Investigation of international traveler with multidrug-resistant tuberculosis (MDR TB)
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Investigation of international traveler with multidrug-resistant tuberculosis (MDR TB)

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      Saturday, December 29, 2007, 19:35 EST (07:35 PM EST)


      The Centers for Disease Control and Prevention (CDC) is working with international, state, and local health officials and other partners on an investigation involving an international traveler to the U.S. who had recently been diagnosed with multidrug-resistant tuberculosis (MDR TB).

      CDC was informed in mid-December 2007 by a local health authority that a patient who had been diagnosed in India with MDR TB traveled from New Delhi, India to Chicago, Illinois on December 13, 2007 on American Airlines Flight # 293 and then on a shorter flight within the United States. Shortly after final arrival, the patient sought treatment for hemoptysis, fever, and chest pain at a hospital. These and other findings indicated a potential for transmission of drug-resistant TB infection to others. The patient has been hospitalized in airborne isolation and is receiving treatment for TB.

      Shortly after being notified about the patient and her travels, officials of CDC's Division of Global Migration and Quarantine contacted American Airlines and U.S. Customs and Border Protection to obtain the information needed to contact passengers who may have been exposed to the traveler with tuberculosis. CDC is collaborating with U.S. state and local health departments, the Indian Ministry of Family Welfare, American Airlines, and the Department of Homeland Security's Customs and Border Protection to ensure notification and follow-up of passengers and crew who may have been exposed to MDR TB.

      In accordance with the World Health Organization (WHO) TB and Airline Travel Guidelines, CDC is ensuring appropriate follow-up and care for persons who may have been exposed to TB on an aircraft. This includes recommending the evaluation and testing of passengers and crew with closest contact to the patient on board American Airlines Flight #293 departing from New Delhi, India on December 13, 2007 and arriving in Chicago, Illinois on December 13, 2007. This includes 44 passengers. These were the passengers seated in the same row as the index patient (row 35), and those seated in the two rows ahead (rows 33 and 34) and the two rows behind (rows 36 and 37), as well as the crew members working in the same cabin. These persons should receive an initial evaluation and testing for TB infection, with follow-up 8 to 10 weeks after the December 13 flight for reevaluation.

      CDC recommends testing of these passengers and crew on only the international flight from New Delhi to Chicago because this flight was longer than the 8 hour duration criteria specified by WHO for passenger testing for exposure to tuberculosis. WHO and CDC do not recommend notification or medical evaluation of passengers on briefer flights because the risk of transmission is minimal. WHO guidelines can be found at

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