world - there were 8.7 million new cases in 2011 and 1.4 million people died. It is particularly a problem in South America, Sub-Saharan and North West Africa and tropical Asia-Pacific (including the Indian subcontinent and Indonesia).
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80% of the TB cases in the world are in the 22 countries highlighted in this map (Source: Stop TB Partnership)
Are travellers and/or expat workers at risk?
That depends: The likelihood of catching TB is proportional to the proximity and duration of contact with infected people who are actively shedding the bacteria. Therefore TB spreads most effectively in crowded, enclosed environments where lots of people live alongside each other and ventilation is poor, for example hospitals, prisons and homeless shelters. There is also evidence that people attending large gatherings such as the Hajj may be at high risk, as well as aid workers in refugee camps where there is likely to be a high number of infected people.
Expatriates and their families are at risk if they live with the local population, particularly if they are there for a long time. For someone who has a normal immune system it usually takes repeated exposure over a long period before TB infection occurs.
Air travel is not thought to pose a significant risk - although transmission within an aircraft cabin on a long flight is theoretically possible, no cases where this has occurred have been confirmed.
People living with HIV are at much higher risk of TB.
What is the illness?
In healthy people infection often causes no disease, as the person’s immune system “walls off” the bacteria and keeps them at bay. Only people with symptoms spread the disease: general symptoms include weakness, weight loss, fever and night sweats. TB infection of the lungs also causes coughing, chest pain and coughing up blood. If you develop these symptoms you should contact your doctor.
How is it treated?
Yes - TB can be treated with a six to nine-month course of antibiotics.
How can it be prevented?
There is a vaccine (the BCG), but it is not very effective, particularly in adults. It is usually only recommended for certain people going to high risk settings.
Prevention is by avoiding high risk settings (see "Are travellers and/or expat workers at risk?" above).
People travelling to higher risk settings may be advised to take a TB skin test before departure and periodically after returning home.
If you develop a persistent productive cough after having spent time in a high risk country, you should see your doctor and tell him/her about your potential exposure to TB.