Fliers Warned About Tuberculosis

CDC Tells Passengers on Flights With Drug-Resistant-Tuberculosis Patient to Get Tested

Medically Reviewed by Louise Chang, MD on May 29, 2007
From the WebMD Archives

May 29, 2007 -- The CDC today announced that a U.S. traveler may have put his fellow fliers at risk for a potentially deadly form of drug-resistant tuberculosis.

The traveler, an unnamed man from Atlanta, has extensively drug-resistant tuberculosis (XDR TB), which is rare but can cause serious illness and death.

XDR TB is an infectious disease spread from person to person through the air. But unlike most tuberculosis cases, XDR TB resists the first and second preferred drug treatments.

While XDR TB is rare, it can cause severe illness and death and is an emerging problem worldwide, CDC director Julie Gerberding, MD, MPH, told reporters in a news conference.

In light of the man's condition, the CDC issued its first federal quarantine order since 1963 for the patient. He is under medical isolation in Atlanta and will remain quarantined until public health officials deem him no longer a public health threat.

The CDC is also encouraging other passengers on the man's flights to get tested for tuberculosis.

Patient's Flights

The man departed Atlanta on May 12 on Air France flight 385, arriving in Paris on May 13. He then flew on Czech Air flight 0104 from Prague in the Czech Republic to Montreal, arriving in Montreal on May 24 and driving to the U.S. on the same day.

The CDC is not yet releasing the man's seat assignments on those flights, pending confirmation of that information with airlines.

CDC officials say that when they learned the man had re-entered the U.S., they contacted him in New York and asked him to report to an isolation hospital. He complied.

The CDC then gave the man a choice between continuing his isolation in New York or returning to Atlanta, where he lives. He chose to return to Atlanta, and the CDC flew him to Atlanta yesterday on a special CDC plane, so as not to expose him to other travelers on commercial flights.

Passengers' Risk

"Passengers most likely to be at risk would be the passengers who were seated in seats immediately close to the patient," Gerberding says.

She notes that the man's tuberculosis didn't appear to be highly contagious. "In fact, the medical evidence would suggest that his potential for transmission would be on the low side, but we know it isn't zero," Gerberding says.

"We also want to reassure people who weren't on these flights that their risk of exposure on a random air flight is extremely low, and we're not concerned about a generic threat to travelers," Gerberding says.

Patient's Case

Before leaving the U.S., the patient knew he had tuberculosis and, like all tuberculosis patients, had been advised not to travel, according to Gerberding.

But he didn't know his tuberculosis was extremely resistant to drugs, and he felt he had a "compelling reason" to travel, says Gerberding, who declined to elaborate on the patient's reason for traveling.

Gerberding says the CDC didn't know that the man had XDR TB until after he left the U.S.

His departure surprised the CDC but wasn't illegal, says Gerberding. "From our perspective, no laws were broken here," she says.

It's not yet clear how or where the man contracted tuberculosis, Gerberding notes.

About XDR TB

Since 1993, the CDC has gotten reports of 49 people in the U.S. who have had XDR TB.

"Unfortunately, that's not true in many other parts of the world, so many people who have XDR TB do not survive their infection," Gerberding told reporters today.

"That's part of the reason why we're taking this situation so seriously and why we took this unusual step of issuing a federal isolation order in an effort to curtail any additional possibility of exposure to passengers or others that were potentially in harm's way," says Gerberding.

In March, Gerberding told a congressional subcommittee that XDR TB has been found in 17 countries from all regions of the world, most frequently in the former Soviet Union and Asia.

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Show Sources

SOURCES: Julie Gerberding, MD, MPH, director, CDC. Statement by Julie Gerberding, MD, MPH, director, CDC, before the U.S. House of Representatives Committee on Foreign Affairs, Subcommittee on Africa and Global Health, March 21, 2007.

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