Tuberculosis :: People potentially exposed to patient with extensively drug-resistant TB

The TB traveler is currently in isolation at an Atlanta hospital, and he’s under the care of infectious disease specialists at this hospital.

“The medical news that we have evolving also continues to be reassuring as Dr. Gerberding indicated yesterday. We believe that his degree of infectiousness is quite low, and as she indicated yesterday, is – even continues to be smear negative, that is, we don’t see the visible evidence of the tuberculosis bacteria on the stain, and we are still awaiting culture results from that, which takes several weeks”, told Dr. Martin Cetron, Director of Global Migration and Quarantine, Centers for Disease Control and Prevention.

“This investigation is just beginning. We’re just initiating this. It is very challenging as you’re well aware. There were multiple flights involved, only two of which that we have been highlighting as ones of concern to us because of the long duration, greater than eight hours in nature, and the confined setting of an aircraft cabin with many people on board, and so our focus has been on these two international flights, but we are piecing together the full itinerary and have a list available to you of all of the flights, including the very-the smaller flights within Europe.”

“The persons according to the WHO guidelines who we focus on and follow are the two rows in front, the row of the index case, and two rows behind, so these five rows in total constitute somewhere in the range of 40 to 50 passengers who would be a priority for initiating outreach and contact, and as well as all 18 crew members on that flight.”

Tuberculosis continues to be one of the most common communicable diseases throughout the world with the World Health Organization reporting approximately 8 million persons per year and accounting for about 1.6 million deaths. The process of extensively drug-resistant tuberculosis was recently defined as recent as 2006 implying that we’re dealing with bacteria that are resistant not only to the most important first line drugs, but you’re also losing some of the most important second line drugs, leaving relatively few choices for appropriate treatment, and the reason for the concern and not wanting anyone infected with these type of strains.

In the case of tuberculosis, there are two stages to tuberculosis. One that we most commonly call latent tuberculosis, so after exposure to air that contains these bacteria, you can become infected. Then following that infection, it may take some time for you to develop the antibodies that would manifest in the – as a positive skin test. That’s why we do the follow-up investigation within about two months, and no more than three, after the exposure has occurred.

It is important to identify that persons who have latent tuberculosis infection pose no threat whatsoever to those around them. They carry a risk of progressing to developing tuberculosis disease if they have debilitating conditions such as a heavy infection, such as cancer, poorly controlled diabetes, and several other conditions, and that’s why we also want to make sure to acknowledge that patients on the flight who may have not been seated in the vicinity that we’re targeting get offered the ability to be tested.

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