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Risk for Travelers

To become infected, a person usually has to spend a relatively long time in a closed environment where the air was contaminated by a person with untreated tuberculosis who was coughing and who had numerous M. tuberculosis organisms (or tubercle bacilli) in secretions from the lungs or voice box (larynx). Infection is generally transmitted through the air; therefore, there is virtually no danger of its being spread by dishes, linens, and items that are touched, or by most food products. However, it can be transmitted through unpasteurized milk or milk products obtained from infected cattle.

Travelers who anticipate possible prolonged exposure to tuberculosis (e.g., those who could be expected to come in contact routinely with hospital, prison, or homeless shelter populations) should be advised to have a tuberculin skin test before leaving the United States. If the reaction is negative, they should have a repeat test approximately 12 weeks after returning. Because persons with HIV infection are more likely to have an impaired response to the tuberculin skin test, travelers who are HIV positive should be advised to inform their physicians about their HIV infection status. Except for travelers with impaired immunity, travelers who already have a positive tuberculin reaction are unlikely to be reinfected.

Travelers who anticipate repeated travel with possible prolonged exposure or an extended stay over a period of years in an endemic country should be advised to have two-step baseline testing and, if the reaction is negative, annual screening, including a tuberculin skin test.

CDC and state and local health departments have published the results of six investigations of possible tuberculosis transmission on commercial aircraft. In these six instances, a passenger or a member of a flight crew traveled on commercial airplanes while infectious with tuberculosis. In all six instances, the airlines were unaware that the passengers or crew members were infected with tuberculosis. In two of the instances, CDC concluded that tuberculosis was probably transmitted to others on the airplane. The findings suggested that the risk of tuberculosis transmission from an infectious person to others on an airplane was greater on long flights (8 hours or more). The risk of exposure to tuberculosis was higher for passengers and flight crew members sitting or working near an infectious person because they might inhale droplets containing M. tuberculosis bacteria.

Based on these studies and findings, WHO issued recommendations to prevent the transmission of tuberculosis in aircraft and to guide potential investigations. The risk of tuberculosis transmission on an airplane does not appear to be greater than in any other enclosed space. To prevent the possibility of exposure to tuberculosis on airplanes, CDC and WHO recommend that persons known to have infectious tuberculosis travel by private transportation (that is, not by commercial airplanes or other commercial carriers), if travel is required. CDC and WHO have issued guidelines for notifying passengers who might have been exposed to tuberculosis aboard airplanes. Passengers concerned about possible exposure to tuberculosis should be advised to see their primary health-care provider for a tuberculosis skin test.

ReliefWeb » Document » Zimbabwe: Health crisis whacks TB efforts – As in many sub-Saharan countries, the re-emergence of TB as a major public health problem in Zimbabwe is strongly linked to the HIV epidemic; an estimated 69 percent of TB patients are co-infected with HIV. …

Distinguishing tuberculosis and Crohn’s disease in developing … – With the reemergence of TB in the West in the wake of the acquired immunodeficiency syndrome epidemic, [2],[4],[5] the ability to cure TB with appropriate antibiotic treatment and the emergence of CD in many tropical countries where it …

Slow-growing TB bacteria point the way to new drug development – The re-emergence of tuberculosis as a major American public… Tuberculosis and the Politics of Exclusion: A History of Public Health and Migration to Los Angeles (Critical Issues in Health and Medicine) by Emily K. Abel …

New discovery gives tuberculosis vaccine a shot in the arm – The re-emergence of tuberculosis as a major American public… Tuberculosis And AIDS: The Relationship Between Mycobacterium Tb And the HIV Type 1 by Lawrence L., M.D. Scharer, John M., M.D. McAdam. St. Luke’s Roosevelt Hospital Center, …

BlogTalkRadio – NorthStarXO – 6-8-08 Show on Potential Threats and … – Unlike typical TB caused by the M. tuberculosis strain, this reemerging bovine variety does not easily spread via human-to-human contact and tends to land less often in the lungs, making it less likely to be transmitted through …

Genocidal Policy- Then they want Your Vote- X Marks the spot … – Vivienne Nathanson, the British Medical Association’s head of science and ethics, said the re-emergence of TB was so serious that ministers should consider the mandatory immunisation of all school children. …

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A Montreal, Quebec Canada may be well forced to shut down almost 25 per cent of its beds. In the past number of years, nearly half the doctors there — 25 of them– have resigned as a result of difficult working conditions, but only several have been hired as replacements.

“ Doctors are said to be working extra long shifts and overtime to provide medical care. “This cannot go on for long without a reduction of the standards of medical care and expertise” states the hospital administration. The hospital will need in order of 20 to 30 doctors to keep this regional center open. Doctors as if seems are in overall short supply.

The Montreal area hospital has had to reduce its level of service to the community at large. Service was reduced in order that the remaining doctors would only have to “work 12 hours or less a day, if possible,” he said.

The impact of the hospital’s decision to close the beds as of Friday is yet unclear.

“There might be longer waits in the emergency room for the patients, as well some of the ambulances may have to be rerouted to other hospitals which, for some patients, might mean being further away from home,” Keyway said.

But while some people at the hospital say it’s frustrating that the beds must close, they understand the reasoning.

