Sunnyvale woman back from India has hard-to-treat case of TB

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John Wildermuth, Chronicle Staff Writer

Friday, December 28, 2007


A 30-year-old Sunnyvale woman, recently back from a stay in India, is in an isolation unit at Stanford Hospital with a tough-to-treat strain of tuberculosis, and health officials are scrambling to find any people with whom she may have come into close contact.

The woman, whose name has not been released, was reportedly diagnosed with multidrug-resistant TB while in India and was being treated for the disease before she returned to the Bay Area on Dec. 13.

\"She was sick when she got on her airplane,\" said Joy Alexiou, a spokeswoman for Santa Clara County's Public Health Department.

That was likely a good thing, said Dr. Marty Fenstersheib, the Santa Clara County health officer.

\"She was really sick when she arrived in the Bay Area, so she wasn't going out Christmas shopping or mingling with crowds,\" he said. \"She finally made her way to the emergency room at Stanford on Dec. 19.\"

County health officials, along with the national Centers for Disease Control and Prevention, are tracking down people who might have been exposed to the disease. The people who shared the emergency room with the woman on Dec. 19 already have been notified, as has her family, Fenstersheib said.

The CDC has identified 44 people from 16 states who were within two rows of the woman on American Airlines Flight 293 from New Delhi to Chicago's O'Hare airport on Dec. 13. On Thursday, the CDC sent health officials in the 16 states a list of the names and asked for help in having them tested for TB.

Since a person typically needs prolonged exposure to a TB carrier to become infected, only plane rides of eight hours or longer are of concern to health officials, said Shelly Diaz, a CDC spokeswoman. Passengers on the shorter flight the woman took from Chicago to San Francisco International Airport are not considered to be in danger.

While the multidrug-resistant strain of TB only accounts for a handful of cases each year in Santa Clara County, the disease itself is all too common in the Bay Area, Fenstersheib said. Santa Clara County had 228 cases of TB in 2006 and about the same number this year. About 90 percent of those infected are foreign born, often coming from countries where the disease is endemic.

\"We work with TB all the time, so this is kind of routine for us,\" he said.

The woman is in stable condition at Stanford Hospital, Fenstersheib said. She will be kept in isolation at the hospital until her disease is no longer infectious, which could take weeks.

The multidrug-resistant strain of TB isn't any more virulent, but is much tougher to treat, since the typical frontline drugs don't work, the doctor said. While the normal TB patient will take antibiotics for as long as nine months, the treatment can stretch out to two years for those with the less common version.

In May, there was a national health scare when an Atlanta attorney originally was diagnosed with an even rarer - and deadlier - form of the disease. The man, who had traveled widely while he was ill, became the first person since 1963 to be hit with a formal federal quarantine order. He later was found to have the multidrug-resistant version.

World Health Organization guidelines call for people with multidrug-resistant TB to avoid commercial air travel until lab tests show they are noninfectious, but that doesn't always happen.

\"eople get on buses, planes and trains and go to malls with illnesses all the time,\" said Diaz of the CDC.

What to do
If you suspect you've been exposed, see your doctor or contact your county health department to be tested for the disease.













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