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Wednesday, May 30, 2007

Man with tuberculosis quarantined

[Update below]

I am going to show you the most troubling comment I saw first, then proceed with the story.

"I'm a very well-educated, successful, intelligent person," he said. "This is insane to me that I have an armed guard outside my door when I've cooperated with everything other than the whole solitary confinement in Italy thing."
(Emphasis mine)

He knew he was risking peoples lives, he knew he was on a no fly list, he still decided to travel depsite his understanding of the potential risk and he calls himself well educated?

hmmmmmmmmmmmm

An Atlanta-area man — infected with a rare, potentially deadly type of tuberculosis — is under federal quarantine at Grady Memorial Hospital with an armed sheriff's deputy outside his door following his odyssey on international flights, including some to smuggle himself back into the country.

The globe-trotting tale of the man, his fiancee, their wedding and honeymoon abroad — and conflicting recollections of what he was told about his disease and whether he could travel — culminated Tuesday with the Centers for Disease Control and Prevention issuing an international health alert.

Now other travelers, because of this man's irresponsibility, must be tested for this rare deadly disease.

Unexcusable.

The CDC is working with airlines to contact passengers who took two transatlantic flights — a May 12 Air France flight from Atlanta to Paris and a May 24 Czech Air flight from Prague to Montreal — to alert them that they may have been exposed to extensively drug-resistant tuberculosis.

The disease, also known as XDR TB, is difficult to treat and can cause severe illness and death. Only 49 cases of it have been identified in the United States between 1993 and 2006, according to the CDC.

"I didn't want to put anybody at risk," the Fulton County man, who declined to be identified because of the stigma attached to his diagnosis, said in a telephone interview with The Atlanta Journal-Constitution. "We just wanted to come home and get treatment."

Since January the man, who said he has no symptoms and feels healthy, has met regularly for treatment with Fulton County health officials. He said they and CDC knew he had drug-resistant TB before he left the United States but did not prohibit him from leaving when he told them about his upcoming wedding in Greece.



A little ways down in the article the CDC explains that usually to balance the need for individual freedoms with the need to protect the public they depend on what they call the covenant of trust, obviously they trusted the wrong man for this.

At a news conference Tuesday, CDC Director Julie Gerberding announced that the agency had taken the rare action of issuing a federal public health isolation order against the man, which allows the CDC to hold people against their will to protect the public. Gerberding believes the isolation order was last used in 1963 in a case involving a potential smallpox exposure.

"Normally when someone has tuberculosis, we influence them through a covenant of trust," Gerberding said. While saying tests show the man is at extremely low risk of transmitting the disease, Gerberding said the agency is urging passengers who sat in nearby seats and rows during the two long trans-Atlantic flights receive TB tests as a precaution, and that others who traveled aboard the flights be offered the opportunity to be tested if they have concerns.


In a typical he said/she said type scenario, the man says he was advised by the health department that they "preferred" him not to travel and they say they advised him not to travel.... either way, when the health department "advises" one not to travel, usually it isn't because they are playing around.

Hence his being under guard now.

The man says he and his bride were in Rome on their honeymoon when they got a message to call the CDC. The CDC official said that they needed to cancel their trip and return home and that the CDC would call the next day with travel information.

The patient says he and his wife canceled plans to move on to Florence the next day as they awaited the CDC's instructions.

The next day, instead of giving the couple travel arrangements, the man said a CDC staff member told him he'd need to turn himself into Italian health authorities the next morning and agree to go into isolation and treatment in that country for an indefinite period of time.

"I thought to myself: 'You're nuts.' I wasn't going to do that. They told me I had been put on the no-fly list and my passport was flagged," the man said.

The man said the CDC told him he could not fly aboard a commercial airliner with his disease. "We asked about the CDC jet and they said no, there wasn't funding in the budget to use the jet," he said.

Dr. Martin Cetron, director of the CDC's division of global migration and quarantine, did not respond to repeated requests for an interview. Cetron told The Associated Press: "He was told in no uncertain terms not to take a flight back."

CDC spokesman Tom Skinner said the agency was considering sending the CDC's jet to Italy to retrieve the man — when he disappeared and didn't meet Italian health authorities.

"We're sitting in a hotel room in Italy and we're looking at each other and we're on our honeymoon and the authorities are coming in hours," the man recalled. They made the decision to run.


So, he was told in Rome that his disease was a potential risk to other peoples lives. Lets take a look at where he went after that.



AFTER being informed he still went to Prague, Montreal and then to New York.

Yes, well educated and very responsible huh?

For those unaware of what XDR-TB is:

XDR-TB is the abbreviation for extensively drug-resistant tuberculosis (TB). One in three people in the world is infected with dormant TB germs (i.e. TB bacteria). Only when the bacteria become active do people become ill with TB. Bacteria become active as a result of anything that can reduce the person’s immunity, such as HIV, advancing age, or some medical conditions. TB can usually be treated with a course of four standard, or first-line, anti-TB drugs. If these drugs are misused or mismanaged, multidrug-resistant TB (MDR-TB) can develop. MDR-TB takes longer to treat with second-line drugs, which are more expensive and have more side-effects. XDR-TB can develop when these second-line drugs are also misused or mismanaged and therefore also become ineffective. Because XDR-TB is resistant to first- and second-line drugs, treatment options are seriously limited. It is therefore vital that TB control is managed properly.

Feel free to leave your comments about this in the comment section.

[Update] The latest news shows that there are now 107 people that are in need of testing because of the irresponsibility of this TB man.

Dr. Martin Cetron, director of the CDC's division of global migration and quarantine, said Wednesday that the agency was trying to contact 27 crew members from the two flights for testing and about 80 passengers who sat in the five rows surrounding the man. About 40 or 50 of those people sat in or near Row 51 on the Air France flight from Atlanta to Paris, and about 30 passengers were in or near seat 12C on the second flight, from Prague to Montreal.


Moron.
.