ROME - Italian officials said Wednesday they were tracing the movements of an American man infected with a rare and dangerous form of tuberculosis who honeymooned in Rome for two days despite being told to turn himself in to health authorities.
The man, who Italian authorities said was 32 years old, is hospitalized in respiratory isolation in an Atlanta hospital.
He flew from Rome to Prague, then to Montreal and the United States - despite being contacted by the U.S. Centers for Disease Control while in Rome and told to turn himself in to Italian authorities to be isolated and treated.
The World Health Organization said Wednesday the chances that the man infected fellow passengers was small, although officials noted that because of TB's long incubation time, it may be years before anyone knows whether the man infected anyone while he was traveling.
Dr. Olivia Callipari of the Italian Health Ministry said local authorities were informed by CDC officials that the infected passenger had passed through Italy last week.
"As a precaution, we have set up a surveillance system and are tracing all his movements," including the flight he boarded to Prague and the hotel where he stayed during his nearly two-day stay in Rome, she said.
"We have identified all the passengers sitting within two rows in front and behind his seat on the plane and are working to inform them," about the potential health risk, Callipari told The Associated Press.
The infected patient flew from Atlanta to Paris on May 12, arriving May 13, on Air France Flight 385. The French Health Ministry said the man took a flight the next day from Paris to Athens.
It's not clear how he got to Rome. But he flew from Rome to Prague on May 24 aboard Czech Air flight 727, airline spokeswoman Daniela Hupakova said.
He returned to the United States on May 24, on Czech Air Flight 410, from Prague to Montreal, and then drove into the United States, according to information released by the CDC.
Callipari declined to say when the man flew out of Rome or which airline operated the flight to Prague. She said the patient did not show any symptoms of the infection during his stay.
Meanwhile, Air France-KLM (AKH) has been asked by French health authorities to provide lists of all passengers seated within two rows of the infected man, a spokeswoman said Wednesday.
She said that Air France uses high-efficiency particulate air filters on its planes, which mean that 50 percent of the air circulating is new and 50 percent is recycled.
French health officials said they would give a passenger list of the May 13 flight to their counterparts abroad - leaving it to them to decide how to inform passengers from their countries.
Tuberculosis usually affects the lungs, and can lead to symptoms such as chest pain and coughing up blood. Caused by germs that are spread from person to person through the air, it kills nearly 2 million people each year around the world.
The man in question is believed to have the rare and "extensively drug-resistant" TB - or XDR-TB - which does not respond to at least three of six classes of second-line drugs.
Nevertheless, the WHO said the risk of transmitting XDR-TB on the flights would have been low.
"It's a small risk, but it's not zero," said Dr. Mario Raviglione, director of WHO's Stop TB department. It's the long-haul flights (eight hours or more) that would have been most dangerous, the short flights were too short for the infection to be passed easily, he said. "The risk exists, but he was not highly infectious."
The risk of infection is related to the infectiousness of the TB patient, the duration of exposure, proximity to the source, and the conditions of ventilation and crowding. The quality of air on an airplane is generally high, and under normal conditions, cabin air is cleaner than that in most buildings.
Raviglione said that there have never been any documented instances of TB transmission on airplanes. But because the incubation period for TB can vary from a couple of weeks to a few decades, it will not be known for a long time if anyone gets TB from the man's travels.