Airborne contagion

A tubercular Mexican national's 76 border crossings and multiple domestic flights over 10 months beginning in August 2006 require explanations from Customs and Border Protection. So, too, does the six-week lag between April 16, when federal authorities first learned of this mobile danger to public health, and May 31, when the Department of Homeland Security finally got around to warning its inspectors.



Add the fact that not until June 7 was the infected Mexican businessman placed on the Transportation Security Administration's "no-board" list, by which time the man had flown to Atlanta, Salt Lake City and Phoenix after dozens of border crossings by land. Finally, add a cover-up. We are witnessing a genuine public-health scandal.



The story of how this came to pass, unearthed and reported in detail by Sara A. Carter and Audrey Hudson in yesterday's editions of The Washington Times, is maddening and cries out for redress. The strain of multi-drug-resistant tuberculosis carried by Mexican national and frequent international traveller Amado Isidro Armendariz Amaya is the same highly contagious strain which the 31-year-old Atlanta, Ga. lawyer and TB patient Andrew Speaker carried to much notice five months ago, when he boarded multiple international flights despite high contagion in an attempt to re-enter the United States after an overseas honeymoon. That incident highlighted the U.S. government's dangerous inability to monitor, control and when necessary prevent travel by persons infected with dangerous pathogens. Federal officials testified in Congress at the time, after which time legislation to bolster TB detection and prevention via the Foreign Assistance Act of 1961 gained steam.



Now we have Mr. Armendariz, who is "self-medicated and non-compliant" with Mexican state health officials. Mexican officials have known for five years of the infection. U.S. authorities became fully apprised only in May. Mr. Armendariz's father and sister died of tuberculosis in his home state of Chihuahua, according to Department of Homeland Security e-mails obtained by The Washington Times. Until May he travelled regularly (and apparently with legality) between Mexico and the United States.



Of course, even had federal officials been fully apprised earlier, it is not entirely clear what would have happened. Under current practice, the Centers for Disease Control and Prevention notifies airlines of possibly infected passengers only when the flights are of a minimum eight-hour duration. On short flights, no notice would be required, according to one CDC physician.



World Health Organization guidelines issued in 2006 which the CDC has adopted stipulate that "physicians should inform all MDR-TB patients that they must not travel by air ?- under any circumstances or on a flight of any duration until they are proven" no longer to carry the pathogen. But, as the Speaker case showed, this is sometimes disobeyed.



The Speaker incident and subsequent congressional inquiries took place at the same time that the Armendariz episode was coming to the attention of federal authorities. No doubt sensing the highly negative new environment, officials speaking to The Washington Times on condition of anonymity said that threats of firings were issued in the event that information on the Armendariz case were to reach the news media.



The unconscionable and inexcusable foot-dragging despite a real and present danger, the poor international coordination, the evident gaps in current procedure and the apparent cover-up should be disturbing to every American. The present lax state of affairs puts travellers at significant risk. Congress should demand accountability, and President Bush should prepare to accept resignations.



Accountability hell. Unheard of in Washington and the seat of power. If it were would Bush still be president.