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Subscribe to Human Interest UpdatesU.S. Air Travelers in TB Alert
by
findingDulcinea Staff
An American citizen infected with a rare form of tuberculosis puts passengers at risk on two transatlantic flights. Health officials advise tests for passengers and crew.
30 Second Summary
The infected man flew from Atlanta to Paris with his wife on May 12, 2007. The couple were attending their wedding in Europe.
Doctors had already informed the groom that he was suffering from "extensively drug-resistant" TB, or XDR-TB. The disease was active and contagious. However, the patient, who at time of writing had not been named, claims doctors refrained from telling him not to fly.
The authorities tried to quarantine the patient in Italy. But fearing that he wouldn't receive the same standard of care that is available in the United States, he and his wife decided to return to America via Canada.
Tuberculosis is an air-borne bacteria that infects the lungs, and causes symptoms such as chest pain, coughing, and bloody mucus.
Drug-resistant strains are harder to treat, and extensively drug-resistant TB is the most difficult to cure.
Centers for Disease Control (CDC) director Julie Gerberding said, "In the next couple of days, we'll be able to say how many people are in the risk zone."
Doctors had already informed the groom that he was suffering from "extensively drug-resistant" TB, or XDR-TB. The disease was active and contagious. However, the patient, who at time of writing had not been named, claims doctors refrained from telling him not to fly.
The authorities tried to quarantine the patient in Italy. But fearing that he wouldn't receive the same standard of care that is available in the United States, he and his wife decided to return to America via Canada.
Tuberculosis is an air-borne bacteria that infects the lungs, and causes symptoms such as chest pain, coughing, and bloody mucus.
Drug-resistant strains are harder to treat, and extensively drug-resistant TB is the most difficult to cure.
Centers for Disease Control (CDC) director Julie Gerberding said, "In the next couple of days, we'll be able to say how many people are in the risk zone."
Headline
Talking to the press, the infected man said, "This is insane to me that I have an armed guard outside my door when I've cooperated with everything other than the whole solitary-confinement-in-Italy thing." The authorities caught up with the patient in Italy, where he was told he must remain under quarantine.
Source: The International Herald Tribune
TB "is a bacteria that is transmitted through the air ... long air flights can pose a risk to passengers," says CDC Director Julie Gerberding in an interview on Good Morning America. "In the next couple of days, we'll be able to say how many people are in the risk zone."
Source: ABC News
Update
The patient is now known to be Andrew Speaker, 31, a personal injury lawyer from Atlanta. In an ironic twist to the tale, it transpires that Speaker's father-in-law is a microbiologist in the Division of Tuberculosis Elimination at the CDC.
Source: The LA Times
Reactions
Air travelers who flew on the plane with the infected man have complained that the CDC is not able to tell them where they sat in relation to the patient. People sitting within two rows of the patient are the most at risk, say health officials, but the risk is low.
Source: Atlanta Journal–Constitution
Need to Know
The patient traveled to Europe via Air France 385 from Atlanta on May 12, arriving in Paris May 13. He returned on Czech Air 0104 on May 24, flying from Prague to Montreal, and then traveled by car into the United States. The CDC details its investigation into the case and
encourages "all U.S. residents and citizens on these flights ... to seek TB testing and evaluation."
encourages "all U.S. residents and citizens on these flights ... to seek TB testing and evaluation."
Source: The Centers for Disease Control––Flight Details
Extensively drug-resistant tuberculosis, or XDR-TB, is rare in the United States. "However," say the Centers for Disease Control, "it is important to acknowledge the ease at which TB can spread." XDR-TB is resistant to almost all drugs used to treat TB. Patients have fewer treatment options as a result, and their treatment outcomes are often worse. The CDC covers the essentials regarding the disease.
Source: The Centers for Disease Control––Tuberculosis
Tuberculosis is either latent and asymptomatic or active, in which case symptoms present themselves. It is only transmittable in the active state. Symptoms during the active stage may include a cough with bloody mucus; fatigue and weight loss; and chest pains and shortness of breath. WebMD covers symptoms, diagnosis, and treatment.
Source: WebMD––TB Overview
Reference Material
The World Health Organization (WHO) issued a report recently on the global TB situation stating, "There were 8.8 million new cases of TB in 2005 and 1.6 million deaths from the disease." The use of counterfeit or substandard drugs and the non-completion of treatment programs have given rise to the drug-resistant strains of the disease, of which XDR-TB is a particularly virulent form.
Source: The World Health Organization
Around one third of the world's population, or two billion people, are infected with tuberculosis, according to the National Institute of Allergy and Infectious Diseases. After being on the decline for years, the number of U.S. cases began to rise in 1985 as a result of the HIV epidemic, international migration, increased poverty, and other factors.
Source: The National Institute of Allergy and Infectious Diseases
The United States has the second lowest rate for TB infection out of 166 countries, according to these 2005 UN figures. There are only 2 people infected out of every 100,000. The disease was most prevalent in Swaziland, where 626 people were infected out of every 100,000.
Source: Nationmaster
Background
Robert Daniels was a 27-year-old TB sufferer who moved from Russia to the States last year, believing himself cured. In actuality, because he failed to complete his treatment, the bacteria had mutated into a drug-resistant strain. He found himself forced into the prison wing of a Phoenix hospital. This Washington Post article tells his story, and looks at the spread of drug-resistant strains in Russia.
Source: The Washington Post
History
The word "quarantine" derives from the Latin term for "40," and dates to the 14th century and the era of the Black Death (or bubonic plague). Ships arriving at Venice would have to lay anchor for 40 days before the crew could step ashore. The practice soon spread to other ports, as explained in this history of quarantine.
Source: PBS––A History of Quarantine
Typhoid Mary, AKA Mary Mallon, was an Irish immigrant in New York who was working as a cook in 1906 when she came to the authorities' attention. A member of her household contracted typhoid, and the infection was traced back to Mary. A typhoid carrier, she spent most of her subsequent life in forced confinement. Popular legend has her infecting hundreds of victims. In truth, 33 people caught typhoid from Mary, and only 3 of them died.
Source: Snopes.com––Typhoid Mary
The Global Tuberculosis Institute details the history of the disease, from the ancient Egyptians whose mummies retain traces of TB to the modern development of drug-resistant strains. "While wealthy industrialized countries with good public health care systems can be expected to keep TB under control," the article concludes, "in much of the developing world a catastrophe awaits."
Source: New Jersey Medical School
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