I couldn't agree more with your thoughts and here are a few more. I firmly believe the man should not have been allowed to board a plane period. I believe when there is a potential life threatening situation it should be posted on a website the FAA can monitor. As this could have been a potentially deadly situation that could have brought and may still sanctions from other countries on us as well for the patients's disrespect for other's well being. Here's a question going further, can co-travelers sue the carrier for harm if they do contract the illness? I think there should be accountability when you knowingly expose others to this level of disease. But in the end, I hope he recovers and no one else is affected.

On the TB story, that should just prove to you the power of the press. The press has the capability to report to people on a wide scale. So please use your power wisely. Don't put a panic into the general public if it is not necessary. Although I'm extremely big fan of yours Dr. Gupta and basically a fan of CNN in general, I still sometimes wonder where you get your stories and what makes the news REAL NEWS. Sometimes I just think that other stories that don't make it into the news are just so much more important that what is getting reported.

But in all, I thank you for all the hard work you do, when I grow up I want to be just like ya. (kidding, maybe someone similar to you). You're an excellent role model Dr. Gupta.

PS: I love the stories that CNN has been doing on the wounded soldiers. Keep up the good work. Don't let out government forget what our soldiers have been though.

Ann Stewart, Nashville, TN

I was suprised that this patient originated from a metropolitan area such as Atlanta. Were there restrictions put in place for travel within his surroundings? I was also suprised to see CNN post with the article the picture of what looks like an African man? Is this the media bias we have been talking about. From the look of the background graphics I assumed that this person was from Africa even without reading the story. From what I read from the article it seemed that the man is caucasian.
With a name like CNN I must say I was a little disappointed that the editor's choice of picture

http://us.cnn.com/HEALTH/

I'm a doctor myself and find the whole thing very concerning. It's scary either way you look. I find it as plausible that failings in communication led to this man truly being ignorant to his condition as much as it being plausible he ignored his doctor's request and took the flight anyway. We may never know, because now that this has happened everyone is trying to cover themselves. It's important for patients to listen to their doctors, but no more so than it is for doctors to "tell it like it is". I think we can have a tendency to sugarcoat bad news to make it easier on us to divulge it. I hope that's not what happened here.

I agree with your article completely. I would like to believe most Americans would not put tens if not hundreds of lives at risk in order to improve their own chance of survival. His actions were selfish and negligent. I don't believe he has actually committed a crime, but his actions were certainly untrustworthy and somewhat immoral. I hope he is ashamed of himself.

I read yesterday about a man in Arizona who has been in hospital-jail for not wearing a mask when he went outside. Why aren't charges being pressed against this man? He willfully and wontonly exposed people on multiple continents after being told not to travel. He admitted purposely evading authorities by changing his travel mode and returning to the US through Canada. And he wants people to know that he is intelligent and successful. He is arrogant and obnoxious. I would sue him so fast if I were infected.

I think this man was incredibly selfish. He may not have known how dangerous a strain of TB he had, but he knew he had TB of some sort. What about other passengers with suppressed immune systems such as people with cancer, elderly, etc. He could have killed them with any type of TB. He obviously was only thinking about himself. Why couldn't he postpone his plans until he was deemed not contagious? He should not need the CDC to tell him not to fly. Common sense should have told him that. Another symptom of today's society--the world revolves around me!

I think people should also be aware that illegal immigrants sneaking in across the Mexican border have also been found to have TB. The cases in the US have actually been rising.

The man in question did tell the medical personnel that he would wear a mask when traveling. I guess he forgot? lied? I think he was also incredibly selfish to put others at risk. He was on several flights during his time out of the USA and there are quite a lot of people on those flights. They may have not heard of this situation yet and spreading to many others. I think the medical personnel should have immediately told their concerns to the authorities when the person told of his plans to travel even when they advised him not to. He KNEW he shouldn't have travelled that is why he snuck back into the states thru Canada. So much for secure borders. But that's another story....

I am surprised more people aren't appalled at this man, based on his decision to expose hundreds (if not thousands; I believe he was on 5 additional flights within Europe) of others to this particularly virulent form of TB. All important lessons aside, I think that at the very least, this man should be subject to public humiliation; CNN...release his name! Someone who knowingly and willingly put so many others at unnecessary risk shouldn't be allowed to cower behind a veil of privacy.

More than anything this episode demonstrates:

1. How little systems have changed since 9/11. What became of the plans to create a database available to all government agencies? Was that all just talk to ease the public mind? Did we not have the funding - again - to protect ourselves and our society because we're building bridges in Iraq?

Had there been a central location to enter this information it might have been available to the airlines when the man reserved his seat.

2. The lack of WILLINGNESS of civil servants to protect us. Even though his physician is not a government employee, medical personnel are considered among the "front line first responders" in emergencies. If there's a vaccine for anthrax or small pox or the terrible flu - that doctor is going to get it long before the average citizen even knows it is available. Whoever his physician is - bore a great responsiblity to the public at large. Everyone is so afraid of litigation that they're not saying anything. I will NEVER believe that the physicians who diagnosed this didn't know immediately how dangerous it was. Knowing the danger, I'm sure they notified the CDC and if not - their local county health dept. Yet no one was willing to order this patient into quarantine to protect society.

Is it because he is a man? The government has a history of imprisoning women with contagious diseases. Why isn't that applied equally?

