Tuberculosis and air travel : guidelines for prevention and control

Growing international mobility and the increasing accessibility of long-distance air travel have heightened concerns about the potential transmission of tuberculosis during commercial flights, particularly in the context of multidrug-resistant and extensively drug-resistant forms of the disease. Developed as a revised third edition in response to evolving epidemiological and regulatory challenges, these guidelines examine the available evidence on the risk of in-flight transmission of Mycobacterium tuberculosis and outline measures to prevent and control exposure associated with air travel. The publication describes the epidemiology and mechanisms of airborne transmission of tuberculosis, the role of cabin ventilation and air filtration systems, and the operational conditions that may influence the likelihood of infection during flights.

Prepared through collaboration among WHO, public health authorities, aviation organizations and international experts, the document establishes recommendations for passengers, airline personnel, physicians and health authorities regarding travel restrictions, risk assessment, management of infectious travellers and procedures for contact investigation following potential exposure. It also addresses communication and coordination mechanisms between airlines, national authorities and international organizations, including responsibilities arising under the International Health Regulations (2005). Particular attention is given to prolonged flights, criteria for identifying close contacts, confidentiality considerations and operational limitations affecting contact tracing. Intended as technical guidance for aviation and public health stakeholders, the publication supports proportionate and evidence-based responses aimed at reducing the international spread of tuberculosis while minimizing unnecessary disruption to travel and trade.