The rising number of tuberculosis infections around the world is raising concern among health experts.

Previously ranked among diseases closely linked to poverty like HIV/Aids and malaria, experts say the highly contagious TB is now spreading fast among all people including the elite.

“Everyone is at risk provided they breathe the same oxygen as everyone else,” says Ann Kathure, the provincial TB and leprosy co-ordinator in Nairobi, adding that anybody who develops symptoms must seek medical attention immediately to lessen the risk of infecting others.

According to World Health Organisation, if untreated, persons suffering from TB could infect an average of 10-15 people annually.

The organisation also notes that a third of the world’s population is infected with latent TB but only one out of every 10 people develops active TB in their lifetime.

TB is caused by a bacteria called Mycobacterium tuberculosis.

It is transmitted through respiratory droplets from a person with active TB through coughing, sneezing, talking or spitting.

Common symptoms include a persistent cough that lasts more than two weeks, weight loss, fever, excessive night sweats, fatigue and loss of appetite.

Since TB is airborne, living in crowded quarters and travelling in crowded vehicles without proper ventilation pose a great risk of infection.

According to Dr Kathure, about 50 per of those who do not seek treatment die in two years. This however, depends on a person’s level of immunity and lifestyle.

Excessive alcohol intake and smoking can also harm the body’s immune system and increase the risk of acquiring TB.

The cigarette smoke destroys the lungs making them susceptible to infection, while alcohol produces an overall nutritional deficiency, depriving the body of valuable immune-boosting nutrients.

Alcohol, like sugar, if consumed in excess can reduce the ability of white cells to kill germs.

“The fact that most alcohol drinkers do it in crowded bars and social places increases their risk of contracting TB,” notes Dr Kathure.

In the past three decades, HIV/Aids has emerged among the greatest risk factors that expose one to TB.

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The nation's top doctor has advised Australians who feel ill after returning from Bali to seek treatment after an outbreak of Legionnaires' disease on the popular Indonesian resort island.

Commonwealth chief medical officer Jim Bishop said Australian health authorities knew of 11 cases of Legionnaires' disease detected in Victorians and Western Australians after holidays in the Kuta area of Bali between August 2010 and January 2011.

Anyone who has flu-like symptoms such as fever and cough following a trip to the region should visit their GP or take themselves to a hospital emergency department, he added.

“There are specific antibiotics available to treat the disease,” Professor Bishop said on Wednesday.

“The time between a person's exposure to the bacteria and becoming sick is usually between two to 10 days.”

Indonesian health authorities and the World Health Organisation are investigating the outbreak.

Professor Bishop said they were testing water samples from possible sources of the disease and had told hotels in the area to disinfect and clean their water supply systems.

A number of people who caught Legionnaires' had stayed in the same hotel in Kuta – the Ramayana Resort and Spa – and most had visited the same local shopping centre.

Legionnaires' disease is contracted by breathing in very fine droplets of water which contain the bacteria.

People most at risk of are those aged over 50, smokers, and anyone whose immune system is suppressed by medication or diseases such as cancer, kidney failure or diabetes.

New Zealanders need to be vigilant about their health and hygiene to help prevent the spread of swine flu, after a fifth death from the H1N1 virus this year was reported today.

New Zealand Self Medication Industry (NZSMI) executive director Tim Roper supports the advice of the Ministry of Health to be thorough about basic hygiene, to consider vaccination, and to stay at home when feeling sick.

He says regular handwashing (and drying) as well as covering coughs and sneezes are important in stopping the spread of influenza.

“Clean your hands with hand-sanitising gels when you can’t wash them and regularly wipe down or spray surfaces with disinfectant.”

People can take steps to build immunity and avoid winter ills through a healthy diet and supplementation with products such as Vitamin C.

“For most people, swine flu is a mild to moderate illness which can be managed at home with medicines that relieve pain and fever.

a 22-year-old Hawke’s Bay man, who had an underlying health condition, died on Tuesday morning in hospital.

His death is believed to be the fifth related to swine flu in New Zealand this year.

Hawke’s Bay District Health Board said his death was suspected to be from H1N1 influenza, though it was yet to be confirmed by the Coroner.

The man’s death came just hours before the World Health Organisation (WHO) announced the swine flu pandemic was over and the world had entered a post-pandemic phase.

The step to downgrade followed advice given Tuesday by the WHO’s advisory emergency committee of 15 external scientists, who heard presentations from health officials from countries reporting cases of H1N1, including New Zealand.

WHO director-general Margaret Chan said the virus had not gone away, and recognised that New Zealand was still experiencing the effects of a second wave of the H1N1 virus.

Deputy director of public health Darren Hunt yesterday said the country was still seeing a significant level of swine flu, and New Zealanders still needed to remain vigilant as there had been significant outbreaks of influenza in some areas.

“While some countries have seen H1N1 virus decline or crowded out by other strains, this is not the case in New Zealand,” he said.

“The pandemic influenza strain is the predominant strain circulating this winter. We are seeing higher levels of hospitalisation in areas that weren’t severely affected last year.

“To date, there had been over 300 people admitted to hospital this year with confirmed H1N1, which includes over 30 people admitted to intensive care,” Dr Hunt warned.

this week, a Christchurch woman, 44, and a Wellington man, 38, died, their deaths following those of a Northland man, 51, last month, and a Tauranga woman, 48, in June.

Worldwide more than 214 countries and overseas territories have reported cases of H1N1, and there have been more than 18,440 deaths.

The symptoms of influenza can include a high fever, headache, cough, sore throat, tiredness and generally aching all over.