3. How totally open to just this kind of medical crisis we are. We hold ourselves to be a mighty world power yet we don't have national health care? Meanwhile, Europeans have developed modern health care systems that aren't broken and underfunded. The nordic countries have the best Mental Health care system on the plant. They have all sat back and allowed us to waste our money on foreign aid - feeding people who hate us. We've spent billions on foreign aid what good could those dollars have done here? There are people in rural states who don't have floridated water. There are children in inner cities who don't have dental care. There are millions of working poor who can not afford to vaccinate their babies.

I don't think people appreciate the real cost to the public of this behavior. We live in a medium sized town in NH. My daughter has been exposed to TB somewhere, most likely at school. No one else in the family has been exposed. She tested positive at the age of 16 during a pre-employment screening. She had to go through 9 months of antibiotic treatment in the hope that when she is an older person or if she becomes immuno-suppressed for some other reason, the disease will not flare up. For the rest of her life, she will always test positive and will always have to explain her condition. In discussing this with her doctors during her treatment, they said that this was not at all uncommon, and yet we persist in believing that TB is not a public health threat.

Unlike yourself, health people do not seem to talk to each other. For instance, when I gave birth to my son, I had a concern that there was a slight chance that he had G6PD. I had to stand on my head to get him tested while I was in my hospital bed. The nurses had never heard of G6PD and had a lot of confusion passing the requests to the doctor. Even before delivery, I had asked the doctor to request the test but it kept falling by the way side. Instead, I got multiple inquiries as to whether or not I wanted to circumcise my child. I had to keep saying no. I felt like I had just ordered off the menu at a McDonalds'.

As far as the nurses, they gave pretty good care, but they don't seem to agree with each other on breastfeeding techniques and such.

Thanks for bringing this issue to light. If we can't even take care of the day to day, mundane things like postnatal care, how can we deal with a disaster. For all the money that we pay into insurance, our nation should be flooded with quality health care people. And I have heard that we do have that. I just wish that there are more distinctive guidelines on communicable diseases and every healthworker should go through training on bioterror prep.

That person need to be in jail. His acted was criminal, he knew he could spread his sickness to others
could be million, and he intended to do that. He has an illness mind, and he should not be free to go around in this society.
Justice should do something to
prove our system to protect innocent and prevent such thing in the future.

Of course we are NOT ready...this is an unfortunate event that exposes the terrifying truth that when a bioligical terrorist attack happens we are not only NOT prepared but horribly ill equipped to handle it...don't think for a moment that the terrorist "sleepers" in this country are ignorant to this disgraceful flaw! I so hope that the government agencies that are suppose to be protecting us are paying attention!!!!!!

I think that more than selfish this man is very irresponsible. He could have infected many people for he doesn't know/understand the power of bacteria.
The airline is not to be held accountable for any possible outcome, but this man should be.

I think this man's actions are beyond selfish and reprehensible.
Did he not think of people with weakened immune systems, children, etc. Worse, why was he not stopped? I agree with all of the above posters that he flat out should not have been allowed to travel until his infection was cured.
Further, he called him self 'an intelligent, educated man' and was outraged that there was an armed guard posted outside of his room. Most importantly, have we learned nothing from 9/11? As a New Yorker, this confirms to me the fact that so much of what the government does to protect us is mostly for show. Clearly, we are not prepared for any sort of biological attack; especially outside of the New York City area.

I agree. I personally am extremely angry that this man could be so selfish. The chances of infecting other people may be extremely small, but they are still there. If he did infect anyone else, they could die. I think his selfishness in this matter is incredulous.

I think this man is selfish and he should be charged for endangering the life of others. His behaviour seems typical of the selfishness pervasive in North American society. Very sad indeed.

He acted selfishly and put many people at unnecessary risk. Based on previous articles regarding this subject, it appeared as if he knew what he was doing (i.e. ignoring doctor's warnings, slipping back into the US via the Canadian border) This was clearly not a case of ignorance.

I wouldn't be surprised if there was a lawsuit (class-action if that is possible) as a result of his actions.

I am surprise to hear from reporters that the patience called himself 'educated'. For his own pleasure, he traveled not only on one but several planes and countries, spreading this deadly decease across the Atlantic and North America. God knows how many people were infected because of his selfish and irresponsible act.

Centers for Disease Control and hospitals should have done something to alert the airlines. The patience has the right to travel, but airlines have the right to denial his boarding.

Back in 2003, a professor carrying 'severe acute respiratory syndrome' from China visited Hong Kong, resulted over 290 deaths when the disease was finally under controlled. Likewise, the professor knew he was sick before traveling. Sounds familiar, isn't it? This is just an example how pandemic started.

If you happened to sit next or behind the patience during those flights, this is not the time to get frustrated. Do the right thing for your family and visit the nearest hospital.

If I had kids on that flight and they got sick I would sue this moron into oblivion. People pay attention only when it costs them money.

It is amazing to me that when there are news discussions regarding illegal aliens, there is no discussion of the number of communicable diseases that have been brought by them into the United States. HIV, Hepatitis and TB have greatly increased in this country due to this problem. It is so naive for a border agent to say a person doesn't look sick. If the news media wanted to do an eduacational service to this country, it might offer indepth coverage of current communicable disease status in the United States, modes of entry, quarentine policy and modes of treatment, instead of the heartstring stories regarding immigration.

