Woman with Drug-Resistant TB May Have Exposed Others on Flight

By Anastacia Mott Austin

Authorities from California’s health department are trying to alert the fellow passengers of a woman infected with a drug-resistant form of tuberculosis who flew from India to Chicago and then to San Francisco during the holiday season.

The woman, whose name has not been released to the public, is being treated in isolation at California’s Stanford Hospital.

The woman boarded American Airlines flight 293 from New Delhi to Chicago on December 13th, and was actively ill with tuberculosis, coughing during the flight. Officials have determined about 44 passengers from 16 different states have potentially been exposed.

Said Joy Alexiou, a representative of Santa Clara’s County Public Health department, to reporters, "She was sick when she got on her airplane."

And while tuberculosis typically requires a prolonged period of exposure before someone can become ill from another person, long flights in the tight, contained environment of an airplane do raise concern for health officials.

The woman became sicker after arriving in the San Francisco Bay Area and went to an emergency room on December 19th. Other emergency room patients have been notified of their possible exposure.

This particular strain of TB is worrisome for doctors treating it because it is resistant to all first-line antibiotics, earning it the name MDR, or multiple drug-resistant tuberculosis.

In May of 2007, Atlanta lawyer Andrew Speaker was given a federal order of quarantine after traveling with a drug-resistant form of TB. The difference between the cases is that Speaker was showing no symptoms when he traveled, whereas the female patient was actively ill with the disease.

Santa Clara County health official Dr. Marty Fenstersheib told reporters that there was definitely cause for concern, but that because she was so ill, the woman likely did not infect anyone between the flight and her hospitalization six days later. "She was really sick when she arrived in the Bay Area," said Fenstersheib, "So she wasn't going out Christmas shopping or mingling with crowds."

That doesn’t offer her fellow passengers on the flight much reassurance. While it is unlikely that one of them was sufficiently exposed to contract the disease, it’s not impossible.

The woman was aware that she had TB, and had been receiving treatment in India before she boarded the airplane. And while people actively infected with TB are advised not to travel, there is no law prohibiting them from doing so.

"People get on buses, planes and trains and go to malls with illnesses all the time, said Shelley Diaz, an official from the CDC.

The woman will be kept in isolation at Stanford Hospital for several weeks, until she is considered no longer contagious. Hospital staff will be taking special precautions to prevent infection themselves.

Drug-resistant forms of tuberculosis require a longer course of treatment than the regular strain of the disease. While she will be released from isolation in a matter of weeks, the patient’s treatment will likely take as long as two years.