Friday, July 13, 2007
TB testing
As someone who grew up in Germany and probably was vaccinated against TB as a child, I've been following the Andrew Speaker case on a personal level - not just as a journalist.

Thursday's revelation that one of the passengers on Speaker's flight back to North America tested positive brought back memories for me. That's because it reminds me that people can test positive for TB without having it. I'm one of those people.

I remember quite vividly being in 3rd or 4th grade and having one of my classmates shout "ew, she has the disease, she has the disease" because I had what looked like a round rash 2 days after getting 5 pricks from a TB tine test (nowadays a single injection is used). I didn't think I was sick and a follow-up x-ray showed my lungs were fine. But the impact was lasting.

I had a couple more TB tests administered while I was in school. But at least I was prepared now. I knew to expect the round redness on my forearm and another set of chest x-rays. Each time I was negative. Why was I testing positive? I may have been given a TB vaccine (I haven't checked my vaccine records in decades). TB vaccine was not commonly used in the U.S., but Europeans did use TB vaccine and it can cause a positive TB test. Or I may have come in contact with someone who had TB. In the end I was always told that I didn't have TB. But to this day, it's with me. When I go to the doctor and go over my medical history, I'll tell the doc I always test positive for TB.

So now, Andrew Speaker is being sued by 8 fellow passengers. Speaker, a 31-year-old Atlanta, Georgia, lawyer, caused an international uproar when he disregarded doctors' advice and traveled abroad to get married, potentially exposing his fellow passengers to the disease.

According to the attorney filing the lawsuit, one of these passengers, who was on the same flight from Prague to Montreal - a 72-year-old man- had tested positive for TB on a skin test. Follow-up x-rays have come back normal, but he's still waiting for further test results.

Could Speaker have infected him on the plane? His own physician, TB expert Dr. Charles Daley tells CNN this positive skin test result is "absolutely not related to Andrew Speaker." And Canadian health officials say so far "no active TB cases have been identified among the 29 passengers."

Why not? This passenger tested positive just 6 days after being on the same plane as Speaker. Not enough time has passed. Several TB experts tell us that a minimum of 2 weeks have to pass before a test would come back positive, if this man had been infected by the attorney from Atlanta.

If any of the other passengers stay TB negative for 2 months (which is just 11 days away), they can be sure they were not infected by Speaker, experts tell us.

The 8 passengers are suing Speaker because they feel he intentionally disregarded their safety. Do you think he did?
i think the issue of the andrew speaker case/TB is being over-flogged in the US. Sometimes in the year 2001, i took ill and went to the hospital. After undergoing series of blood tests, xrays,and all manner of testing i was told i had respiratory infection.All this while i was in the university, attendind classes, and living in the hostel. The doctors couldn't figure out what was wrong exactly, as i had taken all manner of prescriptions and still wasn't getting better. After about a year and a half, i eventually had a biopsy carried out on me and was told i had just survived TB. If TB is so contagious, how come classmated, room mates and family weren't affected. I was then placed on anti TB drugs for a period of 14 months and got completely healed. Having TB doesn't always mean those around you are at risk. It is a disease quite alright, but the issue is being over emphasised in the US.
The word from his doctors is that he was not contagious. Hence he was not putting anyone at risk. We should quarrantine people who are capable of spreading any form of TB. Those who are not contagious should only be required to get treatment.
Saw Gupta's report on CNN where Speaker said that there has never been TB transmission on a plane.

Really?.... check out

http://content.nejm.org/cgi/content/abstract/334/15/933
From
Dr. Gro Harlem Brundtland
Director-General
World Health Organization Open Society Institute, New York
28 October 1999

--http://www.who.int/director-general/speeches/1999/english/19991028_TB_open_society.html


"The emergence of multi-drug resistant tuberculosis around the world could threaten TB control using the DOTS strategy. Multi-drug resistant TB is clearly contagious, and it is associated with high rates of treatment failure. MDR-TB is the result of failure to use the cost-effective DOTS strategy, while state-of-the-art treatment of MDR-TB is prohibitively expensive. We therefore must recognize the vicious circle of bad TB treatment and MDR-TB. We must place it squarely at the centre of our thinking about controlling TB. Bad TB control programmes can create more new cases of MDR-TB faster than DOTS Plus strategies will be able to cure them.

We cannot afford NOT to remove the obstacles to rapid expansion of DOTS. If we fail, efforts to cure MDR-TB cases will be an endless task making merely a cosmetic impact on the global burden of TB. It is equally tragic when an African woman cannot afford the $20 drugs to cure her non-resistant TB as it is when a Russian prisoner will perish because $2,000 is not available for his anti-MDR-TB drugs. In all instances, ensuring low price, high quality and widespread availability of anti-TB drugs is one of our most important challenges."
He absolutely did.

TB isn't particularly contagious. It's hard to catch if you're healthy. But it's also hard to fix if you catch it. He just didn't have the moral (or maybe legal) right to knowingly expose other people to that disease over and over again without taking any sort of preventative measures.

I genuinely hope that they hit him where it matters--his money--for the stress he caused other people unecessarily. To imply that a wedding and honeymoon couldn't be delayed until treatment for your deadly disease is over is possibly the stupidest thing I've ever heard spoken out loud.
Mr. Speaker ignore US health officals not to travel back to the US because he had a deadly form of TB ... Mr. Speaker on his own action ignore that fact and traveled back to the US hopping around country to country, trying to avoid "offical do not fly list". By his own action he should be held accountable for his negligence.

He should know better he is a personal injury lawyer ...
I hope that they take the PERSONAL INJURY AMBULANCE CHASER for every penny he has. He would do it to you!!!
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