Air Traveler With Drug Resistant TB Quarantined By CDC

Drug-resistant TB is both extremely contagious and potentially fatal, and the CDC would like to speak with anyone who sat near a passenger who has since been quarantined with the illness. The passenger was on a May 13, Atlanta to Paris, Air France 385 flight and another Czech Air 0104 from Prague to Canada on May 23.

The CDC is concerned about passengers who sat near the infected person because the conditions on a long transatlantic flight make it the most likely place that another person would contract the illness.

“We are focusing in on these two air lines because they are long trips, because our science indicates these are the kinds of trips that could pose a risk of transmission,” said CDC Director Dr. Julie Gerberding.

“The medical evidence would suggest the potential for transmission would be on the low side. But we know it isn’t zero,” she said.

“We are considering not only his own ability to transmit but also the seriousness of this organism and the chance some passenger could be at a special risk on the basis of their own personal medical history,” Gerberding said.

The form of TB carried by the passenger is extremely rare and difficult to treat. It’s also expensive. According to NPR, “One case last year cost as much as a half million dollars to treat.” This is the first time a patient has been quarantined by the CDC since 1963. —MEGHANN MARCO

Air Traveler With Drug-Resistant TB Quarantined [NPR]
(Photo: Alex-s)

Comments

Edit Your Comment

  1. skittlbrau says:

    that passenger who put people at risk knowingly is perhaps the biggest asshat on the planet.

  2. dbeahn says:

    Did the passenger in question KNOW what they had?

  3. snazz says:

    that sucks!!!!!!

  4. yzerman says:

    According to CNN he knew he was sick with TB but he didnt know it was the kind that is super resistant and very deadly.

    My question is though: Isn’t all TB dangerous. Why would a person with TB be allowed at a airport to fly?

    Apparently common sense doesnt win out here.

  5. davere says:

    What I heard is that he was contacted while in Paris and told that he had a type of drug resistant type of TB and told NOT to fly back home. But he did anyway.

  6. rekoil says:

    According to the AJC story, they were going to quarantine him in Italy, and he really didn’t trust the Italian hospitals to know how to deal with this, which is why he went ahead and flew home. The irony is, the CDC operates a government jet, which they weren’t willing to send to Italy to pick him up. So he flew back to Canada instead of the US then drove home.

  7. rekoil says:

    Here’s the story:

    http://www.ajc.com/health/content/health/stories/2007/05/2

    bugmenot.com is your friend. :)

  8. pinkbunnyslippers says:

    He knew he had it, and claims the airline knew about it as well and still let him fly. At least that’s what the report on this morning’s Today Show was…

    Regardless of whether it was drug-resistant or not, it’s TB. It’s still highly contagious and he should not have flown home. It might’ve been “mild” in him, but god knows who was on that plane…people with compromised immune systems, children, etc. An easy way for a “Mild, non-drug resistant” case to turn a passenger into a fatality.

  9. Wormfather says:

    Common sense tells him to stay put and get help but at the same time, having a sever illness and being far away from family and the doctors you know could have forced him to do something stupid and put other people at risk. I know that if I had the flu and was far away, I’d just want to go home.

    Just playing devil’s advocate.

  10. cooper says:

    @Wormfather: drug-resistant tb cannot be compared with the flu.

    i’m sure we would all want to go home in the same situation, but that does not excuse knowingly placing other passengers at risk. especially if the infected passenger did understand their condition and the risk.

  11. captainbozo says:

    This guy should be put in prison for attempted assault or even attempted manslaughter. He knew what he had and that he shouldn’t fly. If he gets somebody else sick, it’s practically a life sentence. A man in Arizona (who had TB, though not XDR-TB) was put in prison because he was found at a grocery store without his mask, which he had been ordered to wear when out in public.

  12. deweydecimated says:

    I know someone who had regular ol’ TB, and he was quarantined by the state in which he lived. He also had to take his medications in front of a nurse for months. How did a drug-resistant case have less restrictions?

