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KMID : 0608619990090030260
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Korean Journal of Aerospace and Environmental Medicine
1999 Volume.9 No. 3 p.260 ~ p.266
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Tuberculosis and Air gravel: Guidelines for Prevention and Control(I) World Health Organization(WHO)
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World Health Organization(WHO)
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Abstract
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Approximately one third of the world's population is infected with Mycobacterium
tuberculosis, and tuberculosis(TB) is the leading cause of death from a single infectious
agent in adult worldwide. In 1996, 3.8 million new cases of TB were reported to the
World Health Organization(WHO), but it is estimated that nearly eight million cases
might have occurred worldwide.
Effective TB control is based on proper detection of cases and appropriate treatment
until cure. The WHO strategy for TB control, Directly Observed Treatment, Short
course(DOTS), ensure that cases are detected and treated with proper regimens. DOTS
remains the highest priority in order to achieve TB control throughout the world.
Over the past few years, technology has made travelling easy and readily available.
Increasingly larger numbers of people are using international air travel for business,
tourism, and other reasons such as immigration or asylum seeking. Several outbreaks of
communicable disease, such as staphylococcal food poisoning, measles, influenza, and
other, following exposure within a commercial aircraft, have been documented. Likewise,
exposure to infectious TB on commercial aircraft is a real concern for both passenger
and crew.
To date, no case of active TB has been identified as a result of exposure while on a
commercial aircraft. However, there is some evidence that transmission of M.
tuberculosis may occur during long(i.e. more than eight hours) flights, from an infectious
source(a passenger or crew member) to other passenger or crew members.
TB infection is acquired through inhalation of M. tuberculosis in aerosolized
respiratory secretions from an infectious person coughing, talking or sneezing. The risk
of infection is related to the proximity and the duration of exposure to the source
patient. Decreased ventilation in crowded and confined environments is often a
contributing risk factor. Although a single flight carries the risk of a relatively limited
exposure, prolonged sojourn in a confined aircraft cabin may increase the risk of
transmission of M. tuberculosis.
In the past few years several episodes of potential transmission of TB infection
during air travel have been reported, some of which raised great anxiety among the
general population, health authorities, mass media and airline companied. On these
occasion, health and airline representative have sought guidance from WHO and other
general agencies.
This report addresses the growing concern about TB transmission during air
travel(including its prevention, management of infectious passengers, contact tracing, and
passenger information procedures) within the broader context of TB control efforts.
WHO, in collaboration with international TB experts, civil aviation authorities, and
representatives of airline companies, has produced guidelines to provide airline
companies, health authorities, physicians and air passengers with; 1) the available
scientific background on the issue of TB transmission on aircraft; 2) a review of the
past practices adopted for the management of patients with infectious TB and history of
air travel, and of the most commonly encountered difficulties; 3) suggestions on practical
ways to reduce the risk of exposure to M. tuberculosis on board; and 4) guidance on
procedures to follow when a case of infectious TB is diagnosed with a history of air
travel, including tracing and screening of contacts for possible interventions.
These guidelines will apply to all domestic and international airline carriers throughout
the world.
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KEYWORD
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