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TB Patient: Quarantine Conditions "Insane"

A man with a form of tuberculosis so dangerous he is under the first U.S. government-ordered quarantine since 1963 had health officials around the world scrambling Wednesday to find passengers who sat near him on two trans-Atlantic flights.

The man told a newspaper he took the first flight from Atlanta to Europe for his wedding, then the second flight home because he feared he might die without treatment in the U.S.

Centers for Disease Control and Prevention Director Julie Gerberding said Wednesday that the CDC is working closely with airlines to find passengers who may have been exposed to the rare, dangerous strain. Health officials in France said they have asked Air France-KLM for passenger lists, and the Italian Health Ministry said it is tracing the man's movements.

The quarantine order was the first since the U.S. government quarantined a patient with smallpox in 1963, according to the CDC.

Only two of the nearly 14,000 tuberculosis patients in the U.S. last year had the virtually drug-resistant strain the Georgia man has, CBS News correspondent Nancy Cordes reports.

"Is the patient himself highly infectious? Fortunately, in this case, he's probably not," Gerberding said. "But the other piece is this (that) bacteria is a very deadly bacteria. We just have to err on the side of caution."

Researchers are working on developing a new vaccine for tuberculosis. The current vaccine is considered ineffective and rarely used in the United States, reports Cordes.

Dr. Martin Cetron, director of the CDC's division of global migration and quarantine, said Wednesday that the agency was trying to contact 27 crew members from the two flights for testing and about 80 passengers who sat in the five rows surrounding the man. About 40 or 50 of those people sat in or near Row 51 on the Air France flight from Atlanta to Paris, and about 30 passengers were in or near seat 12C on the second flight, from Prague to Montreal.

Health officials said the man had been advised not to fly and knew he could expose others when he boarded the jets from Atlanta to Paris, and later from Prague to Montreal.

The man, however, told the Atlanta Journal-Constitution that prior to his departure, doctors did not order him to avoid flying and only suggested he put off his long-planned wedding in Greece.

He knew he had a form of tuberculosis and that it was resistant to first-line drugs, but he did not realize it could be so dangerous, he said.

"We headed off to Greece thinking everything's fine," said the man, who declined to be identified because of the stigma attached to his diagnosis.

He flew to Paris on May 12 aboard Air France Flight 385. While in honeymooning in Italy, health authorities reached him with the news that further tests had revealed his TB was a rare, "extensively drug-resistant" form, far more dangerous than he knew. They ordered him into isolation, saying he should turn himself over to Italian officials and not take commercial flights.

"I thought to myself: 'You're nuts.' I wasn't going to do that. They told me I had been put on the no-fly list and my passport was flagged," the man said.

CDC spokesman Tom Skinner said the agency was considering sending its jet to pick the couple up in Italy, the newspaper reported.

Instead, the man flew from Prague to Montreal on May 24 aboard Czech Air Flight 0104, then drove across the border to New York where he voluntarily checked into a hospital and was then flown by the CDC to Atlanta. He told the newspaper he was afraid that if he did not get back to the U.S., he would not get the treatment he needed to survive.

The U.S. government is now looking into how the man was able to sneak back into the country after his name and passport were flagged, reports CBS News correspondent Kelly Cobiella.

He is now at Atlanta's Grady Memorial Hospital in respiratory isolation, but will be transferred to National Jewish Hospital in Denver, which specializes in respiratory disorders, the hospital's spokesman said Wednesday. It was not clear when he would arrive.

"The patient continues to feel well and be asymptomatic. He's currently still in isolation," Cetron said Wednesday. Citing privacy concerns, he said the CDC "cannot and won't talk further about this patient."

The other passengers on the flights are not considered at high risk of infection because tests indicated the amount of TB bacteria in the man was low, Cetron said.

But Gerberding noted that U.S. health officials have had little experience with this type of TB. It's possible it may have different transmission patterns, she said.

"We're thankful the patient was not in a highly infectious state, but we know the risk of transmission isn't zero, even with the fact that he didn't have symptoms and didn't appear to be coughing," Gerberding said on ABC's "Good Morning America."

"We've got to really look at the people closest to him, get them skin tested."

Dr. Howard Njoo of the Public Health Agency of Canada said it appeared unlikely that the man spread the disease on the flight into Canada. Still the agency is working with U.S. officials to contact passengers who sat near him.

Daniela Hupakova, a spokeswoman for the Czech airline CSA, said the flight crew underwent medical checks and all are fine. The airline is contacting passengers and cooperating with Czech and foreign authorities, she said. Health officials in France have asked Air France-KLM to provide lists of passengers seated within two rows of the man, an airline spokeswoman said on condition of anonymity according to company policy.

Italian officials said they were tracing the man's movements in Rome and have identified and were trying to notify the passengers sitting near him.

Health officials said the man's wife tested negative for TB before the trip and is not considered a public health risk. They said they do not know how the Georgia man was infected.

Health officials said the man is not facing prosecution.

"I'm a very well-educated, successful, intelligent person," he told the paper. "This is insane to me that I have an armed guard outside my door when I've cooperated with everything other than the whole solitary-confinement-in-Italy thing."

CDC officials told The Associated Press they could not immediately comment on the interview.

Meanwhile, a man with a similar form of tuberculosis in Arizona has been imprisoned for the past eight months in a hospital jail for violating the rules of his voluntary quarantine, CBS News correspondent Hari Sreenivasan reports.

The man, 27-year-old Robert Daniels, is a dual U.S.-Russian citizen. He contracted the deadly strain in Russia and came back to Phoenix for better medical care, agreeing to a voluntary quarantine. He was arrested and placed in isolation at a Maricopa County jail when he was caught walking outside without a mask, Sreenivasan reports.

Tuberculosis is a disease caused by germs that are spread from person to person through the air. It usually affects the lungs and can lead to symptoms such as chest pain and coughing up blood. It kills nearly 2 million people each year worldwide.

Because of antibiotics and other measures, the TB rate in the United States has been falling for years. Last year, it hit an all-time low of 13,767 cases, or about 4.6 cases per 100,000 Americans.

Health officials worry about "multidrug-resistant" TB, which can withstand the mainline antibiotics isoniazid and rifampin. The man was infected with something even worse — "extensively drug-resistant" TB, also called XDR-TB, which resists many drugs used to treat the infection.

There have been 17 U.S. XDR-TB cases since 2000, according to CDC statistics.

The highly dangerous form is "expanding around the world," particularly in South Africa, eastern Europe and the former states of the Soviet Union, said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University.

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