Regardless of what this man was told or not told to do pertaining to travel, this much is certain: the man's wantonly selfish behavior reinforces some of the negative stereotypes many foreigners already have about Americans. Beyond the reports about how freely he could travel, as well as the safety of other passesngers on the flights in question, this is certainly not the type of international publicity US. citizens need right now. In my view, he did all of us a profound disservice.

Why are we always so quick to put the blame on someone else? Certainly everyone flying knows they are breathing the germs from others. This is not fresh air we are breathing in plane's cabin. I have respiratory problems and I wear a mask. Step up to the plate people and protect yourself. I do.

I agree that the actions of this man were wrongful but question whether his intent was because of not knowing any better or malicious. What is confusing is the varied news reports that his strain of TB is not very contagious - some saying even if he breathed right on you it would be near impossible to catch it. What if you had an immune system disorder? I worked in a hospital microbiology lab and this is totally against what they taught us when handling specimens for TB testing. Treat everything like it could infect you and in case of spillage (in a special pressure room with bio-hoods with gowns and masks on) HOLD your breath and leave!

Now that I work at a state college, I was amazed that upon employment I was NEVER asked about my TB status or any other vaccination history. Just think about all the staff that could spread a disease to the student body and community and beyond on a large campus!

I hope this story makes the US re-examine its views on public health and makes everyone think about just how ready are we in the case of an outbreak.

- A NY resident

this incident remimds of the famous President Kennedy's quote -- "ask what you can do for the govt and not what the govt can do for you". Probably the person who had TB -XDR should not have travelled in the aircraft as still there is a remote chance for infecting fellow passengers. But then the CDC has utterly failed as its official already knew that the person had a bad disease and should have been advised not to fly and should have been marked on no-fly list. If needed the person should have been quarantined without endangering the life of others. In case of major epidemic or bio-terrorism the individual will have to play a responsible role in not spreading the disease and govt should be ready to take quick, apprpropritate action, and sometimes drastic measure for example, quarrantine of a huge group of infected or likely infected people, to prevent further spread of the disease.

This guy was told what he had and not to travel; he did. They tracked him down in Italy and they told him NOT to take a flight back, he sneaked back in the US via Canada. What a great act of selfishness to expose all the people in two transcontinental flights, and everyone else he came in contact with including his wedding party!! What a guy!!! I understand that the incubation period for this type of TB is lengthy so even people he had contact with in the last few weeeks could test positive. A real American hero!!

Incredible in this day and age with the levels of surveillance available that something of this magnitude could occur. Which leads me to believe, in general, we here in the US are under a cloque of false security if we truely believe that we will be protected in scenarios equivalent to a bioterrorism act on our homeland. Wake up and smell the coffee!

Forget just suing this idiot; throw his ass in jail and let him rot there for a while. Maybe send him to Gitmo, or back to Haiti so he can take up space in one of their jails instead of ours? And do we know for sure this guy didn't do this intentionally--trying to make people sick--as the biologic equivalent of a suicide bomber?

Joe
Charlotte, NC

He snuck into the USA via the Canadian border? This is laughable, considering he is a US citizen and his travels originated in the USA. He should not have been allowed to leave the US to begin with.

The US continualy blames Mexico or Canada for illegal immigrants or other so called undesirables that enter their country when it is their own customs agents that allow these people in. Perhaps the custom agents in Canada and Mexico should become more selective in who they allow into their countries.

Folks! WAKE UP! The CDC is TOO CAUTIOUS to a fault. Rather than take a stand they chose a course of action that not only would have infected everyone on those planes but also the rest of the people he came in contact with All over Europe, Canada AND the United States! Politics is a mind numbing game and it infects every walk of life we have including the state of our health (or not). When this came up they should have taken his passport away and stopped him from any kind of travel. Do I feel safe? NO!

I was recently exposed to the measles in Albuquerque at an international science fair. There were over 1500 hundred students there, plus chaperones, judges, hotel and convention center workers, caterers, airline passengers, etc., etc. The person who was sick with the measles was a student from India, also the nationality of the person who caused the last measles outbreak in the U.S. in 2006. I found out the student was sick when she came to the U.S. and was sick the whole time she was here. All in all, there were several thousand people exposed to this disease. Why aren't there standards for vaccinations for people coming to the U.S. from these third-world nations? Why was this student allowed to come here when she was sick? It's ironic that this TB scare comes a two weeks after all of this. Maybe it's time the U.S. got a little tougher screening, quarantining or keeping people out altogether who carry these infectious diseases?

Although the infected man did not maliciously try to harm other passengers, he did, according to the medical community, pose a harmful threat to other people. Even after been having tracked down on his honeymoon in Europe by health officials, who warned him not to travel, he did so anyway. Thus, I find it very ironic that this man is a personal injury attorney in Atlanta.

I am appauled that CNN aired the persons' name who carried the TB infection. That person has a right to privacy. HIPPA was violated! If it is going to be "public news" about someone's Health why don't we start posting faces and names of people infected with HIV and Hep B. These are diseases that are killing thousands of people everyday. Many of these people ARE aware they are infected and continue being intimate with people who are unaware. Come on, it was unethical to post his picture and name. I am so disappointed with CNN.

The problem in this particular case is not the failed response of public health officials, nor is it a case of being ill-prepared. The problem was quite simply the patient's noncompliance. While this man was most likely a latent carrier of TB infection, public health officials reacted quickly and decisively to try and stop this man from spreading the disease.

