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ČSA passengers tested in TB case

Incident shows gaps but airline says public is in little danger

By Hilda Hoy
Staff Writer, The Prague Post
June 6th, 2007 issue

Authorities are telling four Czechs to get tuberculosis tests after they sat near an American with a rare form of the disease on an airplane.
Andrew Speaker, a 31-year-old Atlanta lawyer, was diagnosed with TB May 10, but ignored health officials’ warnings not to travel. Speaker came through Prague, where he boarded ČSA flight 0104 May 24 to Montreal.
After being contacted by the U.S. Centers for Disease Control May 23 and told to turn himself in to Italian authorities, he instead boarded a plane for Prague.
Despite Speaker’s transit through the Czech Republic, the population is unlikely to be affected, says chief public health officer Michal Vít. Speaker didn’t spend any time in Prague before boarding his ČSA flight to Montreal, so there’s virtually zero risk of transmission to the city’s residents, he said.
“The risk can never be a zero risk,” but the fact that Speaker wasn’t showing symptoms, particularly coughing, means the risk of transmission is very low, Vít said.
Speaker flew to Athens May 12 for his wedding, then to Rome for his honeymoon. While he was away, test results came back showing his to be a rare, drug-resistant TB strain known as XDR-TB, said Dr. Martin Cetron, director for global migration and quarantine at the CDC.
He was placed under a CDC isolation order, the first since 1963, and, after driving to New York, flown on a CDC plane to Atlanta. He was transferred to an isolation room at the National Jewish Medical and Research Center in Denver May 31, and will remain there until he is no longer contagious.
Airlines and health authorities in Europe and Canada say they weren’t given enough advance notice to contact or apprehend Speaker before he could board the flights.
ČSA spokeswoman Daniela Hupáková said the airline wasn’t able to act because it received the information too late. ČSA didn’t learn about Speaker until several hours after the flight had taken off, when they were notified by the American Transport Safety Administration (TSA), she said. Even then, the airline wasn’t completely sure Speaker was onboard one of its planes.
“The information we received was that there was a possibility that a passenger possibly had TB. It took some time to confirm that information,” Hupáková said.
She could not confirm whether the airline verified that information before or after the plane touched down in Montreal.
Initially, ČSA said it had followed Canada’s Quarantine Act and notified Montreal prior to landing so that Speaker could be taken into quarantine. That statement was soon retracted, said Patti Robson, chief of media relations at Canada’s Public Health Agency.
It wasn’t until Speaker had turned himself in May 25 in New York that the CDC informed Canada, Robson said.
'No need to panic'
Of the 28 passengers that were sitting in the rows nearest Speaker on his flight out of Prague, four were Czechs, Dr. Vít said. All have been identified and authorities are working to track them down and advise skin tests to detect TB infection.
The CDC’s Cetron said Speaker had also taken five commercial flights within Europe during his stay. However, because those flights were less than eight hours, the cutoff set by the World Health Organization for possible transmission of TB, the risk to passengers is negligible, he said.
The case has exposed critical gaps in the global fight to prevent the spread of deadly diseases. Rapid developments and the global nature of the incident complicated the affair, Cetron said.
“It’s very unfortunate that this whole situation wasn’t prevented on the front end,” he said, speaking at a May 30 press conference. “There are different perspectives on who said what to whom when. I think that’s not the focus of what we need to be concentrating on right now. It’s about getting this patient cared for.”
Experts have warned for years that commercial airliners are a likely way for pandemics to quickly spread. In 2003, a deadly outbreak of sudden acute respiratory syndrome (SARS) spread from Hong Kong to Toronto through passenger flights.
Short of forced quarantine, authorities still rely largely on individuals to not fly while sick.
“We influence them through a covenant of trust so that they don’t put themselves in situations where they could potentially expose others,” said CDC Director Dr. Julie Gerberding at a May 29 press conference.
“The patient is fully responsible,” agreed Vít. “Airlines cannot recognize illness. No one asks you about your health before you board the plane.”
Speaker continues to show no symptoms and be in good health, Cetron said.
The CDC has said he will not be prosecuted.
— Naďa Černá contributed to this report.

Hilda Hoy can be reached at hhoy@praguepost.com


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