TB and air travel<\/p>\n
During a domestic flight from Chicago to Honolulu (eight
\nhours, 38 minutes), May 1994, a foreign-born passenger with
\ninfectious tuberculosis managed to infect four U.S.-born
\npassengers sitting in the proximity of the patient.<\/p>\n
This case was mentioned in The Jakarta Post, March 8, 1995, TB
\nsufferers told to avoid air travel, and discussed in the
\nMorbidity and Mortality Weekly Report published by the
\nMassachusetts Medical Society, March 3, 1995, which has just been
\nreceived by me courtesy of Dr. Paul W. Broadbent, American
\nEmbassy.<\/p>\n
I bet the passenger mentioned in the article would not have
\nbeen able to cause those infections had she been immediately put
\non chemotherapy, which is the most rapid and effective means to
\nprevent infection.<\/p>\n
A World Health Organization study on the infectivity of TB
\npatients on chemotherapy since the 1950s showed that, after
\ninitiation of chemotherapy, no further infection of the disease
\noccurred among house contacts of the infectious patients, who
\nwere treated at home, as compared with those admitted to a
\nsanatorium.<\/p>\n
This important finding was supported by Dr. R.L. Riley, who
\ndemonstrated that the air obtained from a TB ward, which
\notherwise would infect guinea-pigs, could not cause infection any
\nlonger, as soon as the patient is under chemotherapy. This
\nfinding was also confirmed by Prof. Jaques Grosset, who
\ndemonstrated that the number of "viable" bacilli in the air,
\nproduced by infectious TB patient under treatment, will
\nimmediately decrease and become too small for the transmission of
\nbacilli.<\/p>\n
The Morbidity and Mortality Weekly Report's editor recommended
\nthat "To prevent exposures to TB aboard aircraft, when travel is
\nnecessary, persons known to have infectious TB should travel by
\nprivate transportation (i.e. not by commercial aircraft or other
\ncommercial carrier)."<\/p>\n
My question is whether any airline could force a person who is
\nsymptomatic, but ignorant about their TB condition, to have their
\nhealth checked prior to the scheduled flight?<\/p>\n
If such a patient proves to have infectious TB, as shown by
\nsputum microscopic examination, when would they (after how many
\ndays of chemotherapy) be allowed to travel by air? Sputum
\npositivity for acid fast TB bacilli, after chemotherapy was
\nstarted, does not imply infectiousness. Some experts would state
\nthat infectivity will disappear after the patient has received
\nchemotherapy for a period of two weeks.<\/p>\n
However, the biggest problem for airlines is that the
\npassenger is consistently producing multiple drug resistant
\nbacilli, despite prolonged treatment(s).<\/p>\n
I wonder if the national Centers for Disease Control and
\nPrevention (CDC), or related state health departments, are
\nauthorized to notify such cases to the airlines?<\/p>\n
DR. MUHERMAN HARUN<\/p>\n
St. Carolus Health Services<\/p>\n
Jakarta<\/p>", "url": "https:\/\/jawawa.id\/newsitem\/tb-and-air-travel-1447893297", "image": "" }, "sponsor": "Okusi Associates", "sponsor_url": "https:\/\/okusiassociates.com" }