Tuberculosis travel

Tuberculosis (TB) is a bacterial infection that mainly affects the lungs. It spreads through the air when a person with active TB coughs, sneezes, or speaks nearby. US travelers who spend extended time in high-burden countries, work in healthcare settings abroad, or stay in crowded indoor spaces face a higher chance of exposure than the average short-term tourist.

How to prevent tuberculosis

The Bacille Calmette-Guérin (BCG) vaccine is used in many countries to protect infants and young children from severe forms of TB. However, the BCG vaccine is not routinely recommended for most US adult travelers, and it is not widely available in the United States. Its protection against pulmonary (lung) TB in adults is limited, according to the WHO.

For most travelers, prevention focuses on reducing exposure. Avoid spending long periods of time in crowded, poorly ventilated indoor spaces such as hospitals, prisons, or shelters in high-burden countries. If you work in a healthcare setting abroad, use proper respiratory protection. Research published on PubMed Central recommends that travelers at higher risk, such as healthcare workers or long-stay visitors, get tested for TB infection before and after travel using a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA), a blood test that checks for TB exposure. Talk to a travel health provider about whether pre-travel or post-travel screening is right for you based on your specific itinerary and risk profile.

WayPax Health recommendation

TB is classified in the WayPax formulary as a reference condition, meaning there is no over-the-counter kit or standby medication for it. Instead, the focus is on pre-travel and post-travel screening for travelers at higher risk, such as healthcare workers, long-stay volunteers, and anyone spending extended time in high-burden regions like South Asia or sub-Saharan Africa. A WayPax provider can review your full itinerary online, assess your personal risk level, discuss whether TB screening or any preventive steps are right for you, and issue any needed prescriptions without you visiting a clinic in person. Getting a personalized travel health review through WayPax before your trip is the same level of care you would receive at a traditional travel clinic, done entirely online and on your schedule.

Get your Tuberculosis prescription and other travel medicines online today.

What is tuberculosis?

Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis. It most often affects the lungs, though it can also affect other parts of the body. TB spreads through the air when a person with active TB disease coughs, sneezes, or speaks, releasing tiny droplets that others can breathe in. According to the WHO, about a quarter of the world's population has been infected with TB bacteria, though most people with TB infection do not feel sick and are not contagious. Only about 5 to 10 percent of infected people eventually develop active TB disease.

Common symptoms of active TB include a persistent cough lasting three weeks or more, chest pain, coughing up blood, fatigue, fever, night sweats, and unexplained weight loss. The time between infection and symptoms, called the incubation period, can range from weeks to many years. The CDC notes that TB is preventable and curable. A systematic review on PubMed confirms that travelers moving from low-incidence to high-incidence countries carry a measurable risk of acquiring TB infection.

Where is tuberculosis a risk?

TB is present in every region of the world, but the burden is far from evenly distributed. According to the WHO, the vast majority of TB cases occur in a handful of high-burden regions. South-East Asia and the Western Pacific region together account for the largest share of global TB cases. Sub-Saharan Africa also carries a very high burden, with TB closely linked to high rates of HIV in the region. South Asia, including countries with large, densely populated urban centers, sees some of the highest absolute numbers of TB cases in the world.

Eastern Europe and Central Asia have significant rates of multidrug-resistant TB (MDR-TB), a form of the disease that does not respond to the most common first-line antibiotics. This makes those regions of particular concern for travelers who may need treatment. The Americas and Western Europe have much lower rates of TB overall, though pockets of higher risk exist in some urban areas and among specific populations. Travelers who spend time in healthcare facilities, prisons, homeless shelters, or other crowded indoor settings in any high-burden region face a greater risk than those on brief tourist visits.

Treatment: what to do if you get tuberculosis

Active TB disease is treated with a combination of antibiotics taken over a long course, typically six months or more. The WHO confirms that TB is curable with proper treatment, but the full course must be completed to prevent the bacteria from becoming drug-resistant. Common first-line drugs include isoniazid, rifampin, ethambutol, and pyrazinamide. Do not attempt to self-treat TB. A doctor must confirm the diagnosis and supervise treatment.