Generally, XDR-TB is by and large the result of patient noncompliance. This deadly form of resistant TB is mostly the result of patients not completing their entire TB treatment regiment therefore allowing the bacteria to gain immunity. This is especially true in areas outside of the US with poor health infrastructure where XDR-TB is highly endemic.

The reason this particular instance has gained such attention in the media is that it involves an educated US citizen who was ultimately apprehended because he knowingly avoided treatment. This “hospital arrest” by CDC officials has raised the more important question of where privacy laws end regarding individuals who are the carriers of specific deadly diseases.

I was surprised to hear criminal defense attorneys and prosecutors state that the behavior of this XDR TB patient could most likely not be prosecuted. Passengers may not board planes with knives, but if they knowingly board a plane with a potentially fatal disease that is airborn transmissible there is no crime?

What does this say about our society? We suspend a kid from school for a month because she brings aspirin to school to alleviate menstrual cramps, and do nothing to a putz who knowingly endangers thousands of lives during a selfish, me-first honeymoon tour of the planet. I say pitch his butt in jail for endangering the public health. Once his TB is dealt with, of course. Intelligent and educated, my eye.

XDR TB exists in many (most?) parts of the world and the US is visited by thousands of people from these areas every year. In this day and age of easy travel, long distance flights (I think newer planes do have HEPA filters to trap some organisms) and far greater interaction between people from far corners of the world -how does one monitor them all for XDR TB and potentially other dangerous conditions that are communicable where the patient may not be obviously sick. During the SARS epidemic body temperature monitoring was used at some airports in SE Asia and Canada - but that was a disease where there is a measurable red flag. The US has far more advanced systems to monitor these diseases that are realtively rare in this country - in some other countries there is no monitoring at all and carriers of such diseases may freely travel wthin and outside the countries.

this is an example of our lack of infrastructure due to misguided priorities and perspectives, our republican politicians are so busy pandering to radical religous zealots and our democrats boud by it that %20 of our population are skewing the business of the nation, educated people are screaming about the impending dangers we NEED to face up to such as the growing drug resistance of of many viruses and such that plague us not just TB, our government is so busy discussing alternate sexuality, serving corporate interests that foot thier reelection bills, flag burning and other such silliness and in general doing anything that feed thier personal ego's and cofers such as this rediculous "war on terror" and equally poorly thought out and implemented "war on drugs" that they simply are not doing the business of the american people which would be to DIRECTLY improve the quality of our lives and what would more directly effect us than to make our health a SERIOUS priority, throw out the ideology and get to work on what we have been warned for something like 30 years is a pending crisis, a real understandable demonstratable immediate crisis, the "bushies" are so good at scaring people about abstracts that are %90 BS it is amazing to me that we have educated scientists and doctors warning about these super bugs and we're complacent as a country, it is a shame that it really looks like our country is heading downhill and the only thing that may bring us out is if some health crisis or such DID happen and we would see our priorities as they should be and stop voting for such egocentric dullards with an ideological bias AGAINST governing and instead get some folks who genuinely have the ability to do the job who will WORK for US

Dear MKB:

Please, if you are going to quote someone, get the wording right. President Kennedy said, "Ask not what your COUNTRY can do for you. Ask what you can do for your COUNTRY." He did not use the word "government." But perhaps you think country and government are the same thing?

This selfish man knowingly exposed hundreds of people to TB. He should be criminally prosecuted and imprisoned for engangering the lives of others. He obviously has no regard for anyone other than himself and a man like this should not be out in society where he can harm others. How can someone be so self-centered and selfish? He represents the worst elements of our society. I hope he is locked away for a very long time.

Dr. Gupta,

I thank you for your honest reports. It has truly shown the world how another epidemic can start, and this, relatively easily.

This man, a lawyer, 31 yrs old, who considered himself intelligent, knowingly, traveled, the US, Canada, Europe. 7 flights I believe! All those people potentially exposed, and also the airports themselves, (where there are a lot more people.

From various movies, and books, where we read about these type of virus's, and how they can spread, one can now readily see, how this selfish, and unconcerned man, basically was ready to take the world down with his disease!

Let us hope, and pray, and send everyone concerned the message, that we hope that he indeed has not started a world wide epidemic.

But it is very apparent, that the US, Canada, and Europe, do not have their acts together,either in communication, law-enforcement, and media,and medical laws, which could enforce, and ensure prompt action inorder to respond quickly enough, in stopping, and apprehending such an individual, before he could inflict all this possible damage.

I believe international cooperation, and perhaps, signed treaties should be done, in order to protect the world from these selfish and "failures" as human beings.

L.Conlin, Montreal, Quebec, Canada

Thousands of people enter this country everyday carrying some or other virus or bacteria. The person with the TB is not the first or the last. We do not live in a sterile world. Get used to it. Take a chill pill and take a deep breath.

In this age of technology I am amazed on how people can be so uneducated. We are constantly exposed to health hazards. Ever ride public transportation? Guess what the person sitting next to you may be infected with TB, symptoms don't appear immediately. It is ashame that this has happened, but people want to just point a finger at someone and put the blame on someone, the patient, the physician, the government. Wake up, this is not a perfect world, humans make mistakes. If you think the world is almost perfect, you are living in a bubble. It should be obvious that we live in a society with warped values. We expect doctors and nurses to be infallible yet don't want to compensate them appropriately for the jobs they do. But yet, we don't put up a protest for stock brokers and politicians who get paid millions. We live in a materialistic, money hungry society people!

