Original information from Centers of Disease Control Advisory #00261, transmitted May 29, 2007:

The Centers for Disease Control and Prevention is working with a number of international, state, and local partners on an investigation involving a U.S. citizen with extensively drug-resistant tuberculosis (XDR TB). XDR TB is a form of TB that is resistant to a lot of the drugs used to treat regular tuberculosis.

CDC learned that a patient with XDR TB traveled to Europe via commercial airline departing Atlanta on May 12 and arriving in Paris on May 13, and returned to the United States after taking a commercial flight on May 24 from Prague, Czech Republic to Montreal, Canada. The patient re-entered the United States on May 24 via automobile. Since May 25, the patient has been hospitalized in respiratory isolation and is undergoing additional medical evaluation.

How is XDR TB spread?

TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can float in the air for several hours, depending on the environment. Persons who breathe in the air containing theses TB germs can become infected.

TB is not spread by:

• shaking someone’s hand

• sharing food or drink

• touching bed linen or toilet seats

• sharing toothbrushes

• kissing

• smoking or sharing cigarettes

However, not everyone infected with TB bacteria becomes sick. People who are not sick have what is called latent TB infection. People who have latent TB infection do not feel sick, do not have any symptoms, and cannot spread TB to others. People with latent TB infection can take medicine so that they will not develop active TB disease.

How many cases of XDR TB have been reported in the United States?

In the United States, 49 cases of XDR TB have been reported between 1991 and 2006.

Is it safe to travel where cases of XDR TB have been reported?

Although XDR TB occur all over the world, it is still rare. HIV-infected travelers are at greatest risk if they come in contact with someone with XDR TB. All travelers should avoid high risk settings where there are no infection control measures in place. Documented places where transmission has occurred include crowded hospitals, prisons, homeless shelters, and other settings where susceptible persons come in contact with persons with TB disease. Air travel itself carries a relatively low risk of infection with TB of any kind.

What are the symptoms of XDR TB?

The general symptoms of TB disease include feelings of weakness or fatigue, weight loss, no appetite, chills, fever, and sweating at night. The symptoms of TB disease of the lungs may also include a bad cough that lasts three weeks or longer, pain in the chest, and coughing up blood or sputum (phlegm from deep inside the lungs). If you believe you have come in contact with someone who has TB contact Preventive Medicine at (804) 734-9063.