  13. madktdisease says:

    Anyone still ragging on that pilot that kicked off the girl on the Hawaii flight for coughing uncontrollably? Anyone? Bueller?

  14. Wormfather says:

    @cooper: Dont get me wrong, I’m not excusing the passanger, I’m just saying that there is a level of compassion towards the situation.

  15. skittlbrau says:

    @Wormfather: Compassion may be warranted.

    However, this passenger showed an astounding lack of empathy towards his fellow passengers when he got on those planes. He didn’t know who was immunocompromised or otherwise prone to infection. He didn’t tell the passengers on the plane he has a strain of a disease that has proven to be nearly universally fatal because there is no effective treatment.

    Would you have wanted to sit next to him for 7 hours plus knowing he is putting your life at risk?

  16. Buran says:

    @yzerman: Do you go telling everyone around you that you’re sick unless they ask, because you sound terrible when you talk or something? Probably not.

  17. Buran says:

    @baa: He probably also showed a severe lack of psychic ability to know that he had something that dangerous. Most people can’t pull a diagnosis out of thin air, and even doctors have to run tests first.

  18. Buran says:

    @madktdisease: A doctor cleared her to stay. That’s something entirely different.

  19. TPIRman says:

    From the OP: “Drug-resistant TB is both extremely contagious and potentially fatal…”

    Potentially fatal, yes. “Extremely contagious”? That’s fearmongering. TB is infectious and should be treated with great caution, but it is actually less contagious than the flu or a common cold. One FAQ notes:

    You cannot get the disease by shaking hands, sitting on a toilet seat, sharing food or even sharing the same tooth-brush with an infected individual.

    And in one news story, a doctor explains:

    The main way that TB is transmitted, is that someone coughs and then someone breathes in those droplets. And then they can get TB. It’s not very contagious. It’s not like the flu or like the common cold. And in general, someone has to be coughing a lot.

    I don’t know where Meghann got the “extremely contagious” bit, but it ought to be changed.

  20. tph says:

    Based on the article, his doctors and the CDC knew that he was sick before he left the US. They also knew that he was planning on leaving. Why didn’t they stop him from going in the first place?

    It’s kind of hard to blame the guy when you take the following into account:
    1.) he’s perfectly healthy. The fact that he has this was only discovered by random chance.
    2.) his fiance, family, and everyone who has been in contact with him has tested negative for infection.
    3.) when he asked whether it was ok to leave the country, they told him he could (though said that they preferred he didn’t), and didn’t tell him to take any precautions.
    4.) when they finally do decide that he’s apparently so sick that he’s not allowed to travel he’s in a foreign country, away from the doctors he knows, and where he may, or may not speak the language. Also, from his point of view nothing has changed since they told him that it was ok to fly.

    I’m of the belief that sick people have as much of a right to fly as I do (especially when you consider how many sick people have no idea what they’ve got). If you’re paranoid about getting sick, wear a mask (or just stay home, because if you are around other people, you are at risk of catching airborne diseases).

  21. TechnoDestructo says:

    @deweydecimated:

    God damn. I didn’t have to be supervised for mine. (Nor was I quarantined) Was he active? Or just exposed?

    @cooper:

    Yeah, when you’re over the flu, you’re really over it. TB just goes dormant, and you hope it stays that way.

  22. Trai_Dep says:

    According to NYT, the CDC called him while he was in Europe and appraised him of the situation. They told him to sit tight until they could arrange gov’t transportation (jet). He thought, “F*ck ‘em” and took a commercial flight to Canada. Then he drove across the US. CDC calls him telling him, “We’re set, here’s the private jet we set up for you,” and the tool says, “Umm, I’m already back in the US.” They then told him to drive to a meeting point, where he was quarantined.

    Guess he’s just too damned important to wait for a private jet flight.

    I hope every passenger/crew member that’s inconvienced sues the ever-living crap out of him for years. And coughs in the face of his children. Repeatedly.

