Multi-drug Resistant Tuberculosis in Travellers

Tuberculosis remains a major global public health crisis, and multidrug-resistant tuberculosis (MDR-TB) has become a threat to disease control in many countries. More than 20% of humanity is latently infected with TB, and an estimated 450,000 people develop MDR-TB disease annually. While the risk to casual travellers is low, even during long-haul air travel, healthcare and humanitarian workers, migrants and refugees from high-burden countries and the immunocompromised may be at substantial risk. BCG vaccination may offer modest protection, and screening strategies for latent infection can identify who may be at risk of future disease after exposure, but the best approach to management of latent MDR-TB infection remains unclear. MDR-TB disease should be suspected in those with relevant symptoms and signs after possible exposure. Rapid molecular testing and susceptibility prediction can speed up diagnosis, while novel all-oral treatment regimens have significantly shortened and simplified the treatment of MDR-TB in recent years.