According to the statistics by WHO, about 95% of the 9 million cases of TB worldwide have occurred in developing countries. This poses a great risk of tuberculosis exposure during travel from one country to another. Hence it is prudent to understand the possible risks and the associated measures to prevent TB during travel. This blog walks you through the same in detail.
The Risk of Air Travel And Tuberculosis
Image Reference: https://www.everydayhealth.com/tuberculosis/guide/risk-factors-causes-prevention/
Research has indicated that the risk of transmitting communicable diseases during air travel is relatively low. However, it’s important to acknowledge that the reported cases of transmission might be underestimated, primarily due to the longer incubation periods of many diseases compared to the duration of flights. Airborne and droplet-borne diseases such as tuberculosis (TB), influenza, meningococcal disease, measles, and SARS can potentially spread on aircraft.
TB, caused by mycobacteria, is among the diseases of concern. It spreads through exposure to airborne droplet nuclei containing tubercle bacilli when an infectious individual coughs, sneezes, sings, or talks. The progression of TB involves two stages: infection and active disease, with only a small minority developing the latter, often within five years of exposure. While the greatest risk of progression is within the first two years, latent infection can persist for life.
Image Reference: https://www.medicoverhospitals.in/diseases/tuberculosis/
To mitigate the risk of TB transmission, the airline industry adheres to WHO guidelines, and some countries maintain “DO NOT FLY” lists for public health reasons. Fortunately, there have been no reported cases of active TB transmission on commercial aircraft, thanks in part to HEPA filter systems that cleanse cabin air. These systems operate even when the plane is on the tarmac, and WHO recommends limiting ground delays to 30 minutes to maintain clean cabin air. Travelers can be reassured that, under normal conditions, cabin air is cleaner than that in most buildings, reflecting the industry’s commitment to passenger health and safety.
Some Precautionary Measures Before Traveling
Before traveling, especially by commercial air transportation, individuals should consider several precautionary measures related to tuberculosis risk. The likelihood of acquiring TB during travel depends on factors such as the extent of disease in a TB patient, the duration of exposure, and the quality of ventilation. It’s crucial to note that the presence of an infectious TB patient on the same flight is a key factor in determining risk, particularly on flights lasting 8 hours or more.
The precautionary measures need to be taken by everyone including the passengers, their physicians as well as the public health authorities. People with infectious or potentially infectious TB should delay air travel until they are no longer contagious. Physicians should emphasize that TB patients must not travel by air until they are sputum smear-negative on at least two occasions, especially for multidrug-resistant TB cases. Physicians should promptly notify public health authorities if a TB patient intends to travel against medical advice or has exceptional circumstances requiring air travel. Public health authorities should collaborate with airlines to ensure safe travel for infectious TB patients with exceptional needs, securing approval and appropriate procedures for their journey. These measures are essential to prevent TB transmission during air travel and safeguard public health.
References:
https://apps.who.int/iris/bitstream/handle/10665/43921/9789241547505_eng.pdf?sequence=1
https://www.iamat.org/travel-and-tuberculosis
https://www.ncbi.nlm.nih.gov/books/NBK143721/
https://www.cdc.gov/tb/publications/factsheets/general/tbtravelinfo.htm
https://www.everydayhealth.com/tuberculosis/guide/risk-factors-causes-prevention/
https://www.medicoverhospitals.in/diseases/tuberculosis/
Note to graphic designer: Both the images added in the draft provide information related to tuberculosis. While the first displays the method of transmission of the disease, the second talks about the signs and symptoms to be vary of.