CDC Seeks Those Who Sat Near TB Patient

ATLANTA --

Health officials in North America and Europe are trying to track down about 80 airline passengers who sat near a honeymooner infected with a dangerous drug-resistant form of tuberculosis on two trans-Atlantic flights. They also want passenger lists from four shorter flights the man also took while in Europe.

"The investigation is just beginning. It's very challenging," said Dr. Martin Cetron, director of the Centers for Disease Control and Prevention's division of global migration and quarantine.

The man, now under the first U.S. government-ordered quarantine since 1963, told a newspaper he flew from Atlanta to Greece for a wedding and then traveled to Italy for a honeymoon. Later he flew back to North America, despite warnings from the CDC not to, because he feared he might die without treatment in the United States.

He and his bride then took four more flights within Europe, flying from Paris to Athens on May 14; Athens to Thira Island May 16; Mykonos Island to Athens May 21; and Athens to Rome May 21.

CDC officials are concentrating on the two trans-Atlantic flights, when the likelihood of spreading the disease was greatest because he was in a confined space with other people for hours. Officials were trying to contact 27 crew members and about 80 passengers who sat in the five rows surrounding the man for testing.

Other passengers are not considered at high risk of infection because tests indicated the amount of TB bacteria in the man was low, Cetron said Wednesday.

"Our big concern is that no one has told us which row he might have sat on," passenger Shannon Boccard, whose 10-year-old son was on the same flight, told WSB-TV in Atlanta.

Health officials in France have asked Air France-KLM for passenger lists, and the Italian Health Ministry also is tracing the man's movements. A spokeswoman for Czech airline CSA said medical checks showed no infections among its crew members who flew with the man, but the airline was contacting passengers.

The man had a supply of masks to wear for the protection of other passengers, but it is not clear if he used them, Cetron said. He said the man, whose identity has not been released. continues to feel well and shows no symptoms.

The man told The Atlanta Journal-Constitution that doctors did not order him not to fly and only suggested he put off his long-planned wedding. He knew he had a form of tuberculosis and that it was resistant to commonly used drugs, but he did not realize until he was already in Europe that it could be so dangerous, he said. The man's wife has tested negative.

"We headed off to Greece thinking everything's fine," he told the newspaper. The newspaper did not identify him at his request, because of the stigma attached to his diagnosis.

He flew to Paris on May 12 aboard Air France Flight 385, also listed as Delta Air Lines codeshare Flight 8517.

He and his bride took then took four more flights within Europe, flying from Paris to Athens on May 14; from Athens to Thira Island on May 16; from Mykonos Island to Athens on May 21; and from Athens to Rome on May 21.

The passengers on the shorter European hops are not considered to be at the same level of risk for infection as the passengers on the trans-Atlantic flights, which each lasted eight hours or more, CDC officials said.

While he was in Rome, health authorities reached him with the news that further tests had revealed his TB was a rare, "extensively drug-resistant" form, far more dangerous than he knew. They told him to turn himself over to Italian health officials and not to fly on any commercial airlines.

Instead, on May 24, the man flew from Rome to Prague on Czech Air Flight 0727. From Prague, the couple left for Montreal the same day, aboard Czech Air Flight 0104, according to CDC officials.

The man then drove into the United States at Champlain, N.Y. He told the newspaper he was afraid that if he did not get back to the U.S., he wouldn't get the treatment he needed to survive.

He was held at Atlanta's Grady Memorial Hospital under the first federal quarantine order since the government quarantined a patient with smallpox in 1963. A sheriff's deputy was assigned to guard him, though he is not facing prosecution, health officials said.

A spokesman for Denver's National Jewish Hospital, which specializes in respiratory disorders, said Wednesday that the man would be treated there.

Dr. Charles Daley, head of the infectious disease division at National Jewish, said the hospital has treated two other patients with what appears to be the same strain of tuberculosis since 2000, although that strain had not been identified and named at the time. He said the patients had improved enough to be released.

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Associated Press writers Daniel Yee in Atlanta and Colleen Slevin in Denver contributed to this report.

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On the Net:

CDC: http://www.cdc.gov/

Public Health Agency of Canada: http://www.phac-aspc.gc.ca/


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