TB carrier denies authorities told him not to fly to Europe

Health officials, Georgia man in quarantine give conflicting accounts

May 31, 2007|By Jia-Rui Chong | Jia-Rui Chong,LOS ANGELES TIMES

A Georgia man infected with a potentially deadly form of drug-resistant tuberculosis told a newspaper that health authorities here never explicitly barred him from leaving on an overseas trip that might have exposed hundreds of people in the U.S., Europe and Canada.

The man, who spoke to the Atlanta Journal Constitution on Tuesday, said health officials only said that they "preferred" he stay home in the Atlanta area. The man then reportedly left for Europe to get married.

Yesterday, officials from the Fulton County Health and Wellness Department and the federal Centers for Disease Control and Prevention said that they clearly and emphatically told him to stay put.

"He was told in no uncertain terms that he had a serious, contagious disease," said Dr. Steven Katkowsky, director of the Fulton County Department of Health. "We told him not to travel."

The conflicting stories are the latest twist in the series of missteps and misunderstandings that have sparked an international effort to track down airline passengers, crew and other people who might have had close contact with the infected man.

Dr. Martin Cetron, director of CDC's division of global migration and quarantine, acknowledged at a news conference yesterday that the agency is making slow progress in reaching passengers and crew aboard the man's trans-Atlantic flights.

CDC officials said they believe that the man was sitting around row 51 on Air France Flight 385 from Atlanta to Paris and in seat 12C on Czech Air Flight 0104 from Prague to Montreal. They believe that about 80 people on the two flights were sitting in the high-risk areas, which include the row the man was sitting in and two rows around him.

About 450 passengers and crew were aboard the Paris-bound plane, and about 200 were aboard the Montreal-bound plane.

Cetron stressed that the chances that other people were infected is low. But because the man's disease, known as extensively drug-resistant tuberculosis, or XDR TB, is so difficult to treat, the agency could take no chances.

The CDC is isolating the man under a federal public health order - the first since the isolation of a smallpox patient in 1963.

Tuberculosis is an infection of the lungs characterized by fever, weight loss, night sweats and coughing up blood. It is spread mainly through prolonged close contact, in microscopic droplets released when an infected person coughs, sneezes or speaks.

The tuberculosis bacterium has developed resistance to antibiotics over the years. XDR TB is the most resistant form. It is six times as lethal as regular TB, but it is extremely rare. Since 1993, there have been 49 cases in the U.S.

The man, identified only as a Fulton County resident, was diagnosed with tuberculosis in January after a small lesion on his lungs was found through a chest X-ray taken for other medical reasons, the CDC said.

County health officials knew by May that his tuberculosis was of a drug-resistant variety, although they didn't know whether it was of the most serious type.

They met with the man to tell him the severity of his disease and to say he should not travel out of the area, Katkowsky said.

But before the health department could deliver an official medical directive, he left for Paris.

The patient and his wife traveled from Paris to Athens to two Greek islands. Only when the couple reached Rome did the CDC discover he had XDR TB.

The man traveled to Prague and then flew to Montreal to avoid being detected by U.S. authorities, according to the Atlanta paper.

Jia-Rui Chong writes for the Los Angeles Times.

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