  23. Trai_Dep says:

    (When the CDC calls you and says they’d love to fly you from where you are to where they are, ASAP, on a government jet, that’s a pretty clear sign that commercial flights aren’t advisable. If you’re a human being. Jerk.)

  24. myrall says:

    Dr. Julie Gerberding of the CDC gave an interview on NPR yesterday afternoon stating that this guy had been dealing with his local health department and then decided that his trip abroad was JUST that much more important than not infecting possibly hundreds of people. She said he was even put on the ‘No Fly’ list and that the carrier that brought him into Canada was probably not one of the carriers that regularly checks the list.

    Also, she said the WHO had been notified of this guy. It sounds like the CDC had everything covered on their end and then this turd blew everything wide open.

  25. cooper says:

    @TechnoDestructo: directly-observed therapy is likely reserved for those who have already demonstrated poor medication adherence. your health authority probably either didn’t have a reason to believe you weren’t taking your meds or did not have a program in place for your risk level. the person being classified as having drug-resistant TB means that they actually have active TB and weren’t just exposed.

  26. madktdisease says:

    @Buran:

    First you said a doctor (who just happened to be on the plane, not an employee of the airline or airport) said she was cleared. Then in the previous comment, you say “even doctors have to run tests first.” ;P

    That pilot still made the right choice. I wasn’t there, who knows what medicine the DR practiced. And he’s not the final say, he’s not an airline employee and can’t make the call for a company he doesn’t work for. If he was wrong and the girl had a medical emergency mid-flight, the parents would still sue the crap out of the airlines.

  27. The Bigger Unit says:

    Man, what’s wrong with people defending this guy? He’s an asshole for flying on a public flight knowing he had TB (ANY kind of freaking TB). Anyone who was on the same flight as him breathing in the recycled air in the flying tube would be pissed too. If you would’ve flown knowing you had it, you’re an asshole too! Standards and decency are quickly going the way of the albatross.

  28. Tallanvor says:

    @madktdisease: Yes, actually. And there’s no comparison in this case anyway. Based on the news articles, there is no way that a pilot could have could have known that he was a carrier of TB unless he/she was told explicitly.

    Illness and fitness to travel should be assessed by medical personnel, not pilots who do not have the training necessary to determine whether or not a person determines a health risk to the plane.

    It sounds like nobody told him not to fly until he was in Rome. Once they told him he should be placed in isolation, he made a calculated risk to return to the States rather than risk not getting the proper treatment where he was. Was that wrong? Yes, but when you look at it from his point of view, more understandable.

    It sounds like his infection isn’t active, so the chances that he passed the infection along to anyone else is virtually 0. And when you consider that it’s estimated that over 1/3 of the world carries the TB bacteria, well, how much do you want to bet that there are a lot more people flying with the disease than just him?

  29. Joafu says:

    @Johnny: Maybe she got that from the fact that he flew trans-atlantic twice and getting an airborne disease on an aircraft is easier than getting it in an open air setting; unless the crew and passengers were wearing N95s than I would bring the entire lot in for testing in the next few months. Of course, if he was latent everyone is probably fine, but if he’s flying all over knowing what he had he might have flown when he was active.

  30. jdch_99 says:

    Having lived through the SARs crisis in 2003 in Toronto, I really appreciate this half-wit knowingly putting others (in multiple nations) at risk.

    The fact that he flew into Canada then snuck into the United States tells us all we need to know about his guilty act, if not his guilty conscience.

  31. Trai_Dep says:

    I think the people excusing this turd by shrugging and saying, “A man’s gotta do what a man’s gotta do” aren’t of the reality-based community…

    I hope that when their toddlers are mauled by a rabid Rottweiler, they’re as understanding of the “hey, stuff happens” excuse given by the owner.

