- The Washington Times - Thursday, May 31, 2007

Federal officials said yesterday they’re working hard to track down about 80 people who sat near a tuberculosis-infected man on two international flights but said new powers are needed to help officials contact travelers more quickly in similar future situations.

Dr. Martin Cetron, director of Global Migration and Quarantine at the Centers for Disease Control and Prevention, said the CDC has long had problems getting quick access to passenger manifest lists in situations like this one but proposed new federal quarantine rules two years ago to help correct this.

“We’ve had this [problem] for years,” he said, adding that “we hope to be able to expedite and bring to closure very quickly” the new CDC rules, which have been in a period of public review.

The rules would, among other things, let the CDC have electronic passenger lists within 24 hours of a request.

In the meantime however, CDC officials said they’re still trying to get manifests and contact information for two international flights earlier this month so they can test about 80 passengers who sat for more than eight hours near a man infected with a drug-resistant strain of tuberculosis.

The officials held a press conference yesterday to get the word out to the public about the May 13 Air France flight from Atlanta to Paris and the May 24 Czech Airlines flight from Prague to Montreal. They would like to check 40 to 50 people who sat in or near row 51 on the Paris flight and about 30 people who sat in or near seat 12C on the Montreal flight. They also are trying to contact the flights’ 27 crew members.

The Atlanta man, whose name hasn’t been released by authorities, is being held in isolation at Atlanta’s Grady Memorial Hospital — a move CDC officials don’t recall having to use since 1963. Dr. Cetron said the CDC is making plans to transport him to a hospital in Denver for treatment.

The trans-Atlantic saga has exposed some breaches in communications and other problems. The man knew he had tuberculosis and was working with Fulton County, Ga., health officials before he left for his wedding in Europe.

CDC and health officials said he was advised not to fly, but the man told the Atlanta Journal-Constitution that county officials knew he was going to travel anyway and never ordered him not to, saying only they “preferred” he wouldn’t.

“We headed off to Greece thinking everything’s fine,” he said.

While he was in Italy, health officials received further test results showing he has a rare, more-dangerous and drug-resistant form of TB. The CDC contacted him and told him to turn himself into Italian health officials to be quarantined in that country.

“I thought to myself, ‘You’re nuts.’ I wasn’t going to do that. They told me I had been put on a no-fly list and my passport was flagged,” the man told the Atlanta paper.

Dr. Cetron said the CDC was then exploring various options — isolating him in Italy, transporting him back to the U.S. privately and alerting airports.

But while they were considering these options, the man bucked authorities, boarded the flight to Canada and drove across the U.S. border. He told the newspaper he voluntarily went to a New York hospital and was flown by the CDC to Atlanta.

Dr. Cetron and Dr. Ken Castro, director of the CDC’s division of tuberculosis elimination, stressed that tuberculosis is only transmitted through prolonged exposure so people who passed him on the street or stood next to him in line are not at risk. The man also flew on several shorter European flights, but officials aren’t as concerned about those.

“We’re really focusing on those prolonged flights,” Dr. Castro said.

The CDC officials said other passengers on the man’s flights can contact the CDC if they wish. But the Atlanta Journal-Constitution reported yesterday that concerned travelers who have contacted the CDC and Air France have had trouble trying to determine whether they were seated near the man.

Dr. Julie Gerberding, CDC director, said that while officials have little experience with the transmission patterns for this TB strain, this case does not appear to be a worst-case scenario.

“We’re thankful the patient was not in a highly infectious state, but we know the risk of transmission isn’t zero, even with the fact that he didn’t have symptoms and didn’t appear to be coughing,” she told ABC’s “Good Morning America.” “We’ve got to really look at the people closest to him.”

The man’s wife was tested before the trip and tested negative, Dr. Cetron said.

Dr. Howard Njoo of the Public Health Agency of Canada said it seemed unlikely that the man spread his illness on the flight into Montreal but the agency is working with U.S. officials to contact passengers who sat near him.

A spokeswoman for Czech Airlines said the flight crew was examined and are not infected, and the airline is contacting passengers and cooperating with Czech and foreign authorities. Air France has been asked by French health officials to provide lists of passengers seated within two rows of the man, an airline spokeswoman said on the condition of anonymity, according to company policy.

In 2005, the CDC proposed new quarantine rules that among other things expanded the list of passenger symptoms that transportation authorities must report and required transportation authorities to hold passenger name, seat location and emergency contact information for 60 days and provide it to the CDC within 24 hours of a request.

Lawrence Gostin, director of the Center for Law and the Public’s Health at Georgetown and Johns Hopkins University, said the new rules are good but have been delayed by complaints from various groups, including privacy advocates, civil libertarians and airlines. He said he hopes this case will change that.

“This case shows we can’t delay another day,” he said.

• This article is based in part on wire service reports.

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