ATLANTA, Georgia — Federal health authorities said Tuesday that they are looking for people who may have been exposed to a rare and potentially lethal form of tuberculosis from an infected passenger during two trans-Atlantic flights this month.
The unidentified American male was found to be infected with a notoriously drug-resistant strain of tuberculosis called XDR TB. He flew on May 12 from Atlanta to Paris aboard Air France Flight 385, then traveled on May 24 from Prague to Montreal aboard Czech Air Flight 410 before driving back to the United States. He is currently hospitalized in an isolation ward.
Dr. Julie Gerberding, director of the Centers for Disease Control, announced the matter personally.
While tuberculosis is not highly transmissible, the deadliness of this strain coupled and the ease of modern transportation, has highlighted the need for rapid response.
TB is usually spread by sneezing and coughing. “During these two long flights, the patient may have been a source of infection to the passengers,” Gerberding told reporters.
According to her, the people most at risk would have been seated within two rows of the man. She also added that she is not sure which seats the man occupied. The C.D.C. is recommending that all passengers be notified.
“I don’t think we would compel people to be tested, but we would strongly recommend” that anyone seated near the man undergo a baseline test now and a follow-up test several weeks from now, she said.
Final diagnosis for XDR TB can take six to 16 weeks.
The first federal quarantine order in decades has been issued, and the C.D.C. is working with state and local health departments, airline officials, international health ministries and the World Health Organization. Dr. Gerberding said “We felt it was our responsibility to err on the side of abundant caution and issue the isolation order.
XDR TB was recently defined as a subtype of multiple-drug resistant tuberculosis. According to Dr. Gerberding. the man’s tuberculosis had been diagnosed before his departure, but he disregarded his doctors’ recommendation that he not travel. “The patient had compelling reasons for traveling and made the decision to go ahead and meet those personal responsibilities,” she said. She also added that federal authorities did not know until he had left the country that he had the rare form of the disease. According to her, the man himself may not have known either
Once he returned, the man was ordered into isolation, “and is required to stay in isolation until the responsible public health officials deem that he is no longer infectious to others,” she said.
Tuberculosis had been a leading cause of death even in the developed world until the development of streptomycin in the 1940s. Today, treatment by anti-tuberculosis drugs like isoniazid and rifampicin can cure up to 95 percent of patients.
But even those first-line drugs do little against multiple-drug resistant TB or MDR TB. The specific strain found in the infected American, called XDR TB resists treatment even by three of the six second line drugs used when first-line drugs fail. Only two cases of the strain were found last year in the United States.
For years, antibiotics have helped lower tuberculosis rates. There was however some resurgence starting in 1985 from recent immigrants and HIV carriers. Even then, TB cases are at an all-time low last year in the United States. According to The Associated Press, there were only 13,767 were reported cases last year.
TB is still deadly specially in countries that lack medical care, killing around 1.6 million around the world every year. It is particularly deadly among those infected with HIV. In one outbreak in South Africa, Dr. Gerberding testified, 41 percent of the 544 patients infected with tuberculosis were found to have multiple-drug resistant strains; of those, 53 met the definition of XDR TB
Of the latter group, all but one person died, on average just 16 days after health workers had tested them.
Source: CNN
