XDR TB: CDC Letter to Heatlhcare Providers

Dear Healthcare Professional,

A person with recently diagnosed culture-confirmed, extensively drug-resistant pulmonary tuberculosis (XDR TB) traveled on the following two extended flights (more than 8 hours in duration) in May 2007:

Date From To Airline / Flight#
May 12/13 Atlanta, Georgia Paris, France Air France #385/Delta #8517
May 24 Prague, Czech Rep. Montreal, Canada Czech Air #104

XDR TB is defined as a subtype of multidrug resistant TB (MDR TB) (i.e., an isolate resistant to at least isoniazid and rifampin), with additional resistance to at least two of the most important second-line antibiotics (i.e., a fluoroquinolone and an injectable agent [amikacin, kanamycin, or capreomycin]).

The patient is currently in respiratory isolation in a hospital in the United States, and is receiving medical therapy for XDR TB. He has remained relatively asymptomatic, and his sputum smear results were negative for acid fast bacilli (AFB), both before and after his travel; however, his sputum culture results are positive for XDR TB.

This is the first investigation of a case of XDR TB during air travel. Due to the serious nature of this strain of TB disease, CDC is recommending that all U.S. residents and citizens on these two flights receive evaluation, testing, and follow-up for TB infection.

We are requesting your assistance to perform TB evaluation and testing on any person identified as a contact on one of these flights. The XDR TB Contact Investigation Form is enclosed. Please keep a copy of this completed form for your records, give a copy to the person tested, and also please contact your State or Local TB control office via: http://www.cdc.gov/tb/pubs/tboffices.htm .

For inquiries related to this investigation, please call your State or Local Health Department. For more information about XDR TB, please see this link: http://www.cdc.gov/tb/XDRTB/default.htm.

We greatly appreciate your assistance on this important international XDR TB contact investigation.