Dec. 31, 2007 -- Health officials continued their 17-state search Sunday for passengers who may have been infected with a rare, potentially deadly form of tuberculosis by a woman on an American Airlines flight from New Delhi to Chicago.
The 30-year-old woman, a native of Nepal who now lives in Sunnyvale, Calif., had been diagnosed with drug-resistant TB in India, the Centers for Disease Control and Prevention in Atlanta says. She was a passenger on Flight 293 from India to Chicago and flew on to San Francisco on Dec. 13.
About a week later, she checked in to the emergency room at Stanford University Hospital. "She was quite sick," says Martin Cetron, director of global migration and quarantine for the CDC. "She was at the extreme end of the severity of the disease."
Today, says Gary Migdol, a hospital spokesman, "she is stable and doing well."
She was seated in row 35; 44 people sat close enough for possible exposure. From Chicago, they traveled to California, Colorado, Florida, Georgia, elsewhere in Illinois, Indiana, Kansas, Michigan, Minnesota, Missouri, New Jersey, North Carolina, Ohio, Tennessee, Texas, Vermont and Virginia.
The CDC recommends that they all undergo testing, with follow-up in eight to 10 weeks. The CDC is concerned because the woman was feverish and had other symptoms on the plane. The risk is believed to be small, but the deadly TB bacillus can float on air for hours and presents a greater threat in the confines of an airline cabin. All passengers considered at possible risk will be contacted.
Cetron says that between June 2006 and June 2007, CDC officials have been involved in about 100 similar investigations, "and the numbers are increasing." Odds are, he says, that won't change: A third of the world's 6.6 billion people are infected with TB, and more than 1 million international travelers arrive here each day.
"The probability that someone with TB is traveling unbeknownst to anyone is still quite high," he says. "We can only prevent this if we have a system of recognizing these cases that goes way back to the patient and their provider."
The World Health Organization in July set guidelines for keeping people with TB off planes. Many nations have laws of their own, but they're porous and difficult to enforce.
In this case, Cetron says, Stanford doctors reacted quickly when they learned the woman had been on an international flight, allowing officials to contact American Airlines "before their records were purged."