4 on flight catch TB from woman

March 03, 1995|By Jonathan Bor | Jonathan Bor,Sun Staff Writer

Federal investigators said yesterday that a woman with severe tuberculosis who took airline flights between Baltimore and Honolulu last May infected four people sitting nearby -- the first recorded case of TB transmission between airplane passengers.

The woman, a native of Korea who had lived in Japan for 12 years, was so sick she was hospitalized as soon as she landed in Hawaii. She died several days later from complications of the disease.

The Centers for Disease Control, which conducted the investigation, did not identify the infected passengers. It appeared unlikely that any of them came from Maryland. All had boarded the plane in Chicago, where the woman had changed from one United Airlines flight to another, and sat within several rows of her during the trip to Hawaii.

The findings, reported today in a weekly CDC report, come amid mounting concerns by flight attendants and consumer advocates about the potential for disease transmission on airplanes. Today's planes tend to pack more seats and recirculate more cabin air than did previous models.

But yesterday, health officials said the risk of transmission is no greater aboard airplanes than in other confined spaces where people spend comparable amounts of time together. They all but ruled out the possibility that the air-handling system helped spread the disease.

"The interesting part of this data is that the people who became infected actually sat very close to this person," said Sarah Bur, director of tuberculosis control for the Maryland Department of Health and Mental Hygiene.

"Probably, the issue here was not air circulation but the passengers' proximity" to the sick woman, she said.

If the air-handling system were to blame, she said, people sitting in distant sections would have become infected.

Dr. Kenneth Castro of the CDC said "the inference is that the sick passenger probably aerosolized the TB bacteria through coughing and sneezing."

The findings prompted the CDC to issue a warning: People with infectious TB should take private rather than commercial transportation, or should avoid traveling until antibiotics render them noncontagious.

None of the four passengers has developed an active case of tuberculosis. A person with latent infection stands a 10 percent chance of developing active TB in his or her lifetime. Even then, most people who get sick are effectively treated with antibiotics.

The ailing woman had spent about a month visiting friends in Howard County before boarding a United Airlines flight at Baltimore-Washington International Airport on May 11. She was treated for tuberculosis several years earlier. The condition resurfaced about the time of her visit.

She was bedridden with a severe cough and other respiratory symptoms for her entire time in Maryland but did not seek medical attention, local health officials said. Antibiotics are usually effective in reducing the symptoms of tuberculosis, and changing the disease from an active to a noncontagious state.

The family she was visiting apparently did not know she had TB until they learned about her hospitalization. Then they contacted the Howard County Health Department. One of the family members -- a young girl -- tested positive for tuberculosis and was placed on antibiotics that prevented her infection from becoming active.

Investigators with the CDC subsequently notified 113 people who traveled the first leg of her trip and 257 who flew from Chicago to Honolulu. All were advised to consult their doctors and get tested.

Three passengers on the first flight and 11 on the second tested positive but carried the bacteria from previous exposures, the investigators said.

The CDC also detailed its investigations of five other cases in which people with active tuberculosis traveled on commercial airliners. The United flight, however, was the only case in which one passenger infected another.

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