/ 30 May 2007

Alert after US quarantines passenger with XDR-TB

An international operation began on Tuesday night to track down dozens of transatlantic passengers who this month flew with a man now quarantined with extensively drug-resistant tuberculosis (XDR-TB).

The American ignored advice not to travel on commercial airlines and took a flight from the US to Europe, exposing other flyers to a highly drug-resistant strain of the potentially fatal illness.

Despite another phone call from a senior US doctor while he was in Italy telling him not to take any further flights, the man insisted on returning to North America before seeking medical advice.

He is the first person quarantined in the US by the government for more than 40 years, and is in hospital isolation in Georgia receiving treatment.

The Centres for Disease Control (CDC), part of the US department of health and human services, is trying though US agencies and through those of other countries to contact the passengers, many thought to be European, who were on the two flights with the man.

”CDC is collaborating with US state and local health departments, international ministries of health, the airline industry, and the World Health Organisation regarding appropriate notification and follow-up of passengers and crew potentially at risk of exposure,” a spokesman said.

CDC director Julie Gerberding said the authorities had been aware of the man’s condition before he left the US and had warned him against travelling. ”Under the circumstances, I think we were surprised that the patient had left the country,” she told Reuters. She said the man had ”compelling personal reasons” to travel. ”I want to emphasise that from our perspective, no laws were broken here.”

After returning to the US the man voluntarily went to a New York hospital before the CDC flew him back to Atlanta on Monday. Doctors have called him ”relatively asymptomatic”.

The strain of TB is very rare, with two US cases last year; but the fact it occurs so infrequently means officials are unsure who needs to be checked. The man had first flown from Atlanta to Paris on May 12 aboard Air France Flight 385. He returned to Canada on May 24 aboard Czech Air Flight 104 from Prague to Montreal. He was potentially infectious while on the flights, so the CDC has urgently recommended medical examinations for the cabin crew, as well as passengers in the same rows or within two rows.

The TB rate in the US has been falling for years because of the effectiveness of antibiotics. Last year, it hit a record low of 13 767 cases. In 2004, 14,6-million people around the world had active TB and there were 8,9-million new cases and 1,7-million deaths, mostly in developing countries.