The "White Death" And Airplane Travel

By Dr. W. Gifford Jones

June 13, 1999

What should you do if you're sitting next to a fellow traveller who is incessantly coughing? The smartest thing to do is get up and move. But suppose you're not on a bus or subway? Rather, you're on an international flight and there's no other seat available? And you don't know whether your fellow traveller has "the white death", tuberculosis?

Á Not too many years ago there would be little reason to write this column. But today this scenario does happen. On a recent flight from Paris to New York more than a dozen passengers were unwittingly infected with MDR (a medically drug resistant strain of tuberculosis).

Á The source of the infection was a single passenger from the Ukraine. Russia has become one of the most dangerous hot zones of the world for the new drug resistant strain of T.B.

Á In the last two years eight other instances have been reported of airline passengers becoming infected with T.B. due to contact with travellers from former Soviet Republics.

Á The Center for Disease Control (CDC) in Atlanta reported this problem five years ago. In 1994 a 32 year old Korean woman travelled from Honolulu to Chicago. A month later she made the return trip.

Á But on arrival in Honolulu she was found to have advanced tuberculosis and died five days later. The CDC contacted and tested 805 passengers on her flight. 15 people were found to be infected with T.B.. But those sitting within two rows of the patient were more likely to have positive tests.

Á There is some reassuring news. The CDC believes that the disease is not transmitted through the planes' air re©circulation system. Why? Because passengers sitting in more distant sections were not infected with the disease.

Á That doesn't comfort me too much. Several years ago I reported that a 12 months of child had contacted T.B. But no member of the family had the disease.

Á Public Health officials eventually identified a person living in the same apartment building who had a large tuberculous lesion. But the families had never met. The only contact could have been in the hallway or laundry room!

Á It's aptly said that "what goes around comes around." And there are few better examples than tuberculosis.Ô 0*0*0* T.B. was once one of the most dreaded diseases. In 1926 one in thirteen North Americans died of T.B. Then in the 1950's drugs became available to treat and prevent the disease.

Á These drugs nearly knocked out T.B. But doctors and public health officials declared an armistice too soon. Now we have a potential world©wide disaster on our hands. It's estimated that 15 million Americans are infected with the T.B germ.

Á The World Health Organization (WHO) estimates that one©third of the world's population is now infected with the T.B. bacillus. And that 30 million people will die from T.B.

Á Part of the problem is that the T.B germ has become a "microbial hitchhiker". The number of people travelling in airplanes has increased 17 times since 1960. And some carry the T.B. bacillus with them.

Á Today in many industrialized countries at least half of T.B. cases are among foreign born people. According to the WHO one©third of T.B cases in the U.S. are foreign born people. A big problem is that neither physicians nor the public think about T.B any more. So for your own protection start thinking about the possibility of T.B. and learn its symptoms.

Some readers may remember the movie about Frederick Chopin's life. During an exhausting concert tour he suffers a bout of coughing and suddenly there's blood on the piano keys.

A persistent cough, unexplained weight loss, low grade fever, night sweats, chest pain, blood in the sputum, extreme weakness and wasting and swollen neck glands are all associated with T.B.

Á Fortunately nine out of ten people infected with the T.B. bacillus never develop symptoms and cannot infect others. Their immune systems are strong enough to keep the germ under control.

Á But others, such as the increasing number of homeless people, those who inject illegal drugs, HIV patients and many people in urban slums, have weakened immune systems. These people are prime candidates for developing active T.B. infection.

Á In 1996 DR Donald Enarson, Director of the International Union Against T.B., had made a shocking remark before the Royal Society of Medicine. He quoted a report showing that the inner city of London, England had double the rate of T.B. than Central Africa!

Á Don't become paranoid about catching T.B if someone starts coughing on your next plane flight. But if you develop symptoms later, be sure to report them to your doctor.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

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