TB traveler update: 8 hours may be more than enough time to contract the disease

I swerved into some of this territory during my audio interview with Sara Carter last week, when I asked whether the tuberculosis-afflicted Mexican national who entered the US at least 76 times on business over the past year might have infected more than just the people who happened to have been on planes with him. After all, he did travel to the US on business, meaning that he met with people for perhaps hours on end in rooms and other more or less confined spaces. TB is contagious and the form that he has is particularly so, so it seems to me that the possibility of him infecting the people with whom he met would be just as high as anyone unfortunate enough to have been on a plane with him. And that turns out to be the case, according to Carter’s follow-up:

Government claims that a Mexican businessman infected with a highly contagious form of tuberculosis posed no serious public health risk by taking numerous domestic flights are based on faulty research and limited data, said a top Harvard physician who specializes in disaster medicine and infectious disease.

“This policy is ill-founded, poorly researched, and puts the population at risk,” said Dr. Greg Ciottone, one of the world’s leading authorities on disaster medicine, including terrorist attacks and the threat of biological warfare.

The World Health Organization pegs 8 hours as the magic threshold for passing on the disease from a Typhoid Maria like the fellow in this story. But that’s probably too generous a standard.

Dr. Ciottone said the guidelines are based on limited studies for all strains of TB done more than ten years ago that, among other flaws, did not even include in the study sample any passengers who had other risk factors for TB before the plane took off, such as spending time in certain foreign countries.

A 1996 article in the New England Journal of Medicine admitted that the studies done to date could not exclude transmission of tuberculosis on flights under eight hours.

Never mind the people that he met with while here; new WHO guidelines just flatly say that people suffering from MDR-TB ought not fly on planes at all. Mr. Armendariz was on at least 11 flights.

Citing the WHO guidelines, neither the CDC nor Homeland Security notified any passengers who flew with Mr. Armendariz that they were exposed to his “dangerous and highly contagious” form of tuberculosis, the same strain involved in the case of Andrew Speaker, whose ability to sneak into the U.S. from Europe via a May flight to Canada prompted national headlines and congressional hearings.

We’ve heard from an official at CPB today, who disputed parts of the first Washington Times story about this case, but I contacted both Audrey Hudson and Sara Carter and they both stand by their report.

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David Strom 9:21 PM on March 24, 2023