If I was faced with this, there is no way I would put anyone else at risk. If I was his wife to be, I would refuse to go along. So to me, she is just as responsible. While I feel bad for his situation, his selfish behavior and lack of concern for other peoples well being is just one more notch in the worlds negative view of Americans in general. He and his wife thought their wedding was more important that other peoples lives. Thats beautiful. Elitist #$^&*(!

The man attended the US Naval Academy, U. of Georgia Law school, and worked at DA office. He certainly knew of both the ethics and his civil rights in this situation. I hope the bar association takes immediate action to discipline him.

Dr. Gupta, being a doctor, I assume more readers are going to listen to and read your comments about this TB situation. CNN initially stated that anyone 2 rows in front of or behind the infected person is at a potential risk of contracting the disease. Here you say, the risk is extremely minimal. I don't see why CNN wouldn't have you report on this issue from the getgo. The passengers do have a right to be scared. As a medical student, I, too, know the dangers of TB. Perhaps not nearly as much as you, however, I know that TB is one bad momma. So anyone would definitely be upset that this man boarded the same plane as him/her knowing he had TB, and a rare form at that. I do believe he should face legal action. Suppossedly he is a lawyer, which only fuels the flame behind the stigma of lawyers being selfish. This man knowingly endangered, though according to you only a small risk, the lives of everyone on board and in the airports and wherever else he traveled. I would have hoped that someone from the US traveling abroad would set an example for our country and do the right thing. Instead, he thought only about himself. And after all this, I have yet to hear an apology. Have you? Instead he said something to the effect of, "I didn't think it was that big of a deal." Please do what you do best about keeping the public informed on the necessary information regarding TB. Like another person commented, the media has the real power in today's society. Use it to better us, not scare or misconstrue information. As a med student, I hope to become as successful as you and perhaps even more. Good job on your reports.

What an incredibly selfish man, I am stunned by his utter lack of concern for the well-being of other people. What if he had been sitting next to small children, the elderly, or people with compromised immune systems, who are at greater risk of this potentially fatal disease? This man should be ashamed of himself. It's frightening to know that arrogant people like that put the rest of us at risk.

Please address the following in your upcoming reports:

1) Where, How, When did Andrew Speaker get exposed and become infected? Is there another individual(s) in the Atlanta area already causing more to be at risk? Is USPHS tracking down the root of this infection?

2) Under what law can the U.S. Govt. hold someone under quarantine without violation of their constitutional protections?

He's a lawyer..'nough said..

If this is any indication of how safe our borders are...The guy flew to Canada & the n came back although there were suppossed alerts to stop him! Terrorists could bring in dreaded diseases through any point here & who would know or care??? We are so lax at taking care of ourseves, perhaps we deserve wretched things to hap-
pen.If you don't watch out for yourself, no on else will!

This situation is not analogous to smallpox. Patients who are infectious with smallpxo are obviously very sick, even if they do not yet have the characteristic rash. This patient showed no signed of illness. The only one who could have screened him out of the airplane would have been the patietn himself, whereas even untrained individual could see that a patient with smallpox was toxic and fgeverish

As many have said before me, this man was acting selfishly and may have endangered the lives of many, possibly (although unlikely) causing an epidemic. People who knowingly expose others to HIV are punished by the law. If this man survives, he to should face consiquences for his self centered actions.

After much thought I can only say, the Dr. should have reported the pompous lawyer to the CDC and the man his a 'horses patut' for knowingly and willingly spreading his infection throughout the world, so he could have the wedding of his bride's dreams, let alone his own neighborhood store. If someone sues the airline, the airline should sue him. How horribly selfish of both of them. They owe the universe an apology.My heavens!
Nobody will get anything unless they get TB, this should not happen ever again.L-Bedford,TX

My comment is more of a question: Where did this young man get exposed to the infection, or did he just manufacture this infection??

I don't understand why even simple precautions were not taken. The most reliable protection against the spread of tuberculosis (which is airborne by droplets) is the use of a face mask by all contagious (or even potentially contagious) persons. This is standard procedure in medical clinics and hospitals. If it was clear that he had tuberculosis, no matter what type, he should certainly have used a face mask to protect all others with which he might come in contact. Obviously, the population of people he exposed is much greater than those solely within a few rows of his seat on the plane. He also exposed people in the airport, all of the airline staff he spoke to, as well as others on the flight which were not in his immediate proximity (due to the air circulation and passenger movement in the plane). It seems that there were several infectious disease protocols which were not followed at all. Of course, the biggest risk will be to young children, the elderly, and persons who may have weakened immune systems. Certainly, this man's thoughtless exposure of others to his tuberculosis may have much greater consequences than he considered.

Having worked in Public Health as an investigator, the release of this patient's name is SHOCKING to me. How will a trained investigator obtain the necessary cooperation of an infected individual when the potential is there for this patient's confidential information being leaked or disclosed to the public? SHAME on everyone who is reporting this patient's information!

This case has exposed the clear problems with public health preparedness and the public's seemingly uninformed preception of what public health does.

