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January
- Testing: Patient's chest X-ray and CT scan are abnormal.
March 8
- Testing: Diagnostic bronchoscopy.
March 26
- Testing: Bronchoscopy specimen culture positive for Mycobacterium tuberculosis at hospital lab; patient notified of diagnosis by private medical doctor (PMD).
April 5
- Testing: Patient starts self-administered first-line 4-drug TB therapy.
April 10
- Testing: Repeat culture of specimen confirmed for Mycobacterium tuberculosis at hospital lab.
- Testing: Georgia Public Health Laboratory receives isolate for Mycobacterium tuberculosis susceptibility testing and reincubation.
April 25
- Testing: Patient reports to the Fulton County Health Department.
- Testing: Patient advises health department physician of overseas travel (not itinerary).
- Testing: Physician asks for expedited susceptibility testing of isolate culture.
April 26
- Testing: Georgia Public Health Laboratory finds sufficient growth to begin susceptibility testing.
April 27
- Testing: CDC receives patient sample for susceptibility testing.
April 30
- Testing: Georgia Public Health Laboratory preliminary susceptibility test indicates MDR TB.
May 10
- Testing: Georgia Public Health Laboratory susceptibility test indicating multidrug-resistant tuberculosis (MDR TB) reported to Fulton County Health Department.
- Testing: Private family meeting held at private doctor's office with Fulton County Health Department represented. Patient verbally advised not to travel.
- Testing: Fulton County Health Department begins review of legal remedies to restrict patient movement.
May 10-11
- Locate XDR/MDR TB Patient: Georgia Department of Public Health asks CDC for options that could be used to restrict travel in a person with untreated MDR TB. CDC responds with options.
May 11-13
- Locate XDR/MDR TB Patient: Fulton County Health Department attempts to hand deliver written advisory to patient. Patient cannot be located.
May 11
- Locate XDR/MDR TB Patient: Patient changes flight departure from May 14 to May 12 (unknown to health authorities).
May 12
- Locate XDR/MDR TB Patient: Patient departs U.S. on Air France #385 (unknown to health authorities).
May 18
- Locate XDR/MDR TB Patient: Georgia Department of Public Health notifies CDC that patient with MDR TB traveled internationally; CDC initiates effort to locate patient and travel itinerary. This is the initial step in CDC's contact tracing efforts.
May 18-25
- Locate XDR/MDR TB Patient: CDC contacts family, acquaintances to find patient.
May 22
- Testing: CDC lab's preliminary tests indicate extensively drug-resistant tuberculosis (XDR TB).
- Locate XDR/MDR TB Patient: Based on CDC request, U.S. Customs and Border Protection (CBP) flags patient for nationwide border lookout.
May 22-23
- Locate XDR/MDR TB Patient: CDC speaks to patient in Rome to discuss diagnosis and options for isolation and evaluation, safe return to U.S., and treatment.
May 23
- Locate XDR/MDR TB Patient: CDC contacts colleague working with Italian Ministry of Health (MOH) to discuss temporary isolation and treatment options for patient in Rome.
May 24
- Locate XDR/MDR TB Patient: CDC discusses transportation options on how to bring the patient back to the U.S. from Europe.
May 24
- Locate XDR/MDR TB Patient: Patient location unknown. Patient leaves Rome on newly booked flight to Montreal, Canada on Czech Air #104 (unknown to health authorities).
- Locate XDR/MDR TB Patient: CDC requests Transportation Security Administration (TSA) issue order to prevent patient from boarding U.S. bound flights.
May 24
- Investigate Spread of Infection: CDC notifies Italian Ministry of Health authorities and World Health Organization (WHO) in Geneva.
May 25
- Investigate Spread of Infection: U.S. Department of Health and Human Services (DHHS) provides formal International Health Regulation (IHR) notification.
- Locate XDR/MDR TB Patient: Customs and Border Protection (CBP) validates U.S. re-entry of patient in New York (NY) by automobile; notifies CDC.
- Locate XDR/MDR TB Patient: CDC contacts patient in New York.
- Isolate XDR/MDR TB Patient: Patient is isolated in New York City (NYC) hospital under provisional federal isolation order.
May 25-27
- Testing: CDCs requests patient evaluation and lab tests in New York City.
May 25 - ongoing
- Investigate Spread of Infection: CDC collaborates with international, federal, state, and local health authorities on airline passenger contact tracing. As of July 17, 99% of U.S. passengers contacted by CDC.
May 26-27
- Isolate XDR/MDR TB Patient: CDC team interviews patient in New York City.
May 26
- Investigate Spread of Infection: From interview, CDC obtains patient itinerary and requests passenger info for contact tracing.
- Isolate XDR/MDR TB Patient: CDC starts discussion on bringing the patient from NYC to Atlanta.
May 28
- Isolate XDR/MDR TB Patient: CDC flies patient to Atlanta; upon arrival, serves federal isolation order.
May 29 - ongoing
- Investigate Spread of Infection: CDC engages news media to notify passengers of possible exposure and direct them to CDC hotline.
- Investigate Spread of Infection: CDC contacts those self-identified passengers who call CDC hotline.
May 29-30
- Isolate XDR/MDR TB Patient: CDC discusses options for safe travel of patient to TB treatment facility in Denver.
May 31
- Isolate XDR/MDR TB Patient: CDC escorts patient to TB treatment facility in Denver by air ambulance under federal isolation order.
- Isolate XDR/MDR TB Patient: Denver County issues isolation order.
- Investigate Spread of Infection: CDC receives passenger contact info from multiple sources for contact tracing to facilitate testing.
June 2
- Isolate XDR/MDR TB Patient: CDC rescinds federal isolation order.
July 3
- Testing: Susceptibility testing of Mycobacterium tuberculosis organisms cultured from multiple induced sputum specimens from the patient is reported to be MDR TB.