RENEE MONTAGNE, host:
As we've heard, a man with a severe form of tuberculosis has been quarantined by the Centers for Disease Control and Prevention. The patient had flown across the Atlantic and come back to the U.S. despite doctor's orders not to travel. The airlines are notifying other passengers and urging them to get tested.
NPR's Brenda Wilson reports that health officials say the TB patient posed a risk, a low risk, mainly to those seated near him.
BRENDA WILSON: It's the first time since 1963 that the CDC has issued an order for a patient to be quarantined. This is usually left up to the states. But this case involved international and interstate travel, and the disease, extensively drug-resistant tuberculosis, is extremely difficult to treat. So CDC director Dr. Julie Gerberding says the agency erred on the side of abundant caution to avoid any potential for exposure.
Dr. JULIE GERBERDING (Director, Center for Disease Control and Prevention): We have note suspicion that this patient was highly infectious. In fact, the medical evidence would suggest that his potential for transmission would be on the low side, but we know it isn't zero.
WILSON: XDR-TB does not respond to treatment with the usual first or second-line TB drugs and treatment takes longer. One case last year cost up to half a million dollars. But CDC is most concerned about the passengers in the rows nearest to the patient on two key flights, one from Atlanta to Paris on Air France 385 on May 13, and another flight from Prague to Canada on Czech Air 0104 on the 23rd of May.
Dr. GERBERDING: We're focusing in on these two airlines because they were long trips, because are science indicates that if there is a risk, these are the kinds of trips that could pose a risk of transmission.
WILSON: Although there have been a number of cases of people acquiring highly infectious diseases on long flights, this is not a common occurrence. The cases are few in number. Dr. Henry Masur, president of the Infectious Disease Society, says exposure, even at close proximity, doesn't usually result in infection.
Dr. HENRY MASUR (President, Infectious Disease Society): You may breathe in the organism, but most people will not actually get that organism into their body to cause an infection.
WILSON: A skin test would show that the person is harboring the organism. The disease can remain latent for years. When a regular case of TB is diagnosed, all it takes is one drug to cure it. If there's a reason to suspect the person has XDR-TB, the prophylactic treatment is not as simple.
Dr. MASUR: Generally, it would take several drugs that were active against the organism, but there's very little experience to know how many drugs or for how long you would have to treat the patient.
WILSON: And if the strain is not known, it becomes a kind of trial and error to find the right drugs. Part of what makes XDR difficult to treat is the time it takes to identify the strain. The patient in this case knew he had TB and had been advised not to travel. But he had already left the U.S. before it was discovered that he had XDR-TB.
Dr. Martin Cetron of the CDC's Global Migration and Quarantine Division says the man ignored CDC orders to stay put in Europe and got on a flight to Canada and then drove into the U.S.
Dr. MARTIN CETRON (CDC): I spoke to him personally and requested his compliance to go to the isolation facility, the isolation hospital in New York City to be evaluated. He voluntarily drove himself there. He was given instructions on how to do that safely even without putting the public health at risk.
WILSON: He was then taken by a CDC plane to Atlanta, where he was transferred to Georgia state health officials and placed in quarantine.
Brenda Wilson, NPR News.
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