Tuesday, June 05, 2007
As a general rule, doctors hate saying "maybe." It shows a lack of confidence and a degree of uncertainty to which medicine is unaccustomed. So, you can imagine my consternation when I had to say it repeatedly this morning on television. The question: Is Andrew Speaker contagious or not?
Well, maybe... sort of. Alright, yes is he is contagious, but not very. Make sense? There are several things doctors look at when determining whether someone is likely to transmit an infectious disease. One is whether he or she is sick (coughing, sneezing with fever). A second is whether a sputum test is positive - meaning bacteria are present in the saliva. In Andrew Speaker's case, both those tests suggested he was not contagious, and may not be now. He did, however, have a third test come back positive, which is a culture test. That means, doctors had Speaker cough onto a slide, and, although no bacteria were initially present, after a few days they did show up when placed in a culture medium. Based on all of that, the hospital where Speaker is staying issued a statement saying he is "relatively non-contagious" and may even consider taking him out of isolation, although he would still wear a mask.
To be clear, there is still a lot of concern surrounding Speaker. Here is one way of looking at it: When examining risk, you really have to balance the likelihood of transmitting the bacteria with the seriousness of the disease. In this particular case, it sounds like the likelihood of spread is low, but the potential consequence is very high. That is especially true with XDR-TB, where there are very few treatment options.
So, now after hearing all of this, which is admittedly confusing even for the medical establishment -- does it make you more or less understanding of Speaker's decision to fly internationally?
ABOUT THE BLOGGet a behind-the-scenes look at the latest stories from CNN's chief medical correspondent, Dr. Sanjay Gupta, and the CNN Medical Unit producers. They'll share news and views on health and medical trends -- info that will help you take better care of yourself and the people you love.