The sleeping giant: the danger of neglecting latent tuberculosis infection

News story

The European Centre for Disease Prevention and Control (ECDC) has published comprehensive guidance on the management of latent tuberculosis infection (LTBI) targeted for European Union/European Economic Area (EU/EEA) countries.

October 2018 saw a historical moment in the fight against tuberculosis (TB) when the United Nations (UN) General Assembly adopted the declaration of the first-ever UN high-level meeting on TB, with all UN Member States pledging to end TB by 2030. Even in low-incidence TB regions such as Europe, this commitment will entail drastic changes to improve TB management and prevention, especially when it comes to latent tuberculosis infection (LTBI).

According to a recent study in PLOS Medicine, an estimated 1.7 billion people had LTBI, which means that approximately a quarter of the world’s population have this ‘dormant’ form of tuberculosis. LTBI carriers are asymptomatic and not infectious; but the bacilli can spread at a later stage, resulting in TB. In low-incidence countries, a majority of TB cases occur due to the progression of LTBI to active TB disease. To fulfil the mandate of ending TB by 2030, thorough screening and treatment for LTBI need to be implemented.

To address the threat, ECDC has created several guidance documents on screening strategies and management of LTBI, with the latest evidence-based guidance targeted at EU/EEA Member States published in October 2018.

Management of latent tuberculosis infection

When people with infectious tuberculosis (TB) cough, sneeze or otherwise exhale droplets, they expose others to Mycobacterium tuberculosis. After a person is exposed, they can be infected with M. tuberculosis without having TB disease and without signs and symptoms. This is called latent TB infection (LTBI).