Health Fugitive Linked to Area: Man Whose TB Infection Set Off Frantic Search Stayed at Albany Motel

May 31, 08:07 AM

Current Headlines: By Cathleen F. Crowley, Albany Times Union, N.Y.

May 31--The man now confined to an Atlanta hospital with a drug-resistant form of tuberculosis spent a night in an Albany motel room, according to New York state health officials.

The man's jet-setting honeymoon triggered an international manhunt by public health officials who were trying to prevent the disease from spreading. Officials at the U.S. Centers for Disease Control and Prevention said the man, who they would not identify, ignored warnings not to travel.

The CDC is reaching out to 80 airplane passengers who sat near him on two trans-Atlantic flights, but there is little concern that his visit to Albany exposed motel staff or guests to the disease.

The man spent two weeks abroad for his wedding in Greece and honeymoon through Europe, but cut the trip short when the CDC chased him down.

He and his wife flew to Montreal on May 24 without the CDC's knowledge and drove through upstate New York. He spent that night at an Albany motel before turning himself in to a New York City hospital on Friday, said Claudia Hutton, state Health Department spokeswoman.

State health officials "have followed up and agree with the CDC that there is no need to do any kind of public health alert to drag everybody who's been at that particular motel to tell them to go get tested," Hutton said.

CDC officials are focusing their efforts on finding the crew and passengers who sat near the man on his two international flights, both of which lasted over eight hours.

"Tuberculosis is spread through prolonged contact and the type of casual contact that you may see in a line, or passing in the street or in the airport, it is not the kind of contact that transmits tuberculosis," said Dr. Martin Cetron, director of the CDC's division of global migration and quarantine.

Flights shorter than eight hours do not pose a significant risk, Cetron said Wednesday at a news conference.

People who sat in the five rows closest to the man should undergo a skin test for tuberculosis, but the CDC is willing to test any passenger on any flight the man took.

According to the CDC, the groom with TB was warned not to get on a plane.

On May 10, the man and his family were told by the health department in Fulton County, Ga., that he had a form of tuberculosis that is resistant to first-line antibiotics.

"They clearly told him not to travel," Cetron said.

The department sent him a written order saying as much, but he had already departed for Europe.

"The patient, from his own perspective, had compelling reasons to travel and there were no legal orders telling him not to," Cetron said.

On May 22, further tests showed the man had XDR-TB -- an even more virulent and deadly form of TB -- that is resistant to second-line antibiotics.

The TB rate in the United States fell to an all-time low last year, at 13,767 cases, or 4.6 cases per 100,000 people. There have been only been 17 XDR-TB cases in the U.S. since 2000, according to the CDC.

The CDC contacted him on his cellphone in Italy on May 23 and begged him to stay put until they found a safe way to get him home, Cetron said.

He was instructed not to fly on commercial airplanes. CDC officials told him he was placed on a no-fly list and that his passport had been flagged. They asked him to go to an Italian hospital and be put in isolation until other plans could be made.

Instead, the man and his bride left Rome on a flight to Prague, Czech Republic, then flew to Montreal. By the time the CDC learned they had left Rome, the couple's plane was already touching down in Montreal, Cetron said.

The couple entered the U.S. after 6 p.m. on May 24 and drove directly to an Albany motel, said Hutton. They ate in the motel room and checked out in the morning without eating breakfast, she said.

The man told The Atlanta Journal-Constitution that Fulton County health officials said they preferred he not travel by plane but did not order him not to. And he said he and his wife sneaked back into the U.S. because they feared that treatment in Italy may be not be as effective.

Once they were back on U.S. soil, the man told the Atlanta newspaper that he contacted the CDC and agreed to go to a hospital. He was hospitalized at Bellevue Hospital in New York City through the weekend and was flown on a CDC plane to Atlanta.

He is at Atlanta's Grady Memorial Hospital in respiratory isolation, though he plans to transfer to Denver's National Jewish Hospital, which specializes in treating drug-resistant TB.

Health officials said there are no grounds for prosecuting the man because there was no legal order preventing him from traveling.

CDC officials said they do not know how the man contracted tuberculosis. It was discovered accidentally when he underwent a chest X-ray for an unrelated reason.

Other than the lesion on his lung, the man has no overt signs of tuberculosis, which would include coughing up sputum or blood.

Tests have shown that the man's TB is not very infectious, Cetron said. His wife has no signs of the illness.

Since arriving at the New York City hospital, CDC officials said the man has been very cooperative, giving public health officials his flight information, travel routes, and names of friends, family and co-workers that he has come in contact with.

State health investigators have been in contact with the motel where the man stayed. No extraordinary measures are being taken at the motel in question because the man had little interaction with the staff and guests, Hutton said.

Even the TB germs he may have left behind would be long dead.

"TB is not as transmissible as people want to think," Hutton said. "People want to think that anybody who saw this guy is exposed to it. It's not that easy." F. Crowley can be reached at 454-5348, or by e-mail at ccrowley@timesunion.com.

Illness in the air

Tuberculosis is caused by bacteria that attack the lungs and other parts of the body. When people with TB in their lungs or throat cough, laugh, sneeze, sing or even talk, the germs may be spread into the air. If another person breathes in these germs, there is a chance that they will become infected with tuberculosis. Repeated contact is usually required for infection. If untreated, TB can be fatal.

Passengers on these flights should call the Centers for Disease Control at 1 (800) CDC-INFO:

--May 12, Atlanta to Paris, Air France, Flight 385, also listed as Delta Air Lines, Flight 8517

--May 14, Paris to Athens, Air France, Flight 1232

--May 16, Athens to Thira Island, Greece, Olympic Airlines, Flight 560

--May 21, Mykonos to Athens, Olympic Airlines, Flight 655

--May 21, Athens to Rome, Olympic Airlines, Flight 239 May 24, Rome to Prague, Czech Air, Flight 0727

--May 24, Prague to Montreal, Czech Air, Flight 0104.

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