Transmission of Multidrug-Resistant Mycobacterium tuberculosis during a Long Airplane Flight

A 1993 investigation of a flight attendant with infectious tuberculosis demonstrated transmission of the disease to other crew members, but evidence of transmission to passengers was inconclusive.1 In June 1994, a state health department notified the Centers for Disease Control and Prevention (CDC) that a visitor from a foreign country had died of complications of pulmonary tuberculosis; her Mycobacterium tuberculosis isolate was resistant to isoniazid, rifampin, pyrazinamide, streptomycin, and kanamycin. Before the tuberculosis was diagnosed in May 1994, she flew from Honolulu to Chicago and from Chicago to Baltimore in April 1994 and returned one month later. Because of the . . .