Canadian Authorities Locate 16 of 28 Passengers Sought From TB Exposure Flight

May 30, 07:06 PM

Current Headlines: By HELEN BRANSWELL

TORONTO (CP) - Public health officials in the United States and Canada revealed Wednesday they have narrowed down to roughly 70 to 80 the number of people on two recent transatlantic flights who were seated in close proximity to a man infected with a rare and potentially deadly form of tuberculosis.

Canadian health authorities are trying to find anyone who sat in Row 12 - plus the two rows ahead and behind - of Czech Airline flight 0104 to Montreal from Prague on May 24. The man, who is infected with extensively drug resistant tuberculosis or XDR-TB, was seated in 12 C.

Dr. Howard Njoo, director-general of the Public Health Agency of Canada's centre of emergency preparedness and response, said so far the agency has been in contact with 16 of 28 passengers from that section of the plane, and have referred them to the appropriate public health authorities for followup.

He would not reveal whether the 16 were Canadians or citizens of other countries.

"We're still in the process of referring them to the appropriate health authorities and at this point in time, we're not at liberty to release the actual, I guess, nationality of those individuals," he said from Ottawa in a teleconference.

"We have some privacy concerns. We want to make sure they're taken into account."

But Montreal Public Health said most of those identified so far are Quebecers.

"The 12 Quebecers who were sitting in the five rows where we felt people should have been tested have been contacted," said Blaise Lefebvre, a spokesman for the city's public health department.

"Even for those people, we consider the risk to be low."

Njoo also said Czech Airlines - which had earlier released a statement saying they had turned the man over to local health authorities in Montreal - would be issuing a statement retracting that claim.

He said Canadian officials first learned on May 25 that a man with XDR TB had travelled through Montreal the previous day, and that word came from the U.S. Centers for Disease Control in Atlanta.

Calls to Czech Airlines' Prague headquarters went unanswered. But spokesperson Daniela Hupakova - who issued the release - told The Associated Press in Prague that the information it contained was erroneous.

She said the airline learned while the flight was en route that a man being sought by health authorities might be on board. But he was not detained when the plane landed because the airline hadn't been able to confirm the facts of the the case. Hupakova said when they did, they contacted U.S. authorities to notify them they had transported the man.

The airline has provided the Public Health Agency of Canada with the flight's passenger manifest - the official list of who was onboard. The agency is using it to try to trace the passengers to urge them to undergo testing for TB.

So far 77 of the 191 passengers on the eight-plus hour flight have been identified, Njoo said. There were also nine crew on board.

Public health authorities around the globe are extremely concerned about the rise of XDR-TB. Extensively drug resistant strains of TB kill roughly 50 per cent of people infected. In the case of people infected with HIV-AIDS, the case fatality rate is a staggering 90 per cent.

The man at the centre of the international incident, an American citizen, flew to Europe on May 12. Authorities say he did so against the advice of his local public health officials, who had informed him on May 10 he was infected with a multi-drug resistant strain of tuberculosis and should not be taking commercial flights. Further testing revealed that he was actually infected with extensively drug resistant TB.

The man disputes the assertion he was told not to fly, telling the Atlanta Journal-Constitution in an interview that public health officials told him they would prefer it if he didn't fly. But he felt healthy and didn't want to cancel his planned wedding and honeymoon and went ahead with the trip.

He and his fiancee arrived in Paris on the morning of May 13. They were en route to Greece, where they got married.

Over the next 11 days the couple crisscrossed Europe, flying from Paris to Athens, then to the Greek island Thera (also known as Santorini). They later flew from the island of Mykonos to Athens, then to Rome.

While in Rome the CDC located the man and told him he had extensively drug resistant TB and should not take any additional commercial flights.

CDC officials began trying to arrange for his safe return to the U.S. but the couple abruptly left Rome, flying to Prague. There they boarded the flight for Montreal, where they rented a car and drove into the United States at the border crossing at Champlain, N.Y.

The man told the Atlanta newspaper he deliberately flew to Canada to try to sneak back into the United States to evade a U.S. no-fly order. But it appears the U.S. order hadn't been conveyed to European public health authorities and airlines.

Dr. Martin Cetron, the CDC's director of global migration and quarantine, said when CDC realized the man had fled, it began the process of putting out the word to European airlines. This was on the afternoon of Thursday, May 24. The CDC later learned that while they were doing that, the man was already in the air, winging towards Montreal.

Although the couple took seven flights in total, the CDC believes only the two international flights were of long enough duration to pose a possible infection risk to passengers located near the man.