Three air travel-related contact investigations associated with infectious tuberculosis, 2007–2008☆
Received 24 July 2009; accepted 3 August 2009. published online 05 October 2009.
Summary
Background
The potential for transmission of Mycobacterium tuberculosis during air travel has garnered considerable attention in the media and among public health authorities due to high-profile cases of international travelers with infectious tuberculosis (TB).
Methods
During 2007 and 2008, state and local health officials were asked to locate and conduct diagnostic follow-up for airline passengers considered contacts of three travelers, two with multidrug-resistant (MDR) TB and one considered highly contagious, who undertook air travel while infectious with TB disease.
Results
Public health departments in 21 states located and evaluated 79 (60%) of the 131 passenger contacts identified; 52 (40%) were lost to follow-up. Eight (10%) contacts had a history of TB disease or latent TB infection and were not retested. Sixteen (23%) of 71 contacts tested had positive TB test results suggesting latent TB infection, 15 of whom were from countries reporting estimated TB disease rates of greater than 200 cases/100,000 persons.
Conclusions
Passenger contacts’ positive test results may represent prior TB infection acquired in their countries of residence or may be a result of new TB infection resulting from exposure during air travel.
aCenters for Disease Control and Prevention, National Center for Preparedness, Detection, and Control of Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, GA, USA
bCenters for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA, USA
cWisconsin Department of Health Services, Bureau of Communicable Diseases and Preparedness, Division of Public Health, Department of Health and Family Services, Madison, WI, USA
dSanta Clara Public Health Department, Tuberculosis Prevention and Control Program, San Jose, CA, USA
eHarris County Public Health and Environmental Services, Division of Disease Control and Clinical Prevention, Disease Control and Medical Epidemiology Section, Houston, TX, USA
Corresponding author: Centers for Disease Control and Prevention, National Center for Preparedness, Detection, and Control of Infectious Diseases, Division of Global Migration and Quarantine, Quarantine and Border Health Services Branch, CDC Los Angeles Quarantine Station, 380 World Way, N-19, Los Angeles, CA 90045, USA. Tel.: +1 310 215 2365; fax: +1 310 215 2285.
☆Funding: This study was supported in part by the Applied Epidemiology Fellowship Program administered by the Council of State and Territorial Epidemiologists (CSTE) and funded by the Centers for Disease Control and Prevention (CDC) Cooperative Agreement U60/CCU007277.
ABSTRACT