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Order Code RS22672
June 5, 2007
~CRS Report for Congress
Extensively Drug-Resistant Tuberculosis
(XDR-TB): Quarantine and Isolation
Kathleen S. Swendiman and Nancy Lee Jones
Legislative Attorneys
American Law Division
Summary
The recent international saga of a traveler with XDR-TB, a drug-resistant form of
tuberculosis, has placed a spotlight on existing mechanisms to contain contagious
disease threats and raised numerous legal and public-health issues. This report will
briefly address the existing law relating to quarantine and isolation, with an emphasis
on the interaction of state and federal laws and international agreements. It will not be
updated.
Background
On May 12, 2007, a man with tuberculosis flew from Atlanta, Georgia, to Paris,
France. After his wedding in Greece, he went to Rome, Italy, where he was contacted by
the Centers for Disease Control and Prevention (CDC) and told that he had XDR-TB, a
drug-resistant form of tuberculosis with a cure rate of approximately 30%-50%.' He was
told that he should not get on an airplane and that his passport was the subject of a no-fly
order. However, fearing he would not be able to return to the United States for treatment,
he flew to Canada and entered the United States by car on May 24. Although CDC had
alerted the Atlanta office of Customs and Border Protection in the Homeland Security
Department, he was not stopped at the border. CDC contacted him and he voluntarily
went to a hospital in New York. He was then flown to an Atlanta hospital. CDC issued
a federal order of isolation under the Public Health Service Act, the first since 1963. The
patient was flown to the National Jewish Medical and Research Center in Denver for
treatment. All tests on the patient have indicated that he posed a low, but possible, risk
of transmitting the infection. American citizens who were most at risk in the airplanes
the patient traveled on are being contacted.2
For a discussion of XDR-TB see CDC, Extensively Drug-Resistant Tuberculosis (XDR TB)
[http://www.cdc.gov/tb/pubs/tbfactsheets/xdrtb.htm].
2 CDC, Questions and Answers: XDR TB in Traveler, from May 30, 2007, CDC Press
(continued...)
Congressional Research Service , The Library of Congress
Prepared for Members and Committees of Congress](ViewImageLocal?handle=hein.crs/crsmthabeka0001&div=1&collection=&method=preview&ext=.png&size=3)