Airplane Passengers Exposed to Tuberculosis

Forty-four airline passengers might have been exposed to a strain of drug-resistant tuberculosis carried by a woman traveling from India to the United States last month, the Los Angeles Times reported yesterday (see GSN, Nov. 14, 2007).

While there was no indication of the incident being anything but an accidental  health threat, U.S. officials have conducted drills to plan for the possibility of terrorists spreading contagious diseases on commercial airlines (see GSN, Jan. 18, 2005).

In response to last month’s incident, public health officials have begun a nationwide search for passengers who took American Airlines Flight 293 from New Delhi to Chicago on Dec. 13.  Although the infected woman took two flights, officials are focusing on the 16-hour overseas trip because the disease is most likely to be transmitted during exposures of more than eight hours.

Officials have not identified the woman, a 30-year-old Sunnyvale, Calif., resident infected with multi-drug-resistant tuberculosis.  The woman was diagnosed on Dec. 19, when she went to the Stanford Hospital emergency room in Palo Alto, Calif., said Joy Alexiou, a spokeswoman for the Public Health Department in Santa Clara County.

Although the strain is less dangerous than a nearly untreatable form of the disease referred to as extensively drug-resistant tuberculosis, officials are concerned that symptoms the woman showed on the flight increased the likelihood of transmitting the disease.

“Coughing, fever, that kind of stuff,” Alexiou said. “So she potentially could have infected someone.”  Alexiou said it remains unclear whether the woman was aware of the tuberculosis infection and the risk of transmitting it at the time she took the flight.

The U.S. Centers for Disease Control and Prevention said flight passengers who sat in the same row as the woman or within two rows of her on either side should be immediately tested for tuberculosis infection.  As the disease can develop slowly, CDC officials also asked the passengers to receive a second test between eight and 10 weeks after the first examination.

So far, officials have located two California residents who sat near the woman and neither is showing signs of infection, Alexiou said.

Stanford Hospital has contacted several people who were in the emergency room with the woman, and Santa Clara County officials have notified members of the woman’s family who might have been infected.

The infected woman has remained in isolation at the hospital and is expected to remain there for several more weeks, said Shelley Hebert, the hospital’s executive public affairs director (Jia-Rui Chong, Los Angeles Times, Jan. 3).

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