No TB found among those who flew with Atlanta patient

Nov 28, 2007 (CIDRAP News) – Tests have detected no tuberculosis in hundreds of people who shared airline flights with an Atlanta man who flew to Europe and back in May despite having a drug-resistant form of TB, health officials from the United States and Canada have told news services.

Andrew Speaker, an Atlanta lawyer, triggered an international health scare after he flew from Atlanta to Paris and later from Prague to Montreal. US authorities tracked him down and put him in isolation after he returned to the United States by car. At the time, he was believed to have extensively drug-resistant (XDR) TB, but he was later found to have multidrug-resistant (MDR) TB, a somewhat less dangerous form.

Of about 250 people who were on Speaker's May 12 Air France flight from Atlanta to Paris and were later tested for TB, none appear to have been infected, according to a report today by the Atlanta Journal-Constitution, citing preliminary data from the Centers for Disease Control and Prevention (CDC).

The story also said Canadian public health officials have found no evidence of infection among 29 passengers who sat near Speaker on a May 24 Czech Air flight from Prague to Montreal.

Dr. Tom Wong of Canada's Public Health Agency said that if people potentially exposed to TB don't have a positive test within 6 months, they are unlikely to experience active disease, according to the newspaper report.

Another Public Health Agency spokesman, Alain Desroches, said people can become ill up to 2 years after exposure to TB, but the lack of positive tests so far is a good sign, according to an Agence France-Presse (AFP) report today.

The CDC announced on May 29 that Speaker (whom officials didn't name at the time) had been put in isolation and recommended that passengers on the two transatlantic flights be tested for TB.

As noted in the Journal-Constitution report, the incident raised questions about why county and state health officials in Georgia, who knew Speaker was planning to fly to Greece for his wedding, didn't stop him. The CDC, which tracked Speaker down in Italy, also came under fire for not preventing Speaker from leaving there and then returning to the United States by a roundabout route. The agency was also criticized for being slow to notify the World Health Organization about the situation.

Speaker was eventually treated at National Jewish Medical and Research Center in Denver, where specialists determined that he had MDR TB, which is more treatable than XDR TB. They treated him with antibiotics and also removed an infected portion of one lung. Speaker returned home in July and is still on antibiotic treatment but is no longer considered potentially contagious, according to the Journal-Constitution.

The newspaper story said Speaker expressed relief that no one had been found infected. "I hope that brings a sense of peace and closure for the people who may have been concerned," he said.

See also:

Sep 13 CIDRAP News story "House panel sees CDC errors in case of traveling TB patient"

Jul 5 CIDRAP News story "Severity of TB in health scare downgraded"

May 29 CIDRAP News story "Airline trips by resistant-TB patient trigger alert"

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