“You can’t push staff beyond their reach either … if closing 30 beds allows them to give safe care, it’s too bad, but I guess that’s the way it has to be done,” one woman told CTV Montreal.

The beds might be closed at the hospital for as long as a year.

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Medical tourism is a cash-rich industry. In Asia alone, studies have shown that some $390 billion are spent annually for health care. Most of this, finds its way into Thailand, India and Singapore, countries which currently lead the way in this field.

Can you imagine if the Philippines can just bite off a 10-percent chunk of this total budget? And that is just for medical tourism, not including the plain pleasure seekers, the bargain hunters, and the sightseers.

Medical tourism consists of medical care, health and wellness, traditional and alternative health care such as acupuncture, herbal medicine, virgin coconut oil, organic food, neutraceuticals and long-term tourism and international retirement health zones where foreign patients can recuperate, rehabilitate and retire. To complete the picture, the components of tourism and shopping have been added to increase the choices of tourists and bring in more.

Among the services that the country offers to foreigners are elective procedures such as cosmetic surgery, liposuction and dental surgery, and life-saving procedures such as coronary bypass surgery, kidney transplants and cancer treatment.

As testimony to the country’s advantages in medical tourism, a general checkup in the United States costs $5,000 while it will cost only the equivalent of $500 in the Philippines. Coronary bypass surgery, which clocks up $50,000 in the United States, will cost only $25,000 locally. And while kidney transplants can reach up to $150,000 abroad, it will only cost $25,000 here.

Even if the plane fare is added, trip to resort and a $100 gift certificate to add to their shopping money after they recover, the Philippine rate will still come out so much cheaper than having the surgeries abroad.

Cost is not only the country’s competitive advantage. The Philippines is also blessed with well-trained and highly skilled medical practitioners that are fluent in English and have received postgraduate training in the developed countries. Nurses and paramedical staff are also one of the best, as attested by the strong demand for their services and skills in foreign countries.

Besides competence, they are also known for their compassion, a key ingredient in caring for patients.

When the patients recuperate from the medical procedures that they came for, the variety of the country’s tourism offerings is also seen as a key advantage to luring medical tourism.

For sure, there will be the staple and indispensable aqua and beach tourism in Cebu, Palawan, Albay, Camiguin, Bohol, Boracay and of course Eastern Visayas. But the country also will offer historical, heritage and cultural tourism in places such as Leyte in Eastern Visayas, Vigan in Ilocos, the Banawe Rice Terraces, Fort Santiago and Intramuros, and the many interesting sites and activities in every province.

And don’t forget the great

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Medical tourism or medical travel is not an entirely new concept. Until recently, medical tourists were usually a very select few who chose to travel for elective surgeries such as tummy tucks and face-lifts, combining surgery with a holiday in a far away locale that ensured both privacy and a pleasant stay. As well, there were also a limited number of people who sought experimental medical treatments for illness and diseases such as cancer in foreign clinics. Today there is a swelling rank of medical tourists comprised of ordinary citizens who seek a wide variety of health care services and medical care outside of their home country, and every year that number grows.

For some, medical tourism or international medical travel can literally be a lifesaver, enabling patients to access quality medical services that they might not otherwise be able to afford. In the United States, patients without private health insurance can be faced with exorbitant medical bills for even the most routine surgeries. Sometimes a heartbreaking choice must be made – to have a life saving operation and suffer extreme financial hardship or to not have the procedure and deal with the health consequences. For those who are fortunate enough to have private health insurance, some may find that their insurer does not cover all medical procedures or that their insurance plan imposes unreasonable restrictions. In Canada, where public health insurance pays for most medical care, it has been well documented that unacceptably long wait times are forcing patients to take matters into their own hands and head off shore for timely medical treatment.

Medical tourism has garnered much media attention of late. Word is rapidly spreading about the excellent medical care that is available for bargain prices in countries such as Thailand, Hong Kong, and India. In the book, ‘Patients Without Borders: Everybody’s Guide to Affordable, World-class Medical Tourism,- author Josef Woodman investigates this growing industry. He reports in depth about the high quality of care available in foreign hospitals and how patients, who have surgery performed overseas, can save up to 80 percent. By example, a heart bypass in India can be had for a fraction of the price of one in the United States.

India has become one of the world’s leading destinations for medical travelers. Over the years, India has developed a stellar reputation with medical tourists, due to its state-of-the-art medical facilities that offer advance medical procedures, such as hip resurfacing, knee replacement, heart surgery, kidney transplant and abdominoplasty, at prices that are a fraction of those charged for similar procedures in North American hospitals. ‘Axiom Health Solutions works with Indian hospitals that are staffed with some of the most highly trained surgeons and professional medical personnel available. Huge investments have been made by each hospital group to ensure the highest of standards and the most modern facilities and equipment obtainable. In many cases the success rate in these hospitals is higher than those of American hospitals.

The future of medical tourism looks bright. Factors such as improved technology and standards of care and the availability of companies that specialize in arranging medical tourism packages makes international travel for medical services a very attractive proposition. Undoubtedly, the driving force behind the rise in medical travel is the high price of medical services in North America factor that is unlikely to change in the near future.

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