Wednesday, May 30, 2007
TB mystery
The story of the patient with XDR-TB - an "extensively drug-resistant tuberculosis" that's rarely seen - is unfolding much like a mystery novel in reverse. It seems we have the end. Patient has XDR-TB and is under a federal quarantine order.

But who is he? Why does he have an armed guard outside is hospital room? Why did he leave in the first place, when health officials told him not to travel? (According to the Atlanta Journal Constitution, he left because he was getting married and health officials knew his plans to leave and could not forbid his leaving.)

Public health officials aren't releasing his name because it would violate his personal privacy and because he's complying now. Some may argue that the information should be released to notify people who may have come in contact with him. Public health officials tell us this is a dilemma they face all the time. And in this case - because he is not very contagious - the risk of infection for anyone who came in contact with him is very low.

So there are lots of questions that many reporters including ours are trying to answer.
Do you think he should have left the country even though health officials told him not to? When do you think public health overrides personal privacy issues?
Miriam-

I am a little bit confused by this story. If he is not very contagious... why is he under Federal Quarantine? I don't think I'm familiar with how it spreads, so maybe therein lies the issue.

I do not understand why the huge deal over releasing his name. Are they afraid of retaliation against his family members by people angry they'd been exposed? I don't think he should have left the country, no, and it seems to me that so many people are so self-absorbed that they cannot see beyond the "me me me" and think about other people.

However, there is a fine line between the Public Health sector ensuring the safety of the public and taking away someone else's right to live. Then again... by letting him out, he may actually be taking away someone ELSE'S right to live- by giving them this disease.

What a conundrum this is.
What a selfish, selfish man. Does the man have any concept that he may have put many innocent lives in danger? Please keep him in your country where he belongs.

Lisa N.
London, ontario, canada
Apart from the rest of the mystery surrounding this case, I keep wondering - what kind of a person goes to have a wedding and a honeymoon trip while being warned about his lethal disease. Not only is he is as selfish as to completely disregard the well being of other strangers on the plane but he goes on a honeymoon? Did he tell his fiance / wife about his condition? I think his main disease is not XDR-TB...
What an arrogant and stupid guy! Risking the health of others for a honeymoon.
Another issue is that only those in direct proximity to the sick man have been advised to be tested according to news reports. IF the bacteria can remain active and airborne for hours following breathing, sneezing, coughing, etc., and IF this person went to the bathroom at any time during the flights, are not all persons who might also have gone to those bathrooms been possibly exposed due to the fact that air is rather trapped in that small area. Additionally, due to recirculation of air in the cabin of the aircraft to all individuals on the plane, are not all people on the plane at greater risk that we are being led to believe?
This case is very unusual. This man had the biggest moment of his life with his wedding in Europe.
To rearrange his wedding plans for another date would have been heart breaking for his family and costly to say the least. But just imagine all of those people who have been exposed to the TB virus and who are very scared about their futures because of his decision.
The decision may have major life/death consequences. What a nightmare this situation is for everybody involved.
So much for CDC, the agency designated to protect the public! Why on earth is CDC compelled to protect the privacy of such a selfish, inconsiderate individual? What about individuals who are autoimmune suppressed and very susceptible to numerous diseases? This is shameful on the part of the CDC and brings into question the extent of this government agency to protect the general population.
I don't think he should have stayed because the health officials told him to stay, I think he should have had the ethics himself to not go and risk the life of others. I sure would be pissed if somebody infected my family by sneaking onto a flight we were on.

Christian Goodman
http://ChristianGoodman.com
If your health puts other people in danger, then public health definitely overrides personal issues. People have gone to jail for knowingly having sex while infected with HIV/AIDS. It's the same in this case. The man knew he had a fatal case of TB, knew it was probably contagious and was warned not to travel. He chose not to listen to the doctors and put others at risk. He should be held accountable.
I am struck by the nonchalant attitude of the traveler with TB. His comments in various news outlets about his education, wealth, and social status suggest that he felt that he was above having to play by the rules. I find his actions, by knowingly placing others at risk, to be deplorably arrogant and self-serving. He demonstrated a careless disregard for the safety of others.

That said, I believe that he should have been prevented from traveling. The fact that the traveler did not feel that he was a risk does not negate the actual risk he posed (however large or small). He may have been seated beside an elderly person, a child, or a person with a compromised immune system who had a legitimate right to travel. We have no way of knowing.
Wasn't there a story a while back about somebody who was arrested or fined or something for not wearing a face mask?

If he "wasn't very contagious", but they knew he was intending to travel,why did nobody provide this man with a face mask and orders to wear it?
It was extremely selfish of this man to put everyone else in danger when he knew he had TB. Never mind that it was later determined to be the worst kind.

I think if your are unfortunate enough to have contracted a serious contagous illness your rights should be put on hold. Can you only imagine if this where say, Ebola? One person does not have the right to put the rest of the world at risk. Its not right. Its selfish plain and simple.
This story has more holes in it than is being told. The CDC did not do the right thing. If it was such a contagious disease, why not just force him to the hospital. I guess the general public has no rights. They would rather let him "do the right thing" then protect us. Im sure if it was Bird flu or small pox, the CDC would have thrown him in quarentine so fast, it would have made your head spin. Then again, maybe not. Looks like we are on our own when a major outbreak happens, in my opinion.
I do not agree that XDR-TB is all that 'rare" if this man had contracted it somehow - it must be out in the community. He had never had TB before, so how did he develop the drug-resistant strain? This XDR-TB is an epidemic in South Africa, where more than 1000 people have already died from it since October 2006 and it is now found outside hospital settings in all the provinces there. It's not 'rare' at all! Also, something like this has also happened before when a multiple-drug resistant Hawaiian woman had infected twenty people on two long-distance flights in 1996 in the USA.
This XDR-TB is not nearly as 'rare' as Dr Gupta seems to think. It's an epidemic in South Africa where 1000 people have already died from it since October 2006. Some 1,054 people per 100,000 are being infected with it. And how could this patient, who had never been treated for TB before and clearly was otherwise healthy and indeed without any symptoms, could have contracted the most deadly drug-resistant form of this TB strain - surely there must have been someone in his vicinity who had it too. So it's not that 'rare'.
This story makes me very sad indeed. After my last chemo treatment, I traveled on a plane against the advice of my doctors. I wasn't putting anyone else at risk, I was putting myself at risk because had I been exposed to ANY disease, I would not have been able to fight it.

I had no idea that folks would be so thoughtless - how can an intelligent educated man put so many at risk?

Apparently, he didn't have any classes in ethics.
Absolutely they should contact anyone and everyone that he has come in to contact with and they should get checked.
Even if he might not be very contagious, he may have come across a person with a weakened immune system, then what?
Knowingly putting other people at risk is deplorable. I hope some of those people affected will take him to court. I will gladly donate money to a legal fund to pursue this end.
If the CDC is not releasing his name, why do you have his name all over your web site along with his picture?
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