A man with a rare and exceptionally dangerous form of tuberculosis got in quarantine after possibly infecting passengers and crew on two trans-Atlantic flights to Paris and from Prague this month.
It is the first time since 1963 that the government issued a quarantine order. The last such order was to quarantine a patient with smallpox, according to the Centers for Disease Control and Prevention.
The CDC urged people on the same flights to get checked for tuberculosis.
The government issued the order after a CDC official reached the man by phone in Italy and told him not to take commercial flights, but he flew back to North America anyway, said Dr. Martin Cetron, director of the CDC's division of global migration and quarantine.
"He was told in no uncertain terms not to take a flight back," Cetron said.
The infected man flew from Atlanta to Paris on May 12 aboard Air France Flight 385. He returned to North America on May 24 aboard Czech Air Flight 0104 from Prague to Montreal. The man then drove into the United States.
Cetron reached the man once he was back in the United States. At that point, he voluntarily went to a New York hospital, then was flown by the CDC to an Atlanta-area hospital. He is not facing prosecution, health officials said. Federal officials declined to release details about him.
The man is hospitalized in Atlanta in respiratory isolation, according to the World Health Organization.
He was potentially infectious at the time of the flights, so CDC officials recommended medical exams for cabin crew members on those flights, as well as passengers sitting in the same rows or within two rows.
CDC officials did not release row numbers but said the airlines were working with health officials to contact those passengers. Passengers who should be tested will be contacted by health officials from their home countries, Cetron said.
The man told health officials he was not coughing during the flights. Tests indicated the amount of TB bacteria in him was low, so passengers are not considered to be at high risk of infection, Cetron said.
The man, who went on the trip with his wife, also traveled within Europe, but CDC officials said they did not have information to release about how he made the trips. His wife is not considered a public health risk, Cetron said.
CDC officials said they are concentrating on investigating the trans-Atlantic flights, when possibility of spread of the disease was greatest.
The man was infected with "extensively drug-resistant" TB, also called XDR-TB. It resists many drugs used to treat the infection. Last year, there were two U.S. cases of that strain.
Because of antibiotics and other measures, the TB rate in the United States has been falling for years. Last year, it hit an all-time low of 13,767 cases, or about 4.6 cases per 100,000 Americans.
Tuberculosis kills nearly 2 million people each year worldwide.