He doesn't have latent TB! He has active TB. He has a mass in his lung which is where they cultured the TB from. Although he is not coughing, he can spread it to others.
CDC: 107 people on TB flights need tests
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He doesn't have latent TB! He has active TB. He has a mass in his lung which is where they cultured the TB from. Although he is not coughing, he can spread it to others.
Buzz Mills
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mentioned on CNN--The Denver Medical Center is apparently planning on operating on Andrew Speaker to remove the infected portion of his lung.
Health law experts said Speaker could be sued if others contract the disease.
"There are a number of cases that say a person who negligently transmits an infectious disease could be held liable," said Lawrence Gostin, a public health law expert at Georgetown University. "So long as he knew it was infectious, and knew about the appropriate behavior but failed to comply, he could be held liable."
http://www.myfoxtampabay.com/myfox/...=14&locale=EN-US&layoutCode=TSTY&pageId=3.3.1
Health law experts said Speaker could be sued if others contract the disease.
"There are a number of cases that say a person who negligently transmits an infectious disease could be held liable," said Lawrence Gostin, a public health law expert at Georgetown University. "So long as he knew it was infectious, and knew about the appropriate behavior but failed to comply, he could be held liable."
http://www.myfoxtampabay.com/myfox/...=14&locale=EN-US&layoutCode=TSTY&pageId=3.3.1
englishleigh
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twinkiesmom
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<<in addition, children who have been adopted from overseas have a HUGE increase in their risk for TB and many do have latent TB which requires lengthy treatment.>>
Why do you think the kids are given a health screening before they're allowed to enter the US?
Why do you think the kids are given a health screening before they're allowed to enter the US?
accordn2me
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Can you speculate on how he got this XDR TB?
I was reading earlier and saw, IIRC, that there were only 49 cases in the US last year. I guess that's 49 known cases. I believe I also read something about Andrew Speaker going to Vietnam. I wonder if he did go and got the TB there?
What is the incubation period? I mean how long from infection to sypmtoms?
Anyone know what made Andrew Speaker get tested for TB in the first place? From what I read, his early detection greatly increases his odds of survival. Most people don't find out they have it until it's advanced. So why did he suspect he had it and get the test?
Sorry for all the questions!
Annie
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By reading some of the posts, it is frightening to me that there are a lot of people who take up for him and would do the same thing. Put their own desires ahead of the safety of others. What will happen if we do get a real lethal disease epidemic in this couuntry? The attitude seems to be, I will do what I want regardless of how many others I hurt. It is especially disturbing to me that a nurse who deals with children takes infectious disease so lightly.
Buzz Mills
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On CNN--it was reported that the incubation period for this disease can be years; which means periodic testing will be required for a few years--this according to one of the passengers who has had his first test. Andrew's father was complaining that his son is being treated just like a terrorist. He should be.
I read this on CNN.com: Between 1993 and 2006, 49 people were diagnosed with XDR TB in the United States, said Dr. Ken Castro, director of the division of TB Elimination at CDC, which is based in Atlanta.
That's less than 4 known cases per year. I, too, am wanting to know how he got it.
And seriously, I know one thing and that is that I would NOT be honeymooning with someone who had such a deadly disease!
Can you imagine WANTING to honeymoon, or anything else for that matter,with the love of your life when you have contracted a contagious disease and you could possibly pass it to them?
Autumn2004
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Autumn2004
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Thank you I completely agree, it screams out narcissistic personality! Thats the main problem with people today and why we have thousands of crimes everyday. No one thinks of others, only themselves and how they feel. I am an lpn and I havent worked for many years but nothing would make me want to go back to it. Nurses can be extremely uncaring and hard. Some of the worst sailor mouths I have heard have come from nurses . They would think nothing of talking about you to others and behind your back. Not all are but let me tell you I only found a few out of the many I worked with. I feel many go in it for the wages for a two year degree.
Oh I know! I was thinking the exact same thing.
This dude was selfish selfish selfish. JMO.
I am not a TB expert, so have to review some old medical books & CBC website to answer some of these, but here goes:
The difference between active TB & latent TB: Latent TB basically means that a person has a positive skin test, but no clinical or x-ray signs of the disease. Active TB means that the patient has ongoing disease caused by the TB bacteria, such as a lesion in the lung, bones, neck, etc. This patient has active TB because he has a pulmonary lesion from which the TB has been cultured. See the CDC website for more:
http://www.cdc.gov/tb/faqs/qa_introduction.htm#Intro4
TB is transmitted through the respiratory route. Usually this means inhaling aerosolized droplets from another person who coughed or breathed out the bacteria. This is why patients with active pulmonary TB are placed in respiratory isolation.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5611a3.htm
The only place I saw any speculation about where he caught the TB in was the article below, where it says he travelled to Asia. He certainly could have caught it there as it is much more prevalent in Asia than in the US. Whereever he caught it, it was probably from being exposed to someone who had active pulmonary XDR TB, in close conditions with poor ventilation.
http://www.ajc.com/health/content/health/stories/2007/05/29/0530meshtb.html?imw=Y
From these articles:
http://www.ajc.com/health/content/health/stories/2007/05/29/0530meshtb.html?imw=Y
http://www.latimes.com/news/nationworld/nation/la-na-tb1jun01,0,702778.story?coll=la-home-center
http://www.iht.com/articles/2007/05/31/news/health.php
He had a chest X-ray done 1/07 after "chest trauma." The CXR showed an abnormality, which was further evaluated. He had sputum cultures which eventually were positive for TB. The bacteria are notoriously difficult to culture because they grow inside other cells.
