TB patient, now in U.S. quarantine, flew on jets

Published May 30, 2007

ATLANTA - A man with a rare and exceptionally dangerous form of tuberculosis has been placed in quarantine by the U.S. government after possibly exposing passengers and crew on two trans-Atlantic flights this month, health officials said Tuesday.

It is the first time since 1963 that the government issued a quarantine order. The last such order was to quarantine a patient with smallpox, according to the Centers for Disease Control and Prevention.

The CDC urged people on Air France Flight 385 from Atlanta to Paris on May 12 and Czech Air Flight 0104 from Prague, Czech Republic, to Montreal on Thursday to get checked for tuberculosis.

"We have no suspicion that this patient was highly infectious, " said the CDC director, Dr. Julie Gerberding. "In fact, the medical evidence would suggest his potential for transmission is on the low side, but we know it isn't zero."

The Georgia man, identified only as a Fulton County resident, was infected with "extensively drug-resistant" TB, also called XDR-TB. It resists many drugs used to treat the infection. Last year, there were two U.S. cases of that strain, and its fatality rate is six times higher than regular tuberculosis, according to the CDC.

Tuberculosis is an infection of the lungs characterized by fever, weight loss, night sweats and coughing up of blood that kills nearly 2-million people each year worldwide.

The disease spreads in microscopic droplets released when an infected person coughs, sneezes or speaks. The infection can be treated with antibiotics, but incomplete treatment can lead to drug resistance.

A CDC official had reached the man by phone in Italy and told him not to take commercial flights, but he flew back to North America anyway, said Dr. Martin Cetron, director of the CDC's division of global migration and quarantine.

"He was told in no uncertain terms not to take a flight back, " Cetron said.

The man drove from Montreal into the United States before voluntarily going to a New York hospital. He was then flown by the CDC to Atlanta, where he is in respiratory isolation, according to the World Health Organization.

He is not facing prosecution, health officials said.

CDC officials said the airlines were working with health officials to contact those passengers sitting within two rows of the man. Medical exams for cabin crew members were also recommended.

Information from the Los Angeles Times was used in this report.

Fast Facts:

Extensively drug-resistant tuberculosis

-Also known as XDR-TB.

-Resists almost all drugs used to treat TB.

-Only 49 cases were reported in the United States from 1993 to 2006; 17 have been diagnosed since 2000. The nation reported 13, 767 ordinary TB cases last year alone, an all-time low.

-XDR-TB can develop from an ordinary case of TB or be caught from other people by breathing the germs from the air.

-TB germs enter the air when an infected person coughs, sneezes or speaks. The germs can float for hours. TB is not spread by a handshake, sharing a glass or by kissing, the federal Centers for Disease Control and Prevention said.

-Successful treatment depends heavily on how resistant the XDR-TB germ is, how severe the disease is and whether the patient's immune system is weakened, CDC says.