  32. TPIRman says:

    @Joafu: The NPR article linked from the OP disputes your “airplane = extremely contagious” theory. Here’s what the CDC director had to say about bringing the passengers seated near the guy in for testing:

    The medical evidence would suggest the potential for transmission would be on the low side. But we know it isn’t zero. We are considering not only his own ability to transmit but also the seriousness of this organism and the chance some passenger could be at a special risk on the basis of their own personal medical history.

    Of course they bring people at potential risk in for testing; that doesn’t make the disease “extremely contagious.” Again: potentially fatal — definitely. Extremely contagious — no. It’s an easy mistake to make; people commonly conflate contagion with virulence, but on an issue as important as this, we should have our facts straight.

  33. FLConsumer says:

    There’s a special quarantine for someone like this — isolation cell in a jail. There have been successful criminal cases against people who’ve intentionally been risky with their infections/diseases and sperad them to others.

    @Joafu: would an N95 be enough to block TB? I don’t have my medical books in front of me to look it up.

  34. TPIRman says:

    @FLConsumer: Yeah, the CDC recommends an N95 for respiratory protection against tuberculosis.

  35. @tph: “I’m of the belief that sick people have as much of a right to fly as I do”

    They don’t when they have TB. Many countries restrict entry of foreign nationals with TB. TB is a regulated disease under various world travel treaties (primarily air, since it’s most transmissible in airplanes).

    1/3 of the world has latent TB, so you can’t prevent EVERYONE with TB from travelling, but individuals with ACTIVE infections or drug-resistant strains should certainly not be travelling without serious preventative measures. But neglect of preventative measures, neglect of routine testing, and the rise in HIV infections has led to a global resurgence of TB and to the emergence of drug-resistant TB.

    My college roommate was exposed to TB when she was working at a hospital as a patient advocate. Two international students had flown in from Africa and one had a cough that wouldn’t improve, so she went to the ER (not having a doctor yet) and, lo and behold, it was TB. To which half the ER personnel, including my roommate, and everyone on the THREE airplanes they had flown on were all exposed. (She should not have been issued a visa without a clear TB test because of her country of origin; either the test was inaccurately performed, the paperwork was forged, or nobody bothered to look.) Both were quarantened. (They may have been deported later; I don’t recall.)

    As a result of the exposure to an active case, everyone exposed had to be notified (including everyone on all those flights), and most (depending on type/duration of exposure) had to be tested according to the rules of their place of residence, which for my roommate was every six months for two years. All had to be tracked by their state departments of health (or equivalent).

    So my roommate gets hauled off by the state department of health for her first test, and it comes back POSITIVE, which means that a) she has to get the X-ray tests every three months and b) I AM NOW LISTED AS A TUBERCULOSIS-EXPOSED PERSON by the state and *I* now have to get routine TB tests reported to the state for two years! (I turned up negative for the duration of the period of testing.) I’m told that once you test positive, you test positive for the rest of your life on the skin test so you always have to get the next-level test.

    Hopping on a plane with TB isn’t fun and games, and it impacts the lives of many people beyond the infected person’s — and beyond those he opts to expose to his potentially deadly disease. My roommate now has to check “yes” on every questionairre asking, “Have you ever tested positive for TB?” which leads to a great deal of extra time and expense in acquiring medical permission for various activities. And I now always have to check “yes” for having been exposed to TB, which often means an extra test for me.

  36. skittlbrau says:

    @Eyebrows McGee: I’m sorry to hear about your personal hassles with TB.

    And yes, TB is incredibly common worldwide. Not so much in the United States. In fact, my university would not allow TB positive students to live on campus, including my sorority sister that had the university pay for an off-campus apartment, rather than sleeping in our cold dorm, possibly infecting the rest of us.

    Part of the reason TB is relatively rare here is because people take it seriously.

  37. tph says:

    @Eyebrows McGee: I agree that the policies for tracking/controlling TB are fairly stringent (as your unfortunate experience would attest to) I also think that in many cases they are somewhat useless. For example, I’ve been in the US for a few years now, and am in the process of applying for my green card. Part of this procedure is a medical exam including a TB test — what is the point of testing me now, when I’ve been here for years and probably got it from a citizen anyways.

