A 30-year-old Sunnyvale woman is in isolation at Stanford Hospital with an active case of multi-drug resistant tuberculosis.
She was infectious when she flew into San Francisco International Airport around Dec. 13, returning from her travels abroad and also when she sat in the waiting room of the Emergency Department at Stanford Hospital several days later, Santa Clara County Health Officer Marty Fenstersheib said.
The woman flew from New Delhi to Chicago, and 44 people sitting near her have been contacted by the Centers for Disease Control and Prevention, Fenstersheib said Thursday. The 44 people were found in 16 states and will be followed by local health authorities, he said.
He said he does not know where she acquired tuberculosis (TB), but she had been receiving treatment abroad, Fenstersheib said.
Officials have also contacted the "very small" number of people in the emergency room and they are being offered tests and treatment if necessary, hospital spokeswoman Shelley Hebert said.
But, she emphasized that only a few people were exposed.
"If people were treated at the emergency room recently and have not been contacted, they have not been exposed," Hebert said. "It's important to know that this patient's condition is not dangerous to the public."
Fenstersheib said the woman was not feeling well enough to go anywhere else after she returned home.
TB is a bacterial infection that attacks the respiratory system. Victims cough violently, sometimes coughing up blood, and have chest pain, fever, chills and weight loss. TB is spread through fluid by sneezing, coughing or talking.
According to World Health Organization guidelines, travelers only need to be notified if they are on a flight longer than eight hours with someone who has active TB.
TB is only contagious if the individual has active symptoms. Many people worldwide carry the bacteria in their bodies but are not contagious, a condition known as "latent" TB. Fenstersheib said the disease has a 10-week incubation period, so those infected won't know for sure until February or March if they have the disease.
Multidrug-resistant TB is a form of the bacteria that is no longer incapacitated by some antibiotics.
It can still be treated, however, Fenstersheib said.
"Treatment may take a lot longer, and the drugs may have some additional side effects," he said.
Someone who is otherwise healthy is likely to survive, he said.
The woman is being kept in a single-bed room and all health care workers are using protective equipment, county Public Health Department spokeswoman Joy Alexiou said. She cannot have any visitors.
Hebert said she is receiving treatment and will be kept in the hospital until it is safe to release her, which could take until mid-January.
Santa Clara County had two cases of multidrug-resistant TB within the last year, although neither person traveled abroad, Fenstersheib said.
If necessary, CDC spokeswoman Shelly Biaz said officials can place an infected person on a "do not-fly" list to prevent them from leaving the country.
She said cases of multidrug-resistant TB rates are holding steady at 1 percent of the approximately 14,000 annual cases in the U.S.
An even deadlier form the disease, extremely drug resistant TB, has emerged also, she said.
The woman had been diagnosed with the disease before returning to the United States and was taking drugs for it, Fenstersheib has said.
If someone develops active TB abroad, they should seek local medical attention, although no laws prevent them from flying home, he said.
"We really don't want people traveling with infectious TB," Fenstersheib said.