Tuberculosis in public ground transport - is there enough evidence to justify contact tracing?

Mohr, Oliver; Schink, Susanne Barbara; Eckmanns, Tim; Krause, Gérard

Travel in public transport, especially in confined spaces, provides an opportunity for the transmission of tuberculosis (TB). In air travel, tracing of passengers to control the further spread of a pathogen is a more or less established approach in infectious disease control in many industrialized countries; however, literature reviews on the risk of TB transmission during public ground travel do not show robust evidence. On short trips, contact tracing (CT) of passengers may be unfeasible since passenger data are generally not collected. In long-distance ground travel, passenger data may not be collected routinely; incomplete data and limited or delayed access to passenger details may be further obstacles. The logistic hurdles and limited evidence suggest that CT in public ground transportation should not be a priority of TB control. However, under specific circumstances, CT in public ground transport might be considered on a case-by-case basis after an evidence-based risk assessment.