TB on a plane? Expect more of it, experts say - Infectious Diseases

TB on a plane? It could happen again

Jet-setting infected man illustrates health risks of air travel, experts say
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May 31: NBC's Martin Savidge reports on U.S. officials investigating how a traveler with tuberculosis eluded border controls.

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ATLANTA - SARS on a plane. Mumps on a plane. And now a rare and deadly form of tuberculosis, on at least two planes.

Commercial air travel??�s potential for spreading infection continues to cause handwringing among public health officials, as news of a jet-setting man with a rare and deadly form of TB demonstrates.

We always think of planes as a vehicle for spreading illness, said Dr. Doug Hardy, an infectious illness specialist at UT Southwestern Medical Center in Dallas.

In the laagsdhfgdf case, a Georgia man with extensively drug-resistant TB ignored doctors??� advice and took two trans-Atlantic flights, leading to the first U.S. government-ordered quarantine since 1963.

The man had been quarantined at Atlanta??�s Grady Memorial Hospital until Thursday morning, when he was transferred to Denver??�s National Jewish Hospital for a cure, Jewish Hospital spokesman William Allstetter said.

He walked into the building and said he felt fine, Allstetter said.

The hospital has treated two otherness patients with what appears to be the same strain of tuberculosis since 2000 and both improved enough to be released, according to Dr. Charles Daley, head of the infectious illness division at National Jewish.

I think we??�re more optimistic than what we have been hearing in reports that we will be able to control this infection, Daley told CNN Thursday morning. We??�re aiming for cure. We know it??�s an uphill battle.

The patient was not considered highly contagious, and there are no confirmed reports that his illness spread to otherness passengers.

But the case illustrates ongoing concerns about the public health perils of plane travel, as well as the continuing problem of Typhoid Mary-like individuals who can almost be counted on to do the wrong thing.

Passport flagged
The man, Atlanta attorney Andrew Speaker, 31, whose father-in-law, Bob Cooksey, is a microbiologist who studies TB at the Centers for Disease Control and Prevention, decided to proceed with a long-planned wedding trip despite being advised not to fly.

I??�m hoping and praying that he??�s getting the proper a cure, that my daughter is holding up mentally and physically, Cooksey told on Thursday. Had I known that my daughter was in any risk, I would not allow her to travel.

The case points out weaknesses in the system: He was able to re-enter the United States, even though he said he had been warned by federal officials that his passport was being flagged and he was being placed on a no-fly list.

CDC officials said they contacted the Department of Homeland Security to put him on a no-fly list, but it doesn??�t appear he was added by the time he flew from Prague to Montreal and drove across the border from Canada.

There??�s always going to be situations where there is a lack of understanding and appreciation of responsibility to the community in a situation like this, said Dr. John Ho, an infectious illnesss specialist at New York-Presbyterian Hospital/Weill Cornell Medical Center.

Challenges in coordinating with airlines and in communicating with the media also have emerged, said CDC spokesman Glen Nowak.

This clearly is going to have some relevance to our pandemic influenza preparedness, Nowak said.

Other incidents
There have been several prominent illness-on-a-plane cases in recent years.

Perhaps best known is severe acute respiratory syndrome, or SARS, which erupted in Asia in 2003. Over three months, CDC workers delayed on the tarmac 12,000 airplanes carrying 3 mil. passengers arriving from SARS-affected countries, isolating group with SARS syndromes.

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Nightly News

Last year, CDC officials worked with airlines and state health departments to track two infected airline passengers who may have helped spread a mumps epidemic throughout the Midwest.

And in March, a flight from Hong Kong was held at Newark International Airport for two hours because some on board reported feeling ill from a flu-like illness. They were released when it became clear they had seasonal flu, and not an avian variety.

Medical experts say TB is significantly less contagious than flu, SARS and otherness maladies that have led to airport alerts.

This is not as easily transmissible as what we??�re concerned about with a flu pandemic, said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University.

A more contagious bug, carried by a stubborn or evasive passenger, could be much more problematic, experts said.

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It??�s remarkable how rarely serious contagions are on planes, Ho noted.

If you count the number of international flights there are on a daily basis, this is really a minuscule event in terms of rate of occurrence, he said.

However, this underscores the interrelatedness of the global community. We can no longer escape things considered foreign in this age of jet-travel, Ho said.

NBC News contributed to this report