    This isn’t like HIV – someone who is HIV positive can stop having sex. Someone with TB can’t stop breathing, and locking someone up (quarantine) when they haven’t done anything wrong is, well, wrong.

    It was the CDC that dropped the ball here. They knew he had something difficult to treat, and they still let him leave. You can’t blame the guy for wanting to come home when he hears “oh yeah, you’ve got something much worse than we thought”

  38. bombaxstar says:

    What a cock.

  39. Kimli says:

    I’m not defending the TB’er, but he was flying to his wedding. If I was told “well, you can go but we’d really prefer it if you didn’t” and my wedding ceremony was up in the air, I would go. If the agencies in question had known what it was he was trying to fly to, I think that a sterner answer of “you may not leave the country – I’m sorry, but you are a danger to others” would have been more appropriate than basically saying “do what you think is best”.

    Would you disappoint your bride and families because the government told you they didn’t want you to do something but really it was up to you?

  40. deweydecimated says:

    @TechnoDestructo:

    he was active.

  41. IRSistherootofallevil says:

    IF they were sending a private jet over to Rome, were they sending it the next day? That day? In a week? A month? A year? Plus, would the CDC pay for his lodging costs in wherever he was in Italy? Yes, he would be a jerk in my book if the CDC rep told him that the jet would pick him up THE NEXT DAY, or TWO DAYS LATER, and the CDC would put him up in a hotel in the meantime and contact his employer about the extra day or two he would miss, and GUARENTEED all of this, but there was no such guarentee. I would have said, “If you’re sending a jet, send me a jet by midnight tonight. If not, I’m flying home anyway.”

    CDC definitely dropped the ball. If they were going to send a private jet to Italy, they should have done so the minute they found out. And about the girl that got kicked off the continental flight, was she put up in a hotel and put on another EWR-HNL flight the next day? Where she would just expose whatever she had to a DIFFERENT set of 300 passengers? Or was she put on a private jet? If continental was concerned about the safety of the passengers, they would have done the latter, not the former.

  42. Trai_Dep says:

    I’m wryly amused that “IRS is the root of all evil” has his panties in a bunch over the fact that the CDC doesn’t have a fleet of $20m private jets to criss-cross the globe so that criminally negligent typhoid marys don’t have to wait longer than 30 minutes to be picked up.

    Or, are you one of those guys that think the government should get a blank check to buy whatever they might conceivable (or not) need, and just charge it to little kids via deficits?

  43. kimsama says:

    @IRSistherootofallevil: Wait, so it’s ok to infect hundreds of people if the alternative is to be inconvenienced?

    Sorry, that argument doesn’t fly (ahem, pardon the pun). The CDC does not have limitless resources to track down people and wisk them away at a moment’s notice. A non-douchebag would have stayed put. This guy cut his honeymoon short to get out of Rome and fly home on a commercial jet, putting multitudes of his fellow passengers at risk. For…his own convenience?!

    This guy is going to be in quarantine far away from his home for several weeks now, according to the news. I doubt that’s convenient for him either, but it is necessary to contain the infection.

    I’d love to see him inconvenienced a little more with a jail sentence or a few lawsuits.

  44. GeekChicCanuck says:

    I’m not only angry at this guy, I’m also baffled by the border inspector that let him in to the U.S. (Not that I want some guy infected with drug-resistant TB running around up here).

    According to the latest AP news article that I can find (http://seattletimes.nwsource.com/APWires/headlines/D8PFL1P00.html), this twit showed up at the border crossing in Champlain, NY where an agent ran his passport and received a warning “including instructions to hold the traveler, don a protective mask in dealing with him, and telephone health authorities”. Despite this, the agent chose to ignore the warning because he thought that the guy seemed “perfectly healthy” though the agent admitted that “he was no doctor”. WTF?!

    The capper, of course, is that this guy is supposedly a personal injury lawyer. *smirk*