In relation to public health surveillance, this was my specialty and it is only as good as they systems in place. NO surveillance system is perfect because they all lack a reporting enforcement component. I can count on my hand the number of times a doctor, who was required by law to report certain diseases, actually took the time make the required report.

Gotta love how everyone screams that he was "selfish" like being selfish is a bad thing. Being selfish is nothing more than doing what you think is right for you. What's wrong with that? It isn't "the world revolves around me," it's acting in your own best interest.

I will agree with "irresponsible." He should have taken his doctor's advice. But he did nothing criminal. He's a criminal on what charge? Because you decided that he should be? It is ironic that the people who scream "lock him up" are the same people who complain about the erosion of freedoms and liberties in this country.

If this had been a pregnant woman who was planning to do something that would endanger her unborn child, you can bet that health officials wouldn't have just said, "Oh, well. We have no legal authority." This selfish man should not have been allowed to travel. And yes he is selfish. While I understand that he wanted to enjoy the wedding he had been planning, there's no excuse for endangering other people's lives. The only person he was thinking about was himself. His wife should be ashamed of herself as well for not insisting that they 1. Put off the trip and 2. once they found out he had a rare form of the disease, not having the good sense to say were going to stay put. Italy is not a third world country and he could have got medical care that was just as good if not better than what he's going to get here. He should face criminal charges.

This is absolutely ridiculous. This "intelligent, educated" man should be sued for everything he has, but, even more appropriately, placed in jail. He deliberately endangered the lives of countless others, which is inexcusable, even if it was his wedding. I am appalled that they let him sneak back into the country, despite an alert. If he hadn't been a young, probably well-dressed, white male, the authorities likely would have carted him off to a Canada hospital faster than you can blink. How lovely this country is.

Here's what I don't understand: this man KNEW he had a form of super-resistant TB, was told NOT to travel, and did so anyway? Potentially risking the lives of many, many people...including his wife? What type of dunce IS this guy?

This man should be put in JAIL. He knowingly and selfishly exposed others do a deadly disease. He acted in a CRIMINAL manner, in addition to irresponsible. One does not exclude the other. He is not an uneducated immigrant who does not understand the consequences of his actions! PUT HIM IN JAIL!

I find it very ironic that this many is a lawyer, and wonder if he will represent himself in the class action suit when folks start to sue the pant off of him.

This man has a complete and utter disregard for others. He clearly acted selfishly and with great premeditated deceit, especially in returning to this country.
He owes everyone more than an apology. He should be responsible for paying for everyone's tests, and anyone that becomes ill because of him should be allowed to sue him to the full extent of the law! What he does to himself and his new bride is their business, but he has no right to irresponsibly infect and potentially ruin other's lives. Shame on him. Take away his lisence to practice law, and have him serve community service on the highways.

"Are we ready?"

With NIH funding to medical research being drastically cut every year (I work in cancer research at a major academic institution) because of the obscene cost of our activities in Iraq, should it come as any surprise that we seem uninformed and unprepared for a potential health crisis? Labs are closing, researchers working on our most pressing health concerns are being forced to scrap their work.

Taxpayer money is funding a war in the middle east instead of improving public health and the health of future generations at home.

I,too, looked at the science but didn't get the assurances that Dr. Gupta conveys in his blog. First, I have no idea of what he means by incredibly small liklihood of infection. Does he just mean probability? If so, I think he missed the most relevant issue. What is most important to me is the risk and I would guess for most people. Risk is a two dimensional varible...product of frequency(probability) times consequence. As noted by an earlier responder, the consequence for those with impaired immune systems is grave. As a cancer surviver, I wouldn't view my risk as incredibly small no matter what the probability, especially when that probability is not well defined. It varies widely from person to person and situation to situation. Like the doctor responder, I wonder if sugarcoating is a factor here.

His name is Andrew Speaker. That's why he is not arrested and in jail. If his name were Abdul Mohammed Hassan, the story will be much more explosive and he would be in jail. I bet my farm on it.

If a highly educated young lawyer whose own father-in-law works on TB research for the CDC ignores common decency and travels on 7 flightrs putting so many people at risk, what does that say about the rest of us who don't know much about TB at all?

It seems to me this man was extremely selfish in his decision making process. I believe he should be made financially responsible for all the problems he has caused.

I would not want him representing me in any legal proceedings--I would be concerned about his common sense and lack of good judgement.

I wonder how many people who do not have medical insurance, do not get tested for TB or other infectious diseases, and are roaming around in society unknowingly infecting other people!

I wonder where he contracted TB. Did it have anything to do with his father-in-law's job?

People in this young man's position don't just turn up with a highly infectious case of TB out of the blue.

I do not feel particularly sorry for this man because of his actions, but in the long run, it is a shame that somebody so young (and with apparent bad judgement) has such a problematic disease.

I'm with the majority of people who've been posting that this piece of crud needs to be punished, but I think that suing him isn't enough. He's essentially knowingly carrying a biological weapon, and spreading it around the air travel system.

Sounds like a terrorist if you ask me - maybe the better term is fullofhimselfist, but you get the point.

So, what do we do with people who use bio weapons on civilians? Lock them up. This guy should be shipped of the Guantanamo post haste, no trial, no jury, just lock him up. See if he can buy his way out of that one...

