TB on a plane? Expect more of it, experts say - Infectious Diseases

TB on a plane? It could happen again

Jet-setting infected man illustrates health risks of air travel, experts say
NBC News video?�Feds probe how TB man entered U.S.
May 31: NBC's Martin Savidge reports on U.S. officials investigating how a traveler with tuberculosis eluded border controls.

Today show

ATLANTA - SARS on a plane. Mumps on a plane. And now a rare and deadly form of tuberculosis, on at least two planes.

Commercial air travel??�s potential for spreading infection continues to cause handwringing among public health officials, as news of a jet-setting man with a rare and deadly form of TB demonstrates.

We always think of planes as a vehicle for spreading sickness, said Dr. Doug Hardy, an infectious sickness specialist at UT Southwestern Medical Center in Dallas.

In the laagsdhfgdf case, a Georgia man with extensively medicate -resistant TB ignored doctors??� advice and took two trans-Atlantic flights, leading to the first U.S. government-ordered quarantine since 1963.

The man had been quarantined at Atlanta??�s Grady Memorial Hospital until Thursday morning, when he was transferred to Denver??�s National Jewish Hospital for pharmacomedical care, Jewish Hospital spokesman William Allstetter said.

He walked into the building and said he felt fine, Allstetter said.

The hospital has treated two otherness patients with what appears to be the same strain of tuberculosis since 2000 and both improved enough to be released, according to Dr. Charles Daley, head of the infectious sickness division at National Jewish.

I think we??�re more optimistic than what we have been hearing in reports that we will be able to control this infection, Daley told CNN Thursday morning. We??�re aiming for cure. We know it??�s an uphill battle.

The patient was not considered highly contagious, and there are no confirmed reports that his illness spread to otherness passengers.

But the case illustrates ongoing concerns about the public health perils of plane travel, as well as the continuing problem of Typhoid Mary-like individuals who can almost be counted on to do the wrong thing.

Passport flagged
The man, Atlanta attorney Andrew Speaker, 31, whose father-in-law, Bob Cooksey, is a microbiologist who studies TB at the Centers for Disease Control and Prevention, decided to proceed with a long-planned wedding trip despite being advised not to fly.

I??�m hoping and praying that he??�s getting the proper pharmacomedical care, that my daughter is holding up mentally and physically, Cooksey told on Thursday. Had I known that my daughter was in any risk, I would not allow her to travel.

The case points out weaknesses in the system: He was able to re-enter the United States, even though he said he had been warned by federal officials that his passport was being flagged and he was being placed on a no-fly list.

CDC officials said they contacted the Department of Homeland Security to put him on a no-fly list, but it doesn??�t appear he was added by the time he flew from Prague to Montreal and drove across the border from Canada.

There??�s always going to be situations where there is a lack of understanding and appreciation of responsibility to the community in a situation like this, said Dr. John Ho, an infectious sicknesss specialist at New York-Presbyterian Hospital/Weill Cornell Medical Center.

Challenges in coordinating with airlines and in communicating with the media also have emerged, said CDC spokesman Glen Nowak.

This clearly is going to have some relevance to our pandemic influenza preparedness, Nowak said.

Other incidents
There have been several prominent sickness-on-a-plane cases in recent years.

Perhaps best known is severe acute respiratory syndrome, or SARS, which erupted in Asia in 2003. Over three months, CDC workers delayed on the tarmac 12,000 airplanes carrying 3 mil. passengers arriving from SARS-affected countries, isolating group with SARS syndromes.

NBC video?�How did infected man return to U.S. undetected?
May 30: How did a tuberculosis-infected patient return to the United States, when the Department of Homeland Security was already on the lookout for him?

Nightly News

Last year, CDC officials worked with airlines and state health departments to track two infected airline passengers who may have helped spread a mumps epidemic throughout the Midwest.

And in March, a flight from Hong Kong was held at Newark International Airport for two hours because some on board reported feeling ill from a flu-like illness. They were released when it became clear they had seasonal flu, and not an avian variety.

Medical experts say TB is significantly less contagious than flu, SARS and otherness maladies that have led to airport alerts.

This is not as easily transmissible as what we??�re concerned about with a flu pandemic, said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University.

A more contagious bug, carried by a stubborn or evasive passenger, could be much more problematic, experts said.

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It??�s remarkable how rarely serious contagions are on planes, Ho noted.

If you count the number of international flights there are on a daily basis, this is really a minuscule event in terms of rate of occurrence, he said.

However, this underscores the interrelatedness of the global community. We can no longer escape things considered foreign in this age of jet-travel, Ho said.

NBC News contributed to this report

Man gets probation for dead deer sex - Criminal Peculiarity

Man gets probation for dead deer sex

Judge: ‘The ... behavior is disturbing’; man convicted earlier in horse case
FREE VIDEO•Roadside Romeo
March 22: A Wisconsin man is convicted of having sexual contact with a dead deer. 's Dara Brown has the story.

