Tuberculosis (TB)

Individuals with latent TB infection are not ill and do not have any symptoms. Active TB disease may cause a persistent cough, fatigue, weight loss, fever, coughing up blood, and night sweats.

Vaccination with BCG is routinely given at birth in most developing countries to minimise the risk of severe illness. In Australia, among other at-risk groups, BCG is recommended for children under five years of age who are travelling for longer than a month, recurrently, or to reside in countries of high tuberculosis prevalence. It should be considered for all children of those visiting friends and relatives in TB-risk countries, as they are likely to travel repeatedly. The effectiveness of BCG in preventing TB in adults has been shown to be variable.

Nonetheless, BCG may be considered (but is often very difficult to obtain) for specific groups of travellers, including missionaries and expatriate aid workers, particularly where they may be exposed to multiple drug-resistant TB infections.

Adult travellers at high risk of exposure to TB while overseas can be screened using a baseline skin test (known as the Mantoux or tuberculin test) or blood test (Quantiferon). These tests may be used to establish a person’s immune status before departure. The test may be done after travel, particularly if there was possible exposure to TB, or if the individual works in a health care environment.

Eradication of latent TB infection with oral medication is generally considered for people under 35 years of age, but not in older individuals who have a higher risk of serious side effects from treatment. It is considered on a case-by-case basis.