June 5, 2007

The Chief Public Health Officer for Canada, Dr. David Butler-Jones, has contacted his counterpart in the United States to request the development of more formal operational protocols to further strengthen information sharing between the two organizations.

The Public Health Agency of Canada and the U.S. Centers for Disease Control and Prevention (CDC) routinely share information on a host of public health issues, and work collaboratively to prepare to respond to threats to public health, such as in the recent case of a U.S. citizen with extensively drug-resistant tuberculosis (XDR-TB) travelling from Montreal to the U.S.

Operational protocols will enhance the information sharing networks already in place to provide guidance for public health authorities on both sides of the border in responding effectively to possible threats to public health.

Meanwhile, the provinces and territories are following up with the 29 passengers who sat within two rows of the ill passenger.  New information indicates a passenger switched seats during the flight, bringing the total number of passengers who sat within two rows of the individual up to 29.  Of the 29 passengers, 20 were Canadian residents (14 from Quebec and 6 from Ontario). The remaining passengers are foreign residents, mainly from Europe.

Skin testing on the passengers for TB is underway by local health practitioners. After exposure, it usually takes 3 to 10 weeks before a TB test would show if someone had become infected. Therefore, tests underway now will provide an indication of the individuals’ TB status prior to their possible exposure to the ill traveller. These individuals will be tested again at a later date for any evidence of infection.

It usually takes prolonged exposure to someone with active TB disease for someone to become infected.

Backgrounder

On May 25, the Public Health Agency of Canada (PHAC) was notified by the US Centers for Disease Control and Prevention (CDC) about a US citizen, recently diagnosed with extensively drug-resistant tuberculosis (XDR-TB), who arrived in Montreal on a flight from Prague, Czech Republic, and then drove to the US via the Champlain, New York, border crossing.

The individual is now in contact with CDC officials and is in a U.S. hospital undergoing further evaluation.  The results of the assessments to date indicate that the individual’s level of infectiousness is low.

The likelihood of transmission to fellow passengers appears to be low at this time.  Although brief contact with an infectious individual poses little to no risk for transmission, PHAC has nonetheless released the flight number and a toll-free phone number so passengers on the flight can receive the appropriate information for follow-up.

Czech Airlines flight # 0104 departed Prague on May 24th and arrived at Montreal International Airport the same day.  For passengers on this flight seeking more information, please call 1-866-225-0709.

PHAC, working with the US CDC and other public health authorities, first identified and located the 29 passengers who sat within two rows of the individual and referred their contact information to the appropriate public health authority for appropriate follow-up.  This approach is consistent with the WHO guidelines for TB contact tracing. 

Of the 29 passengers, PHAC was in contact with 19 of them through the toll-free line.  The remaining 10 passengers were identified through the passenger manifest and customs cards.

As an added precaution, PHAC worked with its provincial and territorial partners to identify and refer the remaining Canadian passengers to their local public health authority.  PHAC also worked with its international partners to refer the remaining passengers to their national health ministries.  Contact information for the remaining 163 passengers has been shared with the appropriate public health authorities.

For more information on XDR-TB and TB in general, visit:

• CDC release
• TB fact sheet