CDC on Tuesday announced it had taken the rare step of issuing a federal public health isolation order against an Atlanta-area man diagnosed with extensively drug-resistant tuberculosis (XDR-TB) after he flew on international flights to Paris and Montreal, potentially putting fellow passengers at risk.

"What is unusual about this circumstance is that this patient's tuberculosis organism is extremely resistant to the TB drugs that we would normally use to treat infection," said CDC Director Dr. Julie Gerberding.

Although she did not release any details on how many people may have been exposed, Gerberding said CDC is working with the airlines to contact passengers on the two transatlantic flights: a May 12 Air France flight from Atlanta to Paris and a May 24 Czech Air plane from Prague to Montreal. The agency is urging passengers who sat near the patient during the two flights to get tested for TB as a precaution, and others who were aboard to seek testing if they have concerns, said Gerberding. CDC officials note that air travel carries a relatively low risk of infection with TB of any kind.

CDC gave few details about what prompted the issuing of the international health alert. "Normally when someone has tuberculosis, we influence them through a covenant of trust," said Gerberding. "In this case the patient had a compelling personal reason for traveling," she said, adding that the man broke no laws in his travels. The patient is currently under quarantine at Grady Memorial Hospital in what is believed to be the first federal isolation order invoked since 1963.

The patient's TB was first diagnosed in January, though tests showing the more serious XDR-TB came back only after he was in Europe on his honeymoon. In an interview, the patient said he had met regularly for treatment with Fulton County health officials. He said CDC had been aware he had drug-resistant TB, and he questioned why the agency allowed him to leave the United States. Dr. Steven Katkowsky, Fulton County's director of public health and wellness, said it is his understanding that the patient was "advised not to travel."

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