Pulmonary tuberculosis

Patients should be informed about the condition; in particular, the following should be discussed:

• The importance of completing the recommended course of treatment. If side effects occur, medical attention should be sought

• The need for routine monitoring of kidney and liver function

• The need for regular sputum samples to be provided and technique for providing sample.

Because of the infectious nature of the condition, the patient may need to be isolated in the short term. After approximately 2 weeks, the patient is less infectious to close contacts.

Physicians should inform all infectious and potentially infectious TB patients that they must not travel by air, on any commercial flight of any duration, until they are sputum smear-negative on at least two occasions.

Physicians should inform all multidrug-resistant (MDR) TB and extensively drug-resistant (XDR) TB patients that they must not travel by any commercial flight until they are confirmed to be noninfectious (i.e., two consecutive negative sputum-culture results).[116]World Health Organization. Tuberculosis and air travel: guidelines for prevention and control. 2008 [internet publication]. http://whqlibdoc.who.int/publications/2008/9789241547505_eng.pdf MDR TB is defined as resistance to isoniazid and rifampin, with or without resistance to other first-line drugs, and XDR TB is defined as resistance to at least isoniazid and rifampin, and to any fluoroquinolone, and either bedaquiline or linezolid (or both).[96]World Health Organization. WHO consolidated guidelines on tuberculosis: module 4: treatment: drug-resistant tuberculosis treatment, 2022 update. Dec 2022 [internet publication]. https://www.who.int/publications/i/item/9789240063129 [97]World Health Organization. WHO announces updated definitions of extensively drug-resistant tuberculosis. Jan 2021 [internet publication]. https://www.who.int/news/item/27-01-2021-who-announces-updated-definitions-of-extensively-drug-resistant-tuberculosis ​ Pre-XDR-TB is resistance to isoniazid, rifampin, and any fluoroquinolone.

Physicians should immediately inform the relevant public health authority when they are aware that an infectious or potentially infectious TB patient intends to travel against medical advice or may have exceptional circumstances requiring commercial air travel.

Physicians should immediately inform the public health authority when an infectious or potentially infectious TB patient has a history of commercial air travel within the previous 3 months.[117]Abubakar I, Fernandez de la Hoz K. WHO publishes the third edition of guidelines for the prevention and control of air-travel-associated tuberculosis. Euro Surveill. 2008 Jun 5;13(23):18898. https://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18898 http://www.ncbi.nlm.nih.gov/pubmed/18761953?tool=bestpractice.com CDC: tuberculosis Opens in new window