Fact Sheet
Tuberculosis Information for International Travelers
For more
information on TB, please see the TB Fact Sheets page
PDF version formatted for print (39 kb)
What is tuberculosis (TB)?
Tuberculosis (TB) is a disease caused by
germs that are spread from person to person through the air. TB
usually affects the lungs, but it can also affect other parts of the
body, such as the brain, the kidneys, or the spine. In most cases,
TB is treatable and curable; however, persons with TB can die if
they do not get proper treatment.
What is multidrug resistant tuberculosis (MDR TB)?
Multidrug-resistant TB (MDR TB) is TB that is resistant to at
least two of the best anti-TB drugs, isoniazid and rifampin. These
drugs are considered first-line drugs and are used to treat all
persons with TB disease.
What is extensively drug resistant tuberculosis (XDR TB)?
Extensively drug resistant TB (XDR TB) is a rare type of MDR TB.
XDR TB is defined as TB which is resistant to isoniazid and rifampin,
plus resistant to any fluoroquinolone and at least one of three
injectable second-line drugs (i.e., amikacin, kanamycin, or
capreomycin).
Because XDR TB is resistant to first-line and secondline drugs,
patients are left with treatment options that are much less
effective.
XDR TB is of special concern for persons with HIV infection or
other conditions that can weaken the immune system. These persons
are more likely to develop TB disease once they are infected, and
also have a higher risk of death once they develop TB.
How does drug resistance happen?
Resistance to anti-TB drugs can occur when these drugs are
misused or mismanaged. Examples include when patients do not
complete their full course of treatment; when health-care providers
prescribe the wrong treatment, the wrong dose, or length of time for
taking the drugs; when the supply of drugs is not always available;
or when the drugs are of poor quality.
How is TB spread?
Drug-susceptible TB and MDR TB are spread the same way. TB germs
are put into the air when a person with TB disease of the lungs or
throat coughs, sneezes, speaks, or sings. These germs can float in
the air for several hours, depending on the environment. Persons who
breathe in the air containing these TB germs can become infected.
TB is not spread by
- shaking someone’s hand
- sharing food or drink
- touching bed linens or toilet seats
- sharing toothbrushes
- kissing
How does drug resistance happen?
Resistance to anti-TB drugs can occur when these drugs are
misused or mismanaged. Examples include when patients do not
complete their full course of treatment; when health-care providers
prescribe the wrong treatment, the wrong dose, or length of time for
taking the drugs; when the supply of drugs is not always available;
or when the drugs are of poor quality.
Are international travelers at risk for getting MDR or XDR TB
while traveling?
Although MDR and XDR TB are occurring globally, they are still
rare. HIV-infected travelers are at greatest risk if they come in
contact with a person with MDR or XDR TB. All travelers should avoid
high risk settings where there are no infection control measures in
place.
Documented places where transmission has occurred include crowded
hospitals, prisons, homeless shelters, and other settings where
susceptible persons come in contact with persons with TB disease.
Air travel itself carries a relatively low risk of infection with
TB of any kind.
What is the risk of acquiring TB on an airplane?
The risk of acquiring any type of TB depends on several factors,
such as extent of disease in the patient with TB, duration of
exposure, and ventilation. Most important, there must be someone
with infectious TB disease on the same flight to present any risk.
If someone on the flight does have TB disease, persons on flights
lasting 8 hours or longer are at greater risk than persons on
shorter flights.
How can TB be prevented?
Travelers should avoid close contact or prolonged time with known
TB patients in crowded, enclosed environments (for example, clinics,
hospitals, prisons, or homeless shelters).
Travelers 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.
They should 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.
Is there a vaccine to prevent TB?
Yes, there is a vaccine for TB disease called
Bacille Calmette-Guérin (BCG). It is used
in some countries to prevent severe forms of TB in children.
However, BCG is not generally recommended in the United States
because it has limited effectiveness for preventing TB overall.
What should I do before traveling internationally?
Travelers who anticipate possible prolonged exposure to persons
with TB (for example, those who expect to come in contact routinely
with clinic, hospital, prison, or homeless shelter populations)
should have a tuberculin skin test (TST) before leaving the United
States. If the test reaction is negative, they should have a repeat
test 8 to 10 weeks after returning to the United States.
Additionally, annual testing may be recommended for those who
anticipate repeated or prolonged exposure or an extended stay over a
period of years. Because persons with HIV infection are more likely
to have an impaired response to the TST, travelers who are HIV
positive should tell their physicians about their HIV infection
status.
What should I do if I think I have been exposed to someone with
TB disease?
If you think you have been exposed to someone with
TB disease, you should contact your doctor or local
health department about getting a TB skin test or
special TB blood test. And tell the doctor or nurse
when you spent time with this person.
What are the symptoms of TB disease?
The general symptoms of TB disease include feelings of sickness
or weakness, weight loss, fever, and night sweats. The symptoms of
TB disease of the lungs also include coughing, chest pain, and the
coughing up of blood. Symptoms of TB disease in other parts of the
body depend on the area affected. If you have these symptoms, you
should contact your doctor or local health department.
Where can I find other health information about my travel
destination?
CDC’s Travelers’
Health website lists health information for travelers by
destination.
CDC issues
travel notices when there is a health threat to travelers. These
notices describe levels of risk for the traveler and recommended
preventive measures to take at each level of risk. Travel notices
are organized by disease and by travel destination.
Additional Information
CDC. Questions and Answers About TB
(2005).
CDC. Tuberculosis: General Information
(2006).
CDC. Tuberculin Skin Testing (2006).
CDC. BCG Vaccine (2006).
CDC. Health
Information for International Travel – The “Yellow Book”: Chapter 4
– Prevention of Specific Infectious Diseases: Tuberculosis
(2005-2006).
WHO. Tuberculosis and Air Travel: Guidelines for Prevention and
Control (2006) (PDF).
Last Modified: 10/7/2008
Last Reviewed: 05/18/2008 Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
|