Patient With XDR TB Sets Off Contacts Hunt


June 09, 2015

A search is on for individuals in at least three states who may have come in close contact with a woman from India now being treated for extensively drug-resistant tuberculosis (XDR TB) at the National Institutes of Health Clinical Center in Bethesda, Maryland.

The woman was transported on June 5 from a hospital in suburban Chicago, Illinois, to the National Institutes of Health facility, which has isolation rooms designed for patients with dangerous respiratory infections, according to the National Institutes of Health and the Centers for Disease Control and Prevention (CDC). The CDC today described her condition as stable.

The woman had previously been treated for TB in India, a spokesperson for the Illinois Department of Public Health told Medscape Medical News.

XDR TB, a rare form of the disease, is resistant to isoniazid and rifampin plus any fluoroquinolone and at least one of three injectable second-line treatments (amikacin, kanamycin, and capreomycin). It is associated with patients with TB who do not take all of the medicines prescribed by their clinicians or who do not take them regularly. The CDC said XDR TB poses a threat especially to persons with an HIV infection or other conditions that weaken the immune system. There have been 63 reported cases of XDR TB in the United States between 1993 and 2011.

The woman entered the United States in early April through Chicago O'Hare International Airport, spent time in Tennessee and Missouri, and then visited relatives in McHenry County, which borders Chicago, on May 18, said the CDC and the McHenry County Department of Health. She sought medical treatment during this visit in May.

Public health authorities are monitoring an unknown number of individuals in Illinois who were in close contact with the patient for signs of TB.

The health departments of Missouri and Tennessee said they are investigating who may have been exposed to the patient while she was in those states.

A spokesperson for the Tennessee Department of Health told Medscape Medical News that it "does not yet know if the person was infectious during the visit."

The CDC said in a news release that it plans to contact the passengers on the airline flight that the woman took from India to the United States. "Although the risk of getting a contagious disease on an airplane is low, public health officers sometimes need to find and alert travellers who may have been exposed to an ill passenger," the agency said.


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