Tuberculosis and air travel: WHO guidance in the era of drug-resistant TB
Stop TB Department, World Health Organization, 1211 Geneva 27, Switzerland.Travel Medicine and Infectious Disease (Impact Factor: 1.67). 08/2008; 6(4):177-81. DOI: 10.1016/j.tmaid.2007.10.004
Air travel provides opportunities for infectious diseases to spread rapidly between countries and continents. There may be a potential risk of transmission during the flight, notably with airborne and droplet-borne respiratory infections. Seven episodes of potential transmission of TB infection during air travel reported in 1992--1994 caused widespread concern. Contact investigations revealed evidence of transmission of infection in two instances but active TB disease was not found in any of the infected individuals, or in subsequently published cases. In recent years, multidrug-resistant TB (MDR-TB) has become an increasingly important public health problem in many countries, exacerbated by the emergence of extensively drug-resistant TB (XDR-TB). The potential risk of transmission of particularly dangerous forms of TB requires renewed vigilance. The revised International Health Regulations (1995) include new provisions which are relevant to the transmission of TB on aircraft. WHO published a second edition of Tuberculosis and air travel: guidelines for prevention and control in 2006, providing updated information and specific guidance for passengers and crew, physicians, public health authorities and airline companies. Following several recent incidents involving MDR-TB and XDR-TB in airline passengers, the 2006 recommendations will be amplified in the light of experience gained and the evolving epidemiological situation.
Article: Travel and public health[Show abstract] [Hide abstract]
ABSTRACT: Increasing international travel and migration can interfere with public health in both the country of destination and back home. The revised International Health Regulations (IHR) and travel disease sentinel networks are means to protect public and individual health. Public health risks related to infectious disease are higher in mass gatherings, in travellers visiting friends and relatives and in sexual encounters away from home. In contrast, in-flight transmission of infections plays only a limited role.
Article: Chagas Disease in Florida[Show abstract] [Hide abstract]
ABSTRACT: Figure 1. Trypanosoma cruzi and Triatoma sanguisuga As many as eight to eleven million people in Mexico, Central America, and South America have Chagas disease. Most people are asymptomatic and do not know they are infected. However, approximately 20% to 30% of those with chronic infection will develop clinically apparent disease, making it a significant public health concern. Chagas disease is caused by infection with Trypanosoma cruzi, a protozoan parasite. In Chagas endemic countries, it is typically transmitted by infected triatomine bugs, commonly known as kissing bugs. The insects defecate during or after feeding and the feces enter the human body through the bite wound or mucous membranes. Alternatively, transmission can occur congenitally (from mother to infant), through blood transfusion or organ transplantation, accidental laboratory exposure, or rarely through ingestion of food contaminated by infected bugs. Transmission in the U.S. is rare and does not follow the same pattern as endemic countries. Congenital and transfusion transmission are more common, mostly attributed to better housing conditions. Additionally, the triatomine species present in the U.S. (Triatoma sanguisuga) prefer animal hosts and do not defecate immediately after feeding.
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