Employers must support TB-diagnosed employees with leave, privacy, and fair treatment while working with health authorities to ensure safe workplaces.

IMAGINE this scenario: An employee walks into the HR department on a Monday morning looking troubled. He says, “The doctor thinks I might have tuberculosis”. Or worse: “According to the doctor, I have TB.”

Immediately, questions begin to pop up: Should we close the office? Should all employees be screened? Should everyone wear masks? Should employees be allowed to work from home?

These responses may seem sensible, especially in light of the Covid-19 epidemic. However, Covid-19 and tuberculosis (TB) spread differently, and many of these reactions are often superfluous.

It is important to keep in mind that TB is still a significant yet frequently misdiagnosed public health issue, notably in the workplace.

TB still exists in Malaysia

Many people think of TB as a disease of the past but it remains a significant global health concern. According to the World Health Organisation (WHO) Global Tuberculosis Report 2025, about 10.7 million people developed TB worldwide and 1.23 million died from the disease in 2024.

Malaysia is classified as an intermediate TB-burden country. Data from the Health Ministry shows that 26,781 TB cases were reported in 2023, with notification rates around 80 to 90 cases per 100,000 population.

Importantly, TB often affects working-age adults – meaning that cases can occasionally arise in workplaces. In recent years, health authorities have also reported TB clusters linked to shared environments such as worker hostels, schools, prisons and workplaces.

A TB cluster generally refers to two or more cases that are epidemiologically linked by time, place or close contact, suggesting possible transmission within a shared environment.

Understanding how TB spreads

TB is caused by the bacterium Mycobacterium tuberculosis. It usually affects the lungs and spreads through tiny airborne particles released when a person with active TB coughs, speaks or sneezes.

However, unlike Covid-19 or influenza, TB usually requires prolonged exposure in enclosed environments for transmission to occur. Situations such as spending long hours in poorly ventilated rooms, daily carpooling or shared accommodation may increase the risk.

Equally important is understanding that TB is not transmitted through handshakes, sharing food or touching surfaces – meaning routine office interactions pose very little risk. Understanding this helps prevent unnecessary panic or stigma when a TB case is reported.

When TB is diagnosed

In Malaysia, TB is a notifiable disease under the Prevention and Control of Infectious Diseases Act 1988 (Act 342). When a doctor diagnoses TB, the case must be reported to the district health office.

Health authorities will then conduct contact tracing to identify individuals who had close and prolonged exposure to the patient. These may include colleagues sharing the same workspace or those who regularly travel together.

Importantly, not everyone in the company needs to be tested. Screening is usually limited to close contacts, identified through risk assessment.

Can the employee return to work?

Another common concern is whether an employee diagnosed with TB can safely return to work.

The reassuring news is that patients who start appropriate treatment typically become non-infectious after about two weeks, provided their symptoms improve and treatment is effective. A doctor will certify when the individual is safe to return to the workplace.

Although TB treatment usually continues for several months, once the patient is no longer infectious, they can generally resume normal work activities.

Employer responsibilities

Employers play an important role in managing TB cases appropriately. Under the Occupational Safety and Health Act 1994, organisations have a duty to provide a safe working environment.

When a TB case occurs, employers should:

• support medical leave and treatment – employees diagnosed with TB require medical leave during the initial treatment period and should be encouraged to complete their treatment;
• maintain confidentiality – medical information must be handled sensitively to protect the employee’s privacy;
• cooperate with health authorities – employers should work closely with the district health office during contact tracing and follow official advice on screening or workplace measures; and
• avoid discrimination – TB is a treatable condition and employees should not face termination or stigma simply because of the diagnosis.

Practical workplace measures

While TB transmission in typical office settings is relatively uncommon, workplaces can still adopt simple, preventive measures:

• Improve ventilation in indoor spaces.
• Avoid overcrowded meeting rooms.
• Encourage employees with persistent cough lasting more than two weeks to seek medical attention.
• Promote cough etiquette and respiratory hygiene.

In most situations, closing the office, mandating masks for everyone or sending all employees for TB testing is unnecessary unless advised by the health authorities.

Knowledge reduces fear

Ultimately, TB control is not only a medical issue but also a workplace and community responsibility. Early diagnosis, proper treatment and supportive workplace policies are key to preventing transmission.

By understanding how TB spreads and responding calmly when cases occur, organisations can protect both employee health and business continuity.

The most important message is: TB is treatable, recovery is possible and workplace TB situations can be managed effectively – without fear or stigma.

Dr Chow Sze Loon is a public health physician and occupational health doctor at Penang Adventist Hospital.

Comments: letters@thesundaily.com

 The Sun Malaysia