Tuberculosis and Air Travel.pptVIP

Tuberculosis and Air TravelIbrahim Abubakar, MBBS, PhD, FFPHConsultant Epidemiologist / Section HeadTuberculosis SectionRespiratory and Systemic Infections DepartmentCentre for InfectionsColindale, London Talk outline Rationale Evidence base WHO Guidelines NICE HPA Interpretation Rationale Newsworthy - More political than public health International – cross border Evidence No cases of TB disease reported among those known to have been infected with M. tuberculosis during air travel All instances of transmission involved highly infectious (smear positive) cases 2 of whom had MDR disease Overall notification rate of 0.05 per 100 000 long haul passengers (BA) Evidence n (%) or Median (IQR) Flights N=39 Duration Hours 8.9 (8 - 11.7) High incidence country Yes 36 (92.3) Flight to notification delay Days 41 (21 - 61) Index cases N=24 Smear positive case Yes 19 (79.2) No 1 (4.2) Unknown 4 (20.8) Drug resistance MDR 2 (8.4) Rifampicin resistant 1 (4.2) Susceptible 3 (12.5) Unknown 18 (75) Contact investigation N=24 Availability of contact information from airlines No further information 13 (54.2) Further information available 5 (20.8) Airline unwilling to share data 2 (8.4) Passenger details deleted by airline 2 (8.4) Passenger lists available but no contact details 2 (8.4) UK incidents Date reported Flight origin and destination Approximate duration Smear status Resistance Passenger contact information / outcome where known 25/06/2007 1. London to Bangalore 10hr 35 each way + None 1. 28 contacts: 3 UK, 1 with address 2. Bangalore to London 2. 28 contacts: 3 UK, 2 with address 26/07/2007 1. London to Hong Kong 11hr 40min each way + Not known 1. 22 contacts: 7 UK with personal/travel agent phone number 2. Hong Kong to London 2. 32 contacts: 4 UK with personal/travel agent phone number 30/08/2007 1. Japan* to London 1. 12hr 15min + Not known 1. 4 UK contacts with travel agent phone numbers 2. London to Japan* 2. 11hr 30min 2. 2 UK contacts with address a