Tuberculosis investigations associated with air travel: U. S. Centers for Disease Control and Prevention, January 2007–June 2008
Received 5 February 2010; accepted 8 February 2010. published online 12 March 2010.
Summary
Introduction
Contact investigations conducted in the United States of persons with tuberculosis (TB) who traveled by air while infectious have increased. However, data about transmission risks of Mycobacterium tuberculosis on aircraft are limited.
Methods
We analyzed data on index TB cases and passenger contacts from contact investigations initiated by the U.S. Centers for Disease Control and Prevention from January 2007 through June 2008.
Results
Contact investigations for 131 index cases met study inclusion criteria, including 4550 passenger contacts. U.S. health departments reported TB screening test results for 758 (22%) of assigned contacts; 182 (24%) had positive results. Of the 142 passenger contacts with positive TB test results with information about risk factors for prior TB infection, 130 (92%) had at least one risk factor and 12 (8%) had no risk factors. Positive TB test results were significantly associated with risk factors for prior TB infection (OR 23; p<0.001). No cases of TB disease among passenger contacts were reported.
Conclusion
The risks of M. tuberculosis transmission during air travel remain difficult to quantify. Definitive assessment of transmission risks during flights and determination of the effectiveness of contact-tracing efforts will require comprehensive cohort studies.
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
bGlobal Health Sector, SRA International Inc., Atlanta, GA, USA
cCenters for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA, 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 Minneapolis Quarantine Station, HHH Terminal, Ste. 2168, 7150 Humphrey Drive, Minneapolis, MN 55450, USA. Tel.: +1 612 725 3014; fax: +1 612 725 3029.
ABSTRACT