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Have you have heard about the attorney who exposed others to tuberculosis or TB on transatlantic flights? The TB he had was so serious the Centers for Disease Control detained and quarantined him upon his return to the US. The last time the CDC quarantined anyone was in 1963 for small pox.

This drastic step was taken because his TB was Multiply Drug Resistant. This means that it does not respond to common antibiotics. Plus TB is highly infectious; even a sneeze can release droplets that rapidly infect others.

So is it dangerous for TB patients to fly? You’d probably say yes until you consider that only a minority of people with TB are infectious and go on to develop the disease.

Also, airline personnel are unlikely to identify someone with TB since symptoms often don’t show for years. And people may not know that they are infected.

The CDC has developed guidelines for TB patients. A person with normal TB should not travel until two weeks after drug treatment is initiated. However those with multiple drug resistant TB or an even more serious strain of TB called XDR should not travel until lab tests show they are non-infectious.

What are the risks to fellow passengers? Studies have found transmission of TB is more likely to happen on flights longer than eight hours. Furthermore, since only 25-50% of the air on a modern jet is re-circulated, studies show the risk is mostly limited to those surrounding the infected person.

It is clear that we need to identify and educate those infected with TB about the risks to themselves and others. Just as important, is the development of new antibiotics to control MDR and XDR TB.