If you develop a persistent cough, unexplained fever, night sweats, or weight loss during or after travel to a high-burden region, see a doctor promptly and tell them where you have traveled. Research on TB management in travelers emphasizes the importance of post-travel evaluation for anyone with significant exposure risk. Seek emergency care immediately if you cough up blood or have severe difficulty breathing.

Frequently asked questions

What are the symptoms of tuberculosis in travelers?

The most common symptoms of active TB are a cough that lasts three weeks or longer, chest pain, coughing up blood, fatigue, fever, night sweats, and unexplained weight loss. Many people who are infected with TB bacteria never develop symptoms at all, because their immune system keeps the bacteria under control. If you notice any of these symptoms during or after travel to a high-burden region, see a doctor right away and mention your travel history.

How can I prevent tuberculosis when traveling?

The most effective steps are avoiding prolonged time in crowded, poorly ventilated indoor spaces in high-burden countries, and using proper respiratory protection if you work in a healthcare setting abroad. Pre-travel and post-travel TB screening with a skin test or blood test is recommended for travelers at higher risk, such as healthcare workers and long-stay visitors. A WayPax provider can review your itinerary online and help you decide which prevention steps make sense for your specific trip.

Can you get tuberculosis on an airplane?

TB transmission on commercial aircraft has been documented, but the overall risk is considered low for most passengers. Research on TB and travel notes that modern aircraft cabin air filtration systems reduce, but do not eliminate, the risk. The greatest concern is prolonged close contact with a person who has active, infectious TB during a long flight. If you are concerned about a specific exposure, speak with a travel health provider after your trip.

Is there a vaccine for tuberculosis?

Yes, the BCG (Bacille Calmette-Guérin) vaccine exists and is given to infants in many high-burden countries. It protects children from severe forms of TB but offers limited protection against pulmonary TB in adults. The BCG vaccine is not routinely recommended or widely available for US adult travelers. Talk to a WayPax provider online to discuss whether any preventive measures are right for your trip.

What countries have the highest risk of tuberculosis?

The highest-burden regions include South-East Asia, the Western Pacific, and sub-Saharan Africa, which together account for the majority of global TB cases. According to the WHO, in 2024 an estimated 10.7 million people fell ill with TB worldwide. Eastern Europe and Central Asia also have elevated rates of drug-resistant TB. Your personal risk depends on where you go, how long you stay, and what activities you do while there.

How is tuberculosis treated?

Active TB is treated with a combination of antibiotics taken for at least six months. The standard first-line drugs include isoniazid, rifampin, ethambutol, and pyrazinamide. Treatment must be completed in full, even if you feel better early, to prevent drug resistance from developing. TB treatment must be supervised by a doctor and is not something you can manage on your own while traveling.

Should I get tested for tuberculosis after my trip?

Post-travel TB testing is recommended for travelers who had significant exposure risk, such as healthcare workers, long-stay volunteers, or anyone who spent extended time in crowded indoor settings in high-burden countries. Guidelines reviewed on PubMed Central recommend using a tuberculin skin test or an IGRA blood test for this purpose. A WayPax provider can evaluate your itinerary and exposure history online and advise you on whether post-travel testing is the right step for you.

Explore by region

South-East Asia

• Thailand
• Vietnam
• Cambodia
• Laos
• Bangladesh

South Asia

• Pakistan
• Afghanistan
• Bhutan

East Asia and the Pacific

• China
• Mongolia

Sub-Saharan Africa

• Tanzania
• Zambia
• Zimbabwe
• Ghana
• Madagascar
• Liberia
• Togo
• Burkina Faso
• Gabon
• Lesotho
• Eswatini
• Central African Republic
• Congo

Central Asia

• Tajikistan
• Uzbekistan
• Turkmenistan

Related diseases

• Measles, a highly contagious airborne disease that also spreads in crowded indoor settings and is a concern in many of the same high-burden regions as TB.
• HIV, which significantly raises the risk of developing active TB disease and is closely linked to TB in sub-Saharan Africa.
• Typhoid fever, a bacterial infection common in South Asia and sub-Saharan Africa that travelers to the same high-burden TB regions may also encounter.
• Hepatitis B, a bloodborne infection prevalent in many of the same regions where TB rates are high, including South-East Asia and sub-Saharan Africa.
• Meningococcal disease, another serious bacterial infection that poses a risk to travelers in parts of sub-Saharan Africa and other high-burden TB regions.