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Drug-Resistant TB Patient in Isolation
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Officials Seeking More than 600 Passengers on Patient's Flight; Patient Feeling Well in Hospital
Reviewed By Louise Chang, MD
May 30, 2007 -- Health officials are reaching out to more than 600 people who flew on recent transatlantic flights with a man who has extensively drug-resistant tuberculosis (XDR TB).
XDR TB is an infectious disease spread from person to person through the air. Unlike most tuberculosis cases, XDR TB resists the first and secondpreferred drug treatments.
The man remains under a federal isolation order at an Atlanta hospital. He "continues to feel well" and shows no obvious signs of his tuberculosis, says Martin Cetron, MD, director of the CDC's Division of Global Migration and Quarantine.
The man's tuberculosis doesn't appear to be highly contagious, Cetron notes, but about 80 people on both flights may be at the highest risk since they were sitting in his row or in the two rows in front of or behind his seat.
Plans are under way to transport the man to Denver for treatment at the National Jewish Medical and Research Center. The CDC is helping with the logistics of those plans so as not to endanger other travelers, Cetron notes.
The CDC today provided more information on the man's transatlantic flights.
On May 12, he flew from Atlanta to Paris on Air France flight 385. His exact seat on that flight isn't clear, but it may have been around row 51, Cetron notes. There were 433 passengers and 18 crew members on that flight. About 40-50 passengers were in the high-risk seats near the patient.
On May 24, the man flew from Prague in the Czech Republic to Montreal on Czech Air flight 0104 in seat 12C. There were 191 passengers and nine crew members on that flight. About 30 passengers were in the high-risk seats near the man.
So far, health authorities haven't reached passengers on those flights, but some have come forward after hearing about the situation. Passengers on those flights can call the CDC at (800) CDC-INFO for more information, says Cetron.
The man also took several other flights: from France to Greece; from Greece to Italy; and from Italy to Prague. But because those flights are shorter than eight hours, they aren't considered as risky for tuberculosis transmission by World Health Organization standards.
In an interview in today's Atlanta Journal-Constitution, the patient told a reporter that he and his wife left the U.S. for their honeymoon.
The man reportedly said he knew he had tuberculosis that hadn't responded to drug treatments but felt healthy. He says that local officials never told him not to travel but said they "preferred" he not travel.
The Atlanta Journal-Constitution says the man and his bride flew to Paris, then Athens, and then Rome. In Rome, he says the CDC called him and asked him to report for quarantine. Instead, he and his new wife left for Prague, flew to Montreal, and then drove into the U.S.
The man told The Atlanta Journal-Constitution that he "didn't want to put anybody at risk" but feared unsuccessful treatment in Italy.
In today's news conference, Cetron says it's the CDC's understanding that local health officials in Atlanta "clearly told him not to travel."
"The patient had, from his own perspective, compelling reasons to travel, and there were no legal orders in place preventing his travel and no laws were broken," Cetron says, noting that the CDC was looking into options to isolate the man in Rome but that opportunity was missed when the man and his wife left Italy.
Cetron says that when he learned the man and his wife had driven from Montreal into the U.S., he called the man on his cell phone with isolation instructions.
"Since we issued our federal isolation order, he has been fully compliant. I believe that aspect of the past is not nearly as important as ... moving forward," Cetron says.
SOURCES: Martin Cetron, MD, director, Division of Global Migration and Quarantine, CDC. Ken Castro, MD, director, Division of Tuberculosis Elimination, CDC. WebMD Health News: "Fliers Warned About Tuberculosis." The Atlanta Journal-Constitution: "Atlantan Quarantined With Deadly TB Strain," May 30, 2007.
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