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American TB traveler: narrow escape for international flyers?

Thursday, 31 May 20073 min read

The rare step of US health officials detaining an air traveler diagnosed with a highly drug-resistant form of TB shows not only security gaps but also how easy it might be to spread the next super-flu.

The US Department of Homeland Security launched what was called a major investigation into how an Atlanta man with a very dangerous form of TB was cleared by border agents who were told to stop him.

US health officials took the rare step of detaining the Georgia man diagnosed with a highly drug-resistant form of tuberculosis after he could have affected other travelers when flying on international flights to Paris and Montreal.

“The unidentified patient had been undergoing TB treatment at an Atlanta clinic. Doctors told him not to travel, but he chose to do so for unspecified compelling reasons,” Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC) told the AP.

The US Center for Disease Control and Prevention tracked the man to Rome and was considering a quarantine when he disregarded their warnings to fly back home.

It was a situation that news accounts called “another narrow escape.”

Tests suggest the XDR-TB patient is not highly infectious, Ms Gerberding said, but the seriousness of the disease warrants warning passengers.

A CDC quarantine officer placed the man in a hotel in Italy, and advised him he should not get on a commercial flight. But instead, he traveled to Prague and boarded a flight to Montreal, then drove into the US.

The passenger went voluntarily to a hospital in New York and then was flown back to Atlanta, where he remains hospitalized in isolation.

Ms Gerberding said CDC officials believe this is the first time a federal isolation order, authorized because the patient crossed state and international borders, has been issued since 1963, when a patient potentially exposed to smallpox was placed under quarantine.

XDR-TB is caused by strains of the bacteria that can’t be wiped out by the two most powerful anti-TB drugs or some of the second-tier drugs available. Like TB in general, it spreads through the air when people with active infections cough, sneeze or even talk.

Airline and health officials are contacting crew and passengers who may have been exposed. The man flew on May 12 from Atlanta to Paris on Air France Flight 385, and from Prague to Montreal on May 24 on Czech Air Flight 0104.

The CDC says there were 49 reported cases of XDR-TB in the US from 1993 to 2006.

Report by David Wilkening