Drug resistant TB, a pandemic in the making


The man has been identified by multiple medical and law enforcement sources as Andrew Speaker, 31, a lawyer from Atlanta, Georgia. Hospital officials have not disclosed his name.

Health officials said they advised him not to travel, but they had no authority to prevent him from doing so.

Since the county was not able legally to stop him from traveling, the officials recommended he at least wear a mask, Benning said. Speaker left for Europe a few days later. [/quote]
The patient is a lawyer and because the US wasn’t legally able to prevent him from going on vacation, he decides to potentially spread TB throughout Europe.

Sounds like a broken system, if they can let a man with a contagious drug resistant disease to walk around and potential start a pandemic.

Scary… and the dude needs a good knock on the head…

any idea how to say TB in chinese??? I’d like to take my mother-in-law for a TB checkup… she’s had a horrid cough for ages, and the medicine the doc gave her doesn’t seem to be helping~

He’s definitely a selfish asshole. Here he is.

Apparently the authorities knew he had TB, but didn’t know how serious it was till he was in Europe. Still, it does sound like a combination of one selfish asshole coupled with possible governmental incompetence.

[quote]Speaker and his wife flew to Denver from Atlanta accompanied by federal marshals. He looked healthy and tan, and “he said he still felt fine,” Allstetter said.

Speaker, who gave an interview to the Atlanta Journal-Constitution on Tuesday, said that health authorities in Atlanta never explicitly barred him from leaving the country and that they only said they “preferred” he stay home in the Atlanta area. The man then reportedly left for Europe to get married.

On Wednesday, officials from the Fulton County Health and Wellness Department and the CDC said that they clearly and emphatically told him to stay put.

He was told in no uncertain terms that he had a serious, contagious disease,” said Dr. Steven Katkowsky, director of the Fulton County Health Department. “We told him not to travel.”

. . . Dr. Martin Cetron, director of CDC’s division of global migration and quarantine, acknowledged at a news conference Wednesday that the agency was making slow progress in reaching passengers and crew aboard the man’s transatlantic flights.

The CDC released more detailed information about the man’s itinerary to help people aboard those flights identify themselves.

CDC officials said they believed the man was sitting around row 51 [Around? WTF?] on Air France Flight 385 from Atlanta to Paris and in seat 12C on Czech Air Flight 0104 from Prague to Montreal. They believe about 80 people on the two flights were sitting in the high-risk areas, which include the row the man was sitting in and two rows around him. . .

The CDC is isolating Speaker under a federal public health order – the first issued since the isolation of a smallpox patient in 1963.

Tuberculosis is an infection of the lungs characterized by fever, weight loss, night sweats and coughing up of blood. The disease is spread primarily through prolonged close contact, in microscopic droplets released when an infected person coughs, sneezes or speaks.

The tuberculosis bacterium has developed resistance to antibiotics over the years. XDR TB is the most resistant form. It is six times more lethal than regular TB.

XDR TB is extremely rare. Since 1993, there have been just 49 cases in the United States.

Speaker was diagnosed with tuberculosis in January after a small lesion on his lungs was found after a chest X-ray was taken for other medical reasons, the CDC said. . .

County health officials knew by May that his tuberculosis was of a drug-resistant variety, although they didn’t know whether it was of the most serious type.

They met with Speaker to tell him the severity of his disease and that he should not travel out of the area, Katkowsky said.

But before the health department could deliver an official medical directive, Speaker left for Paris.

Speaker and his wife traveled from Paris to Athens, then to two Greek islands. “We headed off to Greece thinking everything’s fine,” the man told the Atlanta paper.

Only when the couple reached Rome did the CDC discover that he was infected with XDR TB.

A member of the CDC quarantine team reached him by cellphone May 23, officials said.

There were several communications between my staff and the individual in Rome, begging and asking him to stay put and not travel while we worked on some options,” Cetron said.

Speaker had told the Atlanta paper that the CDC then counseled him to turn himself over to Italian health authorities for an indefinite period of time.

"I thought to myself, ‘You’re nuts,’ " he told the paper.

He traveled to Prague and then flew to Montreal to avoid being detected by U.S. authorities, according to the Atlanta paper.

CDC officials finally reached Speaker on his cellphone near Albany, N.Y., on Friday after he had driven across the border into the U.S. He voluntarily drove himself to an isolation hospital in New York City and was then taken in a CDC plane back to Atlanta on Monday. . .[/quote]

Nice guy.

[quote=“x08”]Scary… and the dude needs a good knock on the head…

any idea how to say TB in Chinese??? I’d like to take my mother-in-law for a TB checkup… she’s had a horrid cough for ages, and the medicine the doc gave her doesn’t seem to be helping~[/quote]

We say 肺結核 fei(4) jie(2) he(2) if it happens to your lung.

結核病 jie(2) he(2) bing(4) could happen to different part of your body, I think.

[quote=“x08”]Scary… and the dude needs a good knock on the head…

any idea how to say TB in Chinese??? I’d like to take my mother-in-law for a TB checkup… she’s had a horrid cough for ages, and the medicine the doc gave her doesn’t seem to be helping~[/quote]
Most people in Asia are vaccinated against TB since birth. Look for the scar on the shoulder, which is evidence of the razor blade cut made to expose the TB antigen to individual.

Is it still possible to catch it even if you’ve been vaccinated? What about this drug-resistant strain, would that be resistant to your vaccination?

Read this, it answers your question …

Yes. The effectiveness of the BCG vaccine ranges from 30-65%, depending on the strain of TB and the age of vaccination (younger is better). The low effectiveness is because it is not really TB that we are being immunised against, but a related bacteria that causes TB in cows, Mycobacterium bovis.

The US, Netherlands and Australia/NZ are four countries that purposely do not have regular TB vaccination requirements, as the rate of infection there is low.

No, the resistance is specific to each kind of antibiotic used. A strain of TB can be resistant to more than one antibiotic, by virtue of having more than one set of resistance genes (genes that code for a protein that enables some change in the bacterium that makes that antiobiotic ineffective). The most resistant strains of TB, so-called MDR (multi drug resistant) or XDR (extended drug resistance) strains, are resistant to either five or six of the most useful classes of antibiotics, but may still be killed by careful use of much more dangerous antibiotics (dangerous to our bodies in that they may cause kidney failure, deafness, liver damage, etc…), which is why they are not in common use and also why the TB has not seen much of them yet.

Vaccines do not rely on antibiotic mechanisms to operate: they train your immune system to attack the bacterium. Bacteria (in general) do not become resistant to immune system attack, whether from the “hunter/killer” cells of the immune system or from antibodies, as there is no way to change enough of themselves to become unrecognisable to the immune system.

Problem with vaccines is that they often do not provide any help for current infection, and particularly so with TB as the bacterium walls itself up in small hard balls in the lungs, which are the ‘tubercles’ referred to in the name tuberculosis, and look like grains of sand on Xray: hence the obligatory chest Xray foir foreigners here.

thanks guys… yeah, I might tell my wife to take her for an x-ray then…

Actually, the guy wasn’t that bad. The doctors told him he wasn’t a threat to anyone and their “explicit” warning not to fly was followed by them saying that he wasn’t that they just said what they did to cover themselves.

He even has a recording of the meeting where they advised him of this.


Then, when he’s already in Europe, he calls them back and they tell him his family has to get US$140,000 so they can send him home on a private plane and that the CDC doesn’t have the funding to transport private individuals.

Considering what was going through his mind, I don’t think it was that bad.