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Federal Quarantine for TB Traveler

Updated 6:42 AM ET May 30, 2007


ATLANTA (AP) - A man placed under the first government-ordered quarantine since 1963 because of a dangerous form of tuberculosis said he took one trans-Atlantic flight for his wedding and honeymoon and another because he feared for his life, a newspaper reported.

The man, whom officials did not identify, is at Atlanta's Grady Memorial Hospital in respiratory isolation.

Health officials have questioned his decision to fly from Atlanta to Paris, citing the danger that he could expose other passengers. The man told the Atlanta Journal-Constitution that while doctors told him they preferred that he put off his long-planned wedding in Greece, they didn't order him not to fly.

"We headed off to Greece thinking everything's fine," said the man, who declined to be identified in the newspaper article because of the stigma attached to his diagnosis.

Dr. Steven Katkowsky, director of the Fulton County Department of Health & Wellness, said the man was told traveling was not advised.

The man flew from Atlanta to Paris on May 12 aboard Air France Flight 385. He returned to North America on May 24 aboard Czech Air Flight 0104 from Prague to Montreal, then drove into the United States at the Champlain, N.Y., border crossing.

He told the newspaper he flew into Canada in a successful attempt to avoid U.S. authorities. He said he believed he had to return to the U.S. to get the treatment he needed to survive.

He was potentially infectious at the time of the flights, so officials at the Centers for Disease Control and Prevention have recommended medical exams for cabin crew members and passengers who sat within two rows of the man.

CDC officials said the airlines were working with health officials to contact those passengers. Those who should be tested will be contacted by health officials from their home countries.

Dr. Howard Njoo of the Public Health Agency of Canada said there appeared to be little chance that the man spread the disease on the flight into Canada.

"The likelihood of transmission to other passengers appears to be low at this time," he said.

Still, the agency was working with U.S. officials to contact passengers who sat near him.

The man told health officials he was not coughing during the flights. Other passengers are not considered at high risk of infection because tests indicated the amount of TB bacteria in him was low, said Dr. Martin Cetron, director of the CDC's division of global migration and quarantine.

The man told the Journal-Constitution the CDC contacted him in Rome during his honeymoon, telling him that he had to turn himself in to Italian authorities to be isolated and be treated. The CDC told him he couldn't fly aboard commercial airliners.

"I thought to myself: You're nuts. I wasn't going to do that. They told me I had been put on the no-fly list and my passport was flagged," the man said.

He told the paper he and his wife decided to sneak back into the U.S. via Canada. When he arrived back in the United States, he voluntarily went to a New York hospital, then was flown by the CDC to Atlanta. He is not facing prosecution, health officials said.

"I'm a very well-educated, successful, intelligent person," he told the paper. "This is insane to me that I have an armed guard outside my door when I've cooperated with everything other than the whole solitary-confinement-in-Italy thing."

CDC officials told The Associated Press they could not immediately comment on the interview.

The man's wife tested negative for TB before the trip and is not considered a public health risk, health officials said. Health officials said they don't know how the Georgia man was infected.

CDC officials said they are concentrating on investigating the trans-Atlantic flights, when possibility of spread of the disease was greatest because he was in a confined space with other people for hours.

The quarantine order was the first since the government quarantined a patient with smallpox in 1963, according to the CDC.

Tuberculosis is a disease caused by germs that are spread from person to person through the air. It usually affects the lungs and can lead to symptoms such as chest pain and coughing up blood. It kills nearly 2 million people each year worldwide.

Because of antibiotics and other measures, the TB rate in the United States has been falling for years. Last year, it hit an all-time low of 13,767 cases, or about 4.6 cases per 100,000 Americans.

Health officials worry about "multidrug-resistant" TB, which can withstand the mainline antibiotics isoniazid and rifampin. The man was infected with something even worse _ "extensively drug-resistant" TB, also called XDR-TB, which resists many drugs used to treat the infection.

There have been 17 U.S. XDR-TB cases since 2000, according to CDC statistics.

The CDC's statement that the patient is at the low end of communicability "provides some reassurance," said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University.

The highly dangerous form is "expanding around the world," particularly in South Africa, eastern Europe and the former states of the Soviet Union, he said.


Associated Press writers Malcolm Ritter in New York and Rob Gillies in Toronto contributed to this report.


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