The "Do Not Board" List Boards Aircraft
January 12, 2010 - Investigators are trying to figure out how a man who
has Tuberculosis, a contagious disease that was placed on a "Do Not
Board" list by the CDC was allowed to board a US Airways Flight 401 out
Tuberculosis or TB (short for Tubercle Bacillus) is a common and often deadly infectious disease caused by mycobacteria, usually Mycobacterium tuberculosis in humans. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air, when people who have the disease cough, sneeze, or spit.
Most infections in humans result in an asymptomatic, latent infection,
and about one in ten latent infections eventually progresses to active
disease, which, if left untreated, kills more than 50% of its victims.
The Centers for Disease Control has reported that the passenger was
added to a "Do Not Board" list due to his medical condition. The
reporting of such medical information is a requirement of CDC in an
effort to make it safe for passengers boarding aircraft. CDC further
reported the agency consistently updates this list and it is provided to
TSA and the airlines.
While in flight, US Airways flight attendants soon realized the
passenger man wasn't fit to travel on an aircraft. Upon reaching
A third of the world's population is thought to be infected with M.
tuberculosis, and new infections occur at a rate of about one per
second. The proportion of people who become sick with tuberculosis each
year is stable or falling worldwide but, because of population growth,
the absolute number of new cases is still increasing. In 2007 there were
an estimated 13.7 million chronic active cases, 9.3 million new cases,
and 1.8 million deaths, mostly in developing countries.
In addition, more people in the developed world are contracting
tuberculosis because their immune systems are compromised by
immunosuppressive drugs, substance abuse, or AIDS. The distribution of
tuberculosis is not uniform across the globe; about 80% of the
population in many Asian and African countries test positive in
tuberculin tests, while only 5-10% of the
Signs and symptoms: When the disease becomes active, 75% of the cases
are pulmonary TB, that is, TB in the lungs. Symptoms include chest pain,
coughing up blood, and a productive, prolonged cough for more than three
weeks. Systemic symptoms include fever, chills, night sweats, appetite
loss, weight loss, pallor, and often a tendency to fatigue very easily.
In the other 25% of active cases, the infection moves from the lungs,
causing other kinds of TB, collectively denoted extrapulmonary
tuberculosis. This occurs more commonly in immunosuppressed persons and
young children. Extrapulmonary infection sites include the pleura in
tuberculosis pleurisy, the central nervous system in meningitis, the
lymphatic system in scrofula of the neck, the genitourinary system in
urogenital tuberculosis, and bones and joints in Pott's disease of the
spine. An especially serious form is disseminated TB, more commonly
known as miliary tuberculosis. Extrapulmonary TB may co-exist with
pulmonary TB as well.
Transmission: When people suffering from active pulmonary TB cough,
sneeze, speak, or spit, they expel infectious aerosol droplets 0.5 to 5
?m in diameter. A single sneeze can release up to 40,000 droplets. Each
one of these droplets may transmit the disease, since the infectious
dose of tuberculosis is very low and inhaling less than ten bacteria may
cause an infection.
People with prolonged, frequent, or intense contact are at particularly
high risk of becoming infected, with an estimated 22% infection rate. A
person with active but untreated tuberculosis can infect 10?15 other
people per year. Others at risk include people in areas where TB is
common, people who inject drugs using unsanitary needles, residents and
employees of high-risk congregate settings, medically under-served and
low-income populations, high-risk racial or ethnic minority populations,
children exposed to adults in high-risk categories, patients
immunocompromised by conditions such as HIV/AIDS, people who take
immunosuppressant drugs, and health care workers serving these high-risk
Transmission can only occur from people with active ? not latent ? TB. The probability of transmission from one person to another depends upon the number of infectious droplets expelled by a carrier, the effectiveness of ventilation, the duration of exposure, and the virulence of the M. tuberculosis strain. The chain of transmission can, therefore, be broken by isolating patients with active disease and starting effective anti-tuberculous therapy. After two weeks of such treatment, people with non-resistant active TB generally cease to be contagious. If someone does become infected, then it will take at least 21 days, or three to four weeks, before the newly infected person can transmit the disease to others. TB can also be transmitted by eating meat infected with TB. Mycobacterium bovis causes TB in cattle.
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