Friday, June 01, 2007

The Tuberuclosis Traveler

I'm sure many of you have heard about Andrew Speaker, the Atlanta lawyer who is positive with a multi-drug resistant strain of tuberculosis and is currently quarantined after disobeying authorities and taking several international flights. As you some of you know, I am getting a Ph.D. in microbiology, specializing in bacterial pathogens. Although I do not work on Mycobacterium tuberculosis, it is one of my favorites. Okay, "favorites" isn't quite the right term....let's just say that it is an important organism that is a major cause of disease worldwide:
currently, 1/3 of the world's population is infected with tuberculosis, with the vast majority of cases occurring in poor countries.

I'm pretty surprised that this story has generated so much press, but there are several intriguing aspects to it. First off, he's the first person to be forcibly quarantined in over forty years.

The man told the Journal-Constitution he was in Rome during his honeymoon when the CDC told him to turn himself in to Italian authorities to be isolated and be treated. The CDC told him he couldn't fly aboard commercial airliners. "I thought to myself: You're nuts. I wasn't going to do that. They told me I had been put on the no-fly list and my passport was flagged," the man said. He told the paper he and his wife decided to sneak back into the U.S. via Canada. He said he voluntarily went to a New York hospital, then was flown by the CDC to Atlanta. "I'm a very well-educated, successful, intelligent person," he told the paper. "This is insane to me that I have an armed guard outside my door when I've cooperated with everything other than the whole solitary-confinement-in-Italy thing."

Um, hello moron, you didn't cooperate at all! You did exactly everything that the authorities told you NOT TO DO!

Secondly, how the hell did this guy get TB? It is extremely rare for a healthy American to contract tuberculosis, let alone one of the multiresistant strains. His father-in-law is a microbiologist at the CDC, who just so happens to study tuberculosis. Although it is an odd coincidence, I think it's highly unlikely he contracted it from his father-in-law's lab, and that possibility should be easy to rule out by genotyping the strain.

Oh yeah, and the border guard who let him back in the U.S. saw the warning and ignored it because he "seemed perfectly healthy."

Honestly, I think the incident has been blown out of proportion- the fellow passengers are at minimal risk from contracting TB. First of all, the reason why it's a problem in poor countries is that unhealthy, malnourished, and immunocompromised people are the type who are likely to contract TB. They are not, however, the type of people who can afford international flights. Secondly, it appears that Speaker does not have active disease- the kind that leads to coughing and bacteria-spewing. However, maybe this news story will make the first world more aware of tuberculosis and the public health problem it poses, ideally leading to increases in funding for research on treatment and prevention.


Courtney said...

I completely agree with you that this has been blown out of proportion by the press. While I worked at a hospital on the reservation, I took care of plenty of people who had contracted TB, one young healthy guy even had the multi-drug resistent kind. After talking to many nurses from around the country, I have found that TB is making a very scary comeback. Maybe has something to do with the cutting of funds for public health?

eileen said...

Court! This must be one of your first comments.

Hmmm...I have heard rumblings that it's on in the increase in the US, but still thought it was primarily among the immunocompromised. Guess it's starting to cross over, which is frightening. Well, maybe all the hullabaloo about this air traveler will throw some $$ towards TB.

tina said...

or worst, create a scare tactic, knee jerk reaction to this situation--I don't know, like banning liquids on board planes...

Braden said...

I think this is a huge porblem. I am very nervous.

Anonymous said...

i think biased comments should be avoided in these articles. i have tuberculosis now and in the past i have travelled abroad. So the idea fo only poor getting tb is absurd! a person with the disease needs to be respected and not laughed about like this..