An Atlanta-area man --- infected with a rare, potentially deadly type of tuberculosis --- is under federal quarantine at Grady Memorial Hospital with an armed sheriff's deputy outside his door following his odyssey on international flights, including some to smuggle himself back into the country.
The globe-trotting tale of the man, his fiancee, their wedding and honeymoon abroad --- and conflicting recollections of what he was told about his disease and whether he could travel --- culminated Tuesday with the Centers for Disease Control and Prevention issuing an international health alert.
The CDC is working with airlines to contact passengers who took two transatlantic flights --- a May 12 Air France flight from Atlanta to Paris and a May 24 Czech Air flight from Prague to Montreal --- to alert them that they may have been exposed to extensively drug-resistant tuberculosis.
The disease, also known as XDR TB, is difficult to treat and can cause severe illness and death. Only 49 cases of it have been identified in the United States between 1993 and 2006, according to the CDC.
"I didn't want to put anybody at risk," the Fulton County man, who declined to be identified because of the stigma attached to his diagnosis, said in a telephone interview with The Atlanta Journal-Constitution. "We just wanted to come home and get treatment."
Since January the man, who said he has no symptoms and feels healthy, has met regularly for treatment with Fulton County health officials. He said they and CDC knew he had drug-resistant TB before he left the United States but did not prohibit him from leaving when he told them about his upcoming wedding in Greece.
He questioned why nobody told him to cancel his wedding before he left Atlanta --- and why the CDC waited until he was on his honeymoon in Rome to order him into isolation.
"I'm a very well-educated, successful, intelligent person," he 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."
At a news conference Tuesday, CDC Director Julie Gerberding announced that the agency had taken the rare action of issuing a federal public health isolation order against the man, which allows the CDC to hold people against their will to protect the public. Gerberding believes the isolation order was last used in 1963 in a case involving a potential smallpox exposure.
"Normally when someone has tuberculosis, we influence them through a covenant of trust," Gerberding said. While saying tests show the man is at extremely low risk of transmitting the disease, Gerberding said the agency is urging passengers who sat in nearby seats and rows during the two long trans-Atlantic flights receive TB tests as a precaution, and that others who traveled aboard the flights be offered the opportunity to be tested if they have concerns.
CDC officials did not release any details about where the man sat on the flights or how many people may have been exposed. They said they would be working with the airlines to contact passengers directly. For now, they said, they're focusing on the trans-Atlantic flights because --- while the risk is very low --- it's where people would have had the most extended period of exposure to him.
"We're balancing both the needs to protect individual freedoms and the responsibility to protect the public," Gerberding said.
"We also want to reassure people who weren't on these flights that the risk of exposure in random air flight is extremely low," she said.
CDC officials note that air travel carries a relatively low risk of infection with TB of any kind.
Because of antibiotics and other measures, the overall TB rate in the United States has been falling for years. Last year, it hit an all-time low of 13,767 cases, or about 4.6 cases per 100,000 Americans. Tuberculosis kills nearly 2 million people each year worldwide.
Man with rare and dangerous form of tuberculosis has been placed in quarantine after possibly exposing passengers and crew on two trans-Atlantic flights.
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