I also echo the comments here. This was an incredibly selfish, deliberate and irresponsible act by this individual. The fact that he describes himself the way he did in his interview only reinforces my opinion of him. Common sense would tell most of us not to fly if we found out we had a communicable, airborne, and deadly disease. But even more, morality and a sense of decency would dictate that once we're told we have a DEADLY, drug-resistant strain of that disease, we'd follow the directions of the people who know better. He didn't want to be isolated in Italy? Boo-hoo. The CDC was working on flying him back home, all he had to do was wait. Instead he took off, fled to another country and changed his itinerary.

He deliberately evaded a no-fly order, endangered countless people, and has the nerve to be indignent about the whole thing. Why are there armed guards outside your door? Because you've already demonstrated that you have no regard for others and will do what suits you at the moment. And his fiance/wife is just as culpable. There's no way I'd be party to this nonsense if I were her. If he doesn't take it seriously, then the other half of the relationship should excercise some common sense. If TB doesn't kill him first, charges should be filed and they should both be prosecuted under every statute that applies.

In the past I worked as a laboratory technologist and have performed microbiological analysis of sputum specimens for TB at a major medical center. I am now an environmental engineer and not an lab tech any longer. I find it exceedingly interesting that his new father-in-law works at the Centers for Disease Control. His father-in-law, Robert C. Cooksey, is a microbiologist who has conducted research on tuberculosis for CDC. The likelihood of this just being a coincidence is extremely small. I bet that the father in-law somehow is the source for the infection. He probably he brought the contamination home via a soiled lab coat, etc. and exposed his son-in-law.

This raises a collateral issue, how did Andrew Speaker contract this strain of TB?

Here in Phoenix, the same thing has happened. An ill man with drug resisant TB did not follow Dr's orders and he is now jailed. Put that on the news.

Dr. Gupta, I really wish you would address situations like this from a medical point of view, and not from a general reporter's view... asking "Are we ready?" for a bio-terror attack. This situation is being viewed from a purely medical standpoint - i.e., are people at risk for contracting this disease based on their exposure. You barely even scratched the surface of that question.
You are a real doctor ... right?

This man was extremely irresponsible. While it's true-anyone can be exposed to diseases on public transportation, most people who are sick don't realize it. This man knew he had TB. Even without knowing the extent of it he showed an appalling lack of concern for his fellow passengers when he chose to fly several times. He knew he was ill-he did not know if the people surrounding him are particularly suscepible to disease. Members of my own family are cancer survivors and at a higher risk of contracting diseases. If I found out that he was sitting near them, I would be extremely upset. There is no cause to be so selfish! I believe he should be prosecuted and if, God forbid, someone else does get sick with TB, I think he should be held accountable.

There is no question that this man knew the risk he posed to others. This is evident from the fact that he re-entered the US from Canada - not aboard the June 5th flight he was originally scheduled to return on. This just proves what an incredibly callous and selfish individual he is. Even if he thought there was only a small chance that he may put others at risk its still inexcusable to put himself in a situation where others could contract this virus. It is unconscionable to board a plane with severely restricted air flow and not even think about those sitting around you. Could he live with himself if a 3 year old child or someone's grandmother was sitting next to him and contracted the disease and died. What if it had been the other way around?

This attorney should be stripped of his right to practice law. His willful actions defy the concept of ethical behavior. Given the premise that he understood he was carrying a transmittable airborne disease onto the confines of an airplane, he chose to put his personal travel plans above the health and welfare of his fellow passengers.

I hope that he also bears some fiscal accountability for the costs the government and affected parties are enduring, both compensatory and punitive. (As an attorney, I am sure he would understand!)

From a prevention standpoint, there needs to be some information systems and business processes developed with tie the intelligence available on such medically ineligible travelers and the travel infrastructure within the U.S.

Another demonstration of Canada's inability to effectively control her boarders. The USA properly alerted her boarders as regards to his travel. Canada once again falls short, letting anyone and everyone in as long as they are alive.

He is a personal injury attorney. Nothing further needs to be said about his character or moral values.

This man is a grossly selfish individual.

i think this tends to point out the typical alpha male stereotype too. my grandpa was sick for a long time but didn't think it was a big deal and then died from stomach cancer because he didn't go to the hospital fast enough. men seem to think that they are stronger than any illness and don't assume that they should seek help or that they could be contagious. this guy was extremely selfish and stupid for not getting educated about the symptoms and risks of both having and spreading this nasty TB. i think this should be a sign to everyone out there that it's OK to seek help and you don't have to pretend to be "macho" or "strong" because it's actually more important to get yourself checked out and healed for the benefit of you and others. and i actually think he should face consequences from this. it seems unlawful.

Educated as a lawyer, this man clearly has no emotional intelligence. Everyone that has not had to go through TB tests, missing work, be in hospital, or even if anyone gets sick or dies, there should be a class action suit against this selfish idiot. His wife should divorce him. Does not his father-in-law have some sort of ethical responsibility in advising him not to travel?

I agree that this person acted with ultimate selfishness. But it seems to me that something vital is being overlooked here. Has anyone asked how, when and where HE contracted the TB? It would seem that many more people than just this guys co-travellers are potentially being exposed if the source has not been identified.

How utterly selfish was this man who so callously put many at risk and created what is now a panic --
just because he wanted to go overseas and get married and have a honeymoon? He should face criminal charges at the very least.