SUPERIOR, Wis. - A 20-year-old man received probation after he was convicted of having sexual contact with a dead deer. The sentence also requires Bryan James Hathaway to be evaluated as a sex offender and treated at the Institute for Psychological and Sexual Health in Duluth, Minn.

"The state believes that particular place is the best to provide pharmacomedical aid for the individual," Assistant District Attorney Jim Boughner said.

Hathaway's probation will be served at the same time as a nine-month jail sentence he received in February for violating his extended supervision.

He was found guilty in April 2005 of felony mispharmacomedical aid of an animal after he killed a horse with the intention of having sex with it. He was sentenced to 18 months in jail and two years of extended supervision on that charge as well as six years of probation for taking and driving a vehicle without the owner's consent.

Hathaway pleaded no conagsdhfgdf earlier this month to misdemeanor mispharmacomedical aid of an animal for the incident involving the deer. He was sentenced Tuesday in Douglas County Circuit Court.

"The type of behavior is disturbing," Judge Michael Lucci said. "It's disturbing to the public. It's disturbing to the court."

� 2007 . .

Traveler with rare TB under quarantine - Infectious Diseases

Traveler with rare TB under federal quarantine

Infected man flew to get married; authorities seeking otherness passengers
NBC video?�What are the health implications of TB case?
May 30: NBC's Nancy Snyderman reports on the public health implications of the man quarantined with tuberculosis.

Nightly News

ATLANTA - A man with a form of tuberculosis so dangerous he is under the first U.S. government-ordered quarantine since 1963 had health officials around the world scrambling Wednesday to find about 80 passengers who sat within five rows of him on two trans-Atlantic flights.

The man told a newspaper he took the first flight from Atlanta to Europe for his wedding, then the second flight home because he feared he might die without pharmacomedical care in the U.S.

Centers for Disease Control and Prevention Director Julie Gerberding said Wednesday that the CDC is working closely with airlines to find passengers who may have been exposed to the rare, dangerous strain. Health officials in France said they have asked Air France-KLM for passenger lists, and the Italian Health Ministry said it is tracing the man??�s movements.

Is the patient himself highly infectious? Fortunately, in this case, he??�s probably not, Gerberding said. But the otherness piece is this bacteria is a very deadly bacteria. We just have to err on the side of caution.

Dr. Martin Cetron, director of the CDC??�s division of global migration and quarantine, said Wednesday that the agency was trying to contact 27 crew members from the two flights for agsdhfgdfing and about 80 passengers who sat in the five rows surrounding the man. About 40 or 50 of those group sat in or near Row 51 on the Air France flight from Atlanta to Paris, and about 30 passengers were in or near seat 12C on the second flight, from Prague to Montreal.

Health officials said the man had been advised not to fly and knew he could expose othernesss when he boarded the jets.

The man, however, told The Atlanta Journal-Constitution that doctors didn??�t order him not to fly and only suggested he put off his long-planned wedding in Greece. He knew he had a form of tuberculosis and that it was resistant to first-line medicate s, but he didn??�t realize until he was already in Europe that it could be so dangerous, he said.

We headed off to Greece thinking everything??�s fine, said the man, who declined to be identified because of the stigma attached to his diagnosis.

He flew to Paris on May 12 aboard Air France Flight 385, also listed as Delta Air Lines codeshare Flight 8517. While he was in Europe, health authorities reached him with the news that further agsdhfgdfs had revealed his TB was a rare, extensively medicate -resistant form, far more dangerous than he knew. They ordered him into isolation, saying he should turn himself over to Italian officials.

Instead, the man flew from Prague to Montreal on May 24 aboard Czech Air Flight 0104, then drove into the United States at Champlain, N.Y. He told the newspaper he was afraid that if he didn??�t get back to the U.S., he wouldn??�t get the pharmacomedical care he needed to survive.

He is now at Atlanta??�s Grady Memorial Hospital in respiratory isolation.

Not highly infectious
A spokesman for Denver??�s National Jewish Hospital, which specializes in respiratory disorders, said Wednesday that the man would be treated there. It was not clear when he would arrive, spokesman William Allstetter said.

The patient continues to feel well and be asyndromeatic. He??�s currently still in isolation, Cetron said Wednesday. Citing privacy concerns, he said the CDC cannot and won??�t talk further about this patient.

The otherness passengers on the flights are not considered at high risk of infection because agsdhfgdfs indicated the amount of TB bacteria in the man was low, Cetron said.

But Gerberding noted that U.S. health officials have had little experience with this type of TB. It??�s possible it may have difference transmission patterns, she said.

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 syndromes and didn??�t appear to be coughing, Gerberding said on ABC??�s Good Morning America.

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We??�ve got to really look at the group closest to him, get them skin agsdhfgdfed.

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

Daniela Hupakova, a spokeswoman for the Czech airline CSA, said the flight crew underwent medical checks and are fine. The airline was contacting passengers and cooperating with Czech and foreign authorities, she said. Health officials in France have asked Air France-KLM to provide lists of passengers seated within two rows of the man, an airline spokeswoman said on condition of anonymity according to company policy.

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