Airline passengers urged to get tested for TB

Montreal health officials on Wednesday urged air travellers on a May 24 Prague-to-Montreal flight that carried a man with tuberculosis to get tested at a local tuberculosis clinic as soon as possible.

"We strongly recommend people come now to be checked," said Dr. Richard Menzies, head of the respiratory division of the Montreal Chest Institute.

Passengers on the Czech Airways flight who were in close proximity to an Atlanta man who is sick with a rare and extremely drug-resistant form of tuberculosis may have been exposed to the dangerous lung disease, experts say.

Those most at risk are the 28 people who were seated within five rows of the TB-infected man on the transatlantic flight.

He isn't believed to be highly infectious, but hundreds of people may have been exposed. The man is in quarantine in Atlanta.

Tuberculosis spreads through airborne droplets when a person with the infection coughs, talks or sneezes. It's far less contagious than the common cold, measles or influenza, but this TB strain could be lethal, because it fails respond to most antibiotics.

Officials have little experience with this rare type of TB and its transmission patterns.

"If you sat in one row or wandered up and down, were you in the right area? All we're saying is that if people are concerned, they should get checked out," Menzies said.

Since it takes about a month to develop a reaction to the bacterium, health officials suggest passengers get tested immediately.

"We want to avoid someone coming in three to four weeks. If they test positive in a month, we won't know if it's TB from this guy," Menzies said.

Officials have already notified the 12 Quebecers seated in the five rows near the passenger aboard Czech Airways Flight 0104 on May 24, said Blaise Lefebvre, of the Montreal public health department.

The World Health Organization and Health Canada are involved in helping trace the remaining passengers.

Mario Raviglione, director of the WHO' s Stop TB department, warned Wednesday of another SARS-type crisis. The lung disease spread around the world through airline passengers in 2002 and 2003, killing 774 people.

"If TB control programs don't know what they're doing and don't take this seriously, we'll have cases of infected people travelling around the world all the time," Raviglione said.

"In an era of globalization, no one can feel comfortable that this is not my problem.' "

Despite advances in treatment, TB is a global pandemic, fuelled by the spread of HIV/AIDS, poverty, a lack of health services and the emergence of drug-resistant strains of the bacterium that causes the disease.

"We have forgotten about infectious diseases but these are still the No. 1 killer," said Karl Weiss, a microbiologist at Maisonneuve-Rosemont Hospital.

The scary part is that infections are transmissible and anyone can be affected anywhere, anytime, Weiss said.

"The story of travel and infectious diseases is an old one. It's just that the speed has changed," Weiss said.

Marco Polo took 20 years to get to China, he noted; today, it's possible to travel anywhere within 24 hours.

"You can bring back something (a highly contagious and resistant organism) that seems far away but in fact is not that distant."

The issue of globalization and the transmission of diseases calls for good infection control measures, whether boarding planes or entering countries, plus active surveillance worldwide, Weiss said.