The Centers for Disease Control and Prevention (CDC) in the United States have placed a trans-Atlantic air traveler under quarantine because he has a rare and dangerous form of tuberculosis.
The man has the XDR strain of TB and authorities fear he may have exposed fellow passengers and air crew to the bacterial infection; they are trying to contact all those who traveled with him.
The man traveled on Air France 385 from Atlanta to Paris on 12/13 and back on Czech Air Flight 0104 on May 24 from Prague to Montreal; he then drove into the United States.
Passengers on those flights are being asked to notify authorities and get themselves checked out as a precaution.
According to the World Health Organization (WHO) the man is now in respiratory isolation in a hospital.
As the man was possibly infectious at the time of the flights to and from Europe, CDC and WHO officials are recommending medical evaluation of cabin crew members on those flights and for passengers sitting in the same rows as the man or two rows in front or behind him.
Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, says a similar action was last taken in 1963.
Dr. Gerberding says this particular strain of TB is an unusual one which is extremely difficult to treat and the CDC wants to ensure everything possible is done to identify people who could be at risk.
Tuberculosis is a bacterial infection that usually attacks the lungs; it is a disease caused by germs that are spread from person to person through the air.
TB can lead to symptoms such as chest pain and coughing up blood and kills almost 2 million people globally each year.
Antibiotics along with other measures, have meant the TB rate in the United States has been falling for decades and the rate hit an all-time low last year with a total of 13,767 cases.
But health authorities are always on the alert for the "multidrug-resistant" TB strains which resist the mainline antibiotics isoniazid and rifampin.
According to the CDC such cases represent about 1.2 percent of U.S. TB cases.
XDR-TB is a rare form of the disease which does not respond to at least three of six classes of second-line drugs; there were two just cases of the infection in the U.S. last year.
The medical treatment for just one case of XDR-TB can amount to $500,000 or more, say CDC officials.
The CDC is working with U.S. state and local health departments, international Ministries of Health, the airline industry, and WHO over the case.