Details of TB patient's trek emerge

WASHINGTON — The Atlanta man with extensively drug-resistant tuberculosis, who sparked an international health alarm by flying to Europe and back for his wedding, ignored requests twice to stay put and not travel, officials said Wednesday.

He apparently also shortened his honeymoon — which included stays in Greece and Italy — and returned home early to avoid the complicated procedure being put together to get him back to the United States in a way that would not expose others to his dangerous microbe.

The man, back in Georgia and undergoing treatment, provided a different version of events to The Atlanta Journal-Constitution, saying he was never explicitly told he could not travel.

The man and his fiancée traveled from Paris to Athens, where the two married, and to two Greek islands. "We headed off to Greece thinking everything's fine," the man told the Atlanta paper.

He declined interview requests Wednesday. Because of privacy issues, he has not been identified; he is said to be in his 30s.

Wednesday, officials from the Fulton County Health and Wellness Department and the federal Centers for Disease Control and Prevention (CDC) said they emphatically told him to stay put.

"He was told in no uncertain terms that he had a serious, contagious disease," said Dr. Steven Katkowsky, director of the Fulton County health department. "We told him not to travel."

Dr. Martin Cetron, director of CDC's division of global migration and quarantine, said the agency is making slow progress in reaching passengers and crew aboard the man's trans-Atlantic flights.

Authorities in the United States and several European countries are tracking down about 50 people who sat near the man on his Atlanta-to-Paris flight May 12, and 30 people on his Prague-to-Montreal return last Thursday.

They will be offered testing to see if they are infected.

CDC officials are concentrating on the trans-Atlantic flights, when the likelihood of disease spread was greatest because the man was in a confined space with others for hours.

Authorities also disclosed that the man was on several flights between various European locales during the time he was abroad. Passenger lists for those flights also were being tracked down, officials said.

Cetron stressed that the chances that other people were infected is low. But because the man's disease, extensively drug-resistant tuberculosis, or XDR-TB, is so difficult to treat, the agency could take no chances.

The CDC is isolating the man under a federal public-health order, the first issued since the isolation of a smallpox patient in 1963.

It remained unclear how the man contracted TB, and his wife tested negative for the illness, the CDC said.

The man's illness was discovered after he fell, hurt his ribs and got an X-ray, which revealed an abnormality in his right lung, suggesting TB.

In March, lab tests revealed he had TB. By May 10, further tests showed it was "multidrug-resistant" version: It could not be killed by the two most commonly used drugs.

That same day, Eric Benning, of the Fulton County health department, met with the patient and his personal physician. Benning said he told the man "it was our recommendation that he not travel because of the potential exposure of other people but also for his benefit."

The Atlanta Journal-Constitution quoted the man as saying local health officials told him they "preferred" he not travel.

When more tests revealed the man had the extensively drug-resistant TB, the CDC reached the man in Rome by cellphone, told him not to travel and said arrangements for travel and treatment were being made, Cetron said.

The man told the Atlanta paper he interpreted that conversation as meaning he was stuck in Italy and decided to sneak home because he feared he would die without treatment in the United States. "I thought to myself: 'You're nuts.' I wasn't going to do that," he said.

Although his plans were to return June 5, he and his wife returned to the United States on Thursday.

CDC officials reached the man on his cellphone Friday near Albany, N.Y. He drove himself to a hospital in New York and was taken in a CDC plane back to Atlanta on Monday.

He is isolated at Grady Memorial Hospital in Atlanta and is in stable condition, the CDC said.

Cetron said the man wants to be taken to the National Jewish Medical and Research Center in Denver, one of the few U.S. institutions where TB has been a research focus for decades.

Compiled from The Washington Post, Los Angeles Times, Newsday and The Associated Press