Air Passenger Might Have Exposed Travelers to TB

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The federal government has quarantined someone for the first time in nearly 50 years after a man with a drug-resistant form of tuberculosis — called XDR TB — traveled by airplane.

The man, who has not been identified, took two commercial flights to Europe and back to Canada, possibly exposing other passengers. Federal officials are now searching for those passengers and crew members so they can be tested. The man is being held in a Centers for Disease Control and Prevention facility in Atlanta.

Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, talks with Day To Day's Madeleine Brand.

This man was advised not to travel and did. Why?

You're dealing with human behavior. We know that, dating back to the earliest of times, there are people who, for selfish reasons, for unclear purposes, will in fact do whatever they please. In this case, this is where public health has to battle the issue of individual rights and privacy with that of the greater health good. This was a collision that was bound to happen sometime and will happen more often in the future.

Shouldn't there be more stringent rules preventing them from doing whatever they please?

This individual had been compliant with public health action. It was only with the advent of his wedding in Europe that he decided that he wasn't going to be. There was actually an order issued before he left the United States, but [public health officials] were unable to serve it on him. This just points out that you have to have extreme measures for the very, very small number of people who just won't be compliant.

Extreme measures being what?

Putting someone in a legal hold. Actually, today the terminology is a bit confusing. While what we're really talking about is holding this individual under what is called quarantine laws, it is really "isolation," where you're holding someone against their will so that they don't transmit the disease to others.

"Quarantine" is the process where we find people who may have been exposed to someone and put them under some kind of watchful eye, or in some cases actually hold them until the time period has passed in which they would have become infected.

So, technically speaking, this is really isolation. But either way you look at it, it is holding people against their will so that they will not continue to transmit to others.

Should this guy be sanctioned in some way?

What we need to do is really understand it better. What could we have done to have supported this individual in not continuing to travel?

So maybe the CDC should have sent a plane?

In the future, we're going to have more of these situations, and one of the ways we're going to help people be compliant — and this is in the public's best interest to do this — is ask ourselves what can we do to assure someone that if they are in a far distant land and have an urgent need to get home for health care, that we in fact support them in doing the right thing. That may sound like we're really taking care of them. In a sense, we're protecting the public.

This story contains only a portion of the conversation, and excerpts have been edited for clarity.



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