Before his identity was revealed my friends and I were talking that this guy must be white, wealthy, and well connected guy.
Imagine if this was a poor minority sneaking back to the country. . .
He is so arrogant and he definitely should be punished along with his wife.

I'm afraid, most of you are being way too nice. This guy deliberately endangered hundereds of people. He should spend some time in the slammer for total disregard for his fellow man. I'm stunned at his stupidity...but he is a lawyer, isn't he. If I was on that flight, I'd want to smack him down!

The man's an attorney for christ's sake.. Need I say more?? Another example of someone who's got some intelligence, money or power, who thinks they're above the law, or can wiggle around it.

This whole story is a little strange in how it's being reported by the media, and even the extent of the reports. If TB, even this drug-resistant strain, seems to be fairly common throughout the world and there have even been recent cases in the U.S., why so much hype over this particular man?

Secondly, why is there so much focus on these people on the airplane? Aren't others he would have come in contact with anywhere be at risk? His wife - hardly anything is being mentioned about her. Secondly, if this man was just in a small bathroom or in close proximity to, say, a ticketing agent at the airport, or at a home with other people, what about them? Simply no mention by CNN or other news agencies of these issues. Very odd reporting decisions.

In one sense, this incident shows how far removed we are from the days when TB, and other diseases, were a much bigger problem, and when the need for aggressive public health initiatives was more obvious. Our success, unfortunately, has lulled us into a false sense of security. This should be a wake-up call not just for public health officials, but for physicians and other medical professionals in private practice.

As for Mr. Stewart, I supect he's going to find his skills as a lawyer tested mighty soon, having already flunked the test for common sense and decency. His wife behaved stupidly and selfishly, too.

I cannot believe this selfish man thumbed his nose at the warnings from his doctor, his father-in-law who happens to work for the CDC, and the CDC itself for the gravity of his illness and the strong likelyhood of infecting others. Based on his elusive behavior, he had zero intentions of following any orders and doing exactly what he pleased, regardless of whether he could harm others. I hope he is fined and jailed for his negligence. I certainly hope that he also does not cause a wider outbreak that could prove to be lethal.

This situation is so unfortunate. It shows you the mentality of someone who just cares about himself and his life. You wonder how he would feel if he or his family found themselves exposed unknowingly.

For those who just look at what you want, wake up and realize you live in a society with other people. Your actions have a bearing on others.

For those quick to criticize the government officials for what was done or not done, are you one of those who believe in cutting taxes, smaller government and less regulation? I do not enjoy paying taxes any more than the next person, but time after time whether it is the CDC, FDA, EPA or Homeland Security, people have huge expectations. Don't forget your expectations when officials talk about cutting taxes or shrinking the government.

The man should not have been allowed to travel until he was treated given that only 30% of cases are successfully treated.

While they were not able to prevent him from traveling from a criminal point of view, I have to believe there are some civil liabilities that he could have. At the very least, the other crew members should ban together to pursue repayment for ALL costs associated with medical treatment that they themselves needed to undergo (ie. TB testing, Physician costs, parking, childcare, lost work wages, etc). Not to mention any liability associated with pain and suffering. I* am not typically a litigious type of person but in this case, when someone knowingly travels with a contageous disease and expects the others to pick up the bill for testing, then I think they should be held accountable. Why should others have to foot the bill for one selfish and self centered person.

As far as the country's ability to prevent / control a great outbreak, the CDC is definitely lacking. It does not have the clout or authority and the political agenda is typically to hush it up so that there will not be a panick. So consequently, many unfortuante individuals would needlessly be infected before any real action would be taken.

I am unbelievably shocked that CNN would post the patient's name and photo on their website. Doing so is a clear violation of a patient's rights under HIPAA. It is illegal to disclose who has HIV, Hep C, and other chronic illnesses, so how is it possible that this patient's identity was revealed?

I agree with the general sentiment of the previous comments: this man was selfish and has placed innumerable individuals at risk for a potentially fatal disease. As a health care professional, I have a few other comments:

1.) Health care providers in the United States have essentially no legal ability to quarantine an individual. In fact, even government officials lack that power, or are wary of exercising what power they have due to substantial "gray area" in legislature. Due to the bloated ideal of autonomy shared by most Americans, legislature that extends the ability of professionals to act on behalf of the public good has been turned down time & time again. Physicians are constantly frustrated by the fact that legislature is made with individual rights in mind, often at the expense of the public good. The medical field is utterly unable to change unless the general public becomes educated about the situation and allows for changes in the current system.

2.) Infectious diseases are equal-opportunity. None of us, unless you are Native American, are actually "native" to the United States. We are a country of immigrants, and that is what makes our country so rich in culture. Please don't use this horrible situation as an excuse to point fingers to immigrants, minorities, or other underrepresented peoples. Case in point: this man was not an immigrant; in fact, he was an educated Caucasian man, probably of high socioeconomic status.

This is an incredibly unfortunate situation. The only good that can come of this is if we are able to learn & make lasting changes. Pointing fingers and making accusations only hurts us all.

There will be some law that this man will be prosecuted under, also his wife for her role. Think of the countless people who stood in a queue near him, entered a WC near him, walked by him as he coughed (if he did), the people who dont speak English and/or dont read the paper/listen to the news how will these people ever know that they should see a doctor? This idiot should be sent to Guantanamo with no trial, locked up on a cage and thrown leftovers. He has probably inflicted more harm to the USA and other countries than some of the accused terro