The difference between active TB & latent TB: Latent TB basically means that a person has a positive skin test, but no clinical or x-ray signs of the disease. Active TB means that the patient has ongoing disease caused by the TB bacteria, such as a lesion in the lung, bones, neck, etc. This patient has active TB because he has a pulmonary lesion from which the TB has been cultured. See the CDC website for more:
http://www.cdc.gov/tb/faqs/qa_introduction.htm#Intro4
TB is transmitted through the respiratory route. Usually this means inhaling aerosolized droplets from another person who coughed or breathed out the bacteria. This is why patients with active pulmonary TB are placed in respiratory isolation.
According to the CDC: 49 cases of XDR TB from 1993-2006, 17 from 2000-2006.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5611a3.htm
The only place I saw any speculation about where he caught the TB in was the article below, where it says he travelled to Asia. He certainly could have caught it there as it is much more prevalent in Asia than in the US. Whereever he caught it, it was probably from being exposed to someone who had active pulmonary XDR TB, in close conditions with poor ventilation.
http://www.ajc.com/health/content/health/stories/2007/05/29/0530meshtb.html?imw=Y
This can vary widely. Some people get infected and never develop symptoms of active TB; ie, their TB remains latent. It usually takes at least 2-3 weeks, and sometimes a few months, for the skin test to turn positive.
From these articles:
http://www.ajc.com/health/content/health/stories/2007/05/29/0530meshtb.html?imw=Y
http://www.latimes.com/news/nationworld/nation/la-na-tb1jun01,0,702778.story?coll=la-home-center
http://www.iht.com/articles/2007/05/31/news/health.php
He had a chest X-ray done 1/07 after "chest trauma." The CXR showed an abnormality, which was further evaluated. He had sputum cultures which eventually were positive for TB. The bacteria are notoriously difficult to culture because they grow inside other cells.
Annie, I completely agree with you! It is scary. Hopefully something good will come out of this, such as improved laws and procedures for quarantining people with highly contagious life threatening diseases. It is fortunate that the risk of transmission seems to be low in this case, but that doesn't mean it is zero, or that it was okay for him to decide to put all of the people around him at risk. There are thousands of people out there who do not have healthy immune systems: transplant recipients, HIV/AIDS patients, diabetics, etc. How did he know that the person sitting next to him on the plane wasn't one of them?
Sorry for the long quote below but I think this is an interesting discussion about the legal procedures for quarantining a patient...I bet there will be some changes in the law after this case.
Skinner said Fulton County health officials contacted CDC on May 10 and said that Speaker, who at the time was diagnosed with multi-drug resistant tuberculosis, had told them he planned fly aboard airlines. The discussions continued on May 11, Skinner said. "We discussed with them several options to prohibit him from flying," Skinner said. All of those options involved actions that needed to be taken by state or local health authorities, he said.
Skinner said CDC never heard back from local health officials until May 18 -- after Speaker had already left the United States.
Lance said: "They gave us some options on how to proceed, but none of them were basically available," she said. She did not elaborate on what those options were.
While Georgia health officials can obtain a court order to restrict the actions of a person or to even involuntarily commit them for treatment, Lance said the individual first needs to be served with a medical order telling them what they can and cannot do.
"If they don't comply with the medical order, then we seek a court order to compel them to comply," Lance said.
Fulton County health officials have said they tried to hand deliver Speaker a medical order telling him he could not travel, but that his home was vacant and he was not at his office when they tried to serve him with it on May 11.
Lance said state and county health officials thought Speaker was departing at a later date, not on May 12 when he flew from Atlanta to Paris. "I think the Fulton County Department of Health and Wellness did their job to the best of their ability," Lance said, but she added that "there probably needs to be a review" of the state's laws and procedures governing restricting an ill person's travel.
http://www.ajc.com/health/content/health/stories/2007/05/30/0531meshcdctb.html
Sooo...when the doctors went to hand deliver him a written letter instructing him not to travel, they were actually starting the legal process to prevent him from doing so.
Dr MSM..thank you for that info. I haven't had a chance to read it critically, but you touched on something that I wanted to post and ask about.
My understanding of a skin TB test is that it can tell if you have EVER had TB in your life. Doesn't tell us if it is active or not , just whether you have EVER had it in your life.
The implication, is that the body can fight off TB on its own. because there are many people that test positive, yet have never been treated or diagnosed.
I am not referring to this man's XDR form, but to other forms of TB.
My understanding of a skin TB test is that it can tell if you have EVER had TB in your life. Doesn't tell us if it is active or not , just whether you have EVER had it in your life.
The implication, is that the body can fight off TB on its own. because there are many people that test positive, yet have never been treated or diagnosed.
I am not referring to this man's XDR form, but to other forms of TB.
accordn2me
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UGH! Thank you for this information. I was thinking if we only have 49 known cases, it should be pretty easy to find out how he got it. Then I really thought about that. :bang: No telling how many people have it and don't know! Even though it's airborne....it must be rather hard to transmit if his wife doesn't have it.
I have a friend who went to China. He said one of the things that really stood out was nearly everyone was smoking. You couldn't go anywhere without breathing smoke......even on trains etc. And they SPIT all the time! GROSS! :sick:
Yes, exactly. The PPD skin test will be positive forever if you have been infected with TB, whether it is a latent or active infection. Also, in some countries such as India where TB is endemic, a vaccine called BCG is given to infants. This vaccine can often cause a person to have a positive PPD test even if they have never been infected with TB. So, a positive PPD test is just a starting point for a diagnosis of TB. You have to take a history from the patient of travel, prior BCG vaccine, known TB exposure, symptoms, etc, then the patient must be evaluated with X-rays, etc. Only a small percentage of people with latent TB (positive PPD) will go on to develop active TB.
