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Fri 1 Jun, 2007 06:11 am
Thursday, May 31, 2007
TB: bigger questions raised
As I have been covering the story of tuberculosis, specifically XDR - TB, several things have occurred to me. So, I thought I would just muse for a few lines and get a sense of what you are thinking as well.
I think, after looking at the science and talking to most people involved, the likelihood of anyone getting infected is incredibly small. Even the TB patient's wife, who was just on a honeymoon with him, has tested negative so far. That's the good news. The bad news is that a lot of people on those flights have been incredibly confused, and a little angry. I spoke to a few of them this morning.
First off, they were first contacted by CNN, not the Centers for Disease Control and Prevention - even though they had sat in the same exact row as the infected man. They were tested after seeing news reports on television. One man was immediately placed into a temporary quarantine and asked to wear a mask at his local hospital. The doctors had no idea how to deal with this problem. Many others who were not in the nearby two rows were told to get tested only if they were concerned. Well, what does that mean? Shouldn't everyone be concerned?
Now, the latest CDC advisory simply says everyone who flew on those planes should get tested. That's the confusing part. The anger part: the passengers seemed to think that this infected man was not malicious or out to hurt anyone in particular, but that he was selfish and unnecessarily put many people at risk and created anxiety and worry.
More than anything, I think this one case reflects deeper failings in our public health system. What if there were ten cases, instead of just the one? What if it were smallpox or a bioterrorism attack? Are we ready?
Dr. Sanjay Gupta
CNN.com
Get used to it. Our TB rates are dramatically rising, primarily entering from Mexico. Infected individuals can be either human or domestic animals. NAFTA theoretically means that TB testing of cattle is equal on both sides of the border, but the sad fact is that Mexican testing is often less sensitive than the U.S. testing methods. I find it inevitable that we will again see tuberculosis in our cattle and pig populations.
As an oldie observing this, it is a kind of full circle thing. I was a bacteriology major at my university, '60-64. Some fair part of our training was about tb - I still remember the giant room of guinea pigs at Olive View Sanitarium. Squeal City. I think now Olive View is a big LA area hospital.
Anyway, that became much less of a concern as time went by, and then... when I'm not sure as I wasn't following it .... concern ratcheted up again to this present level.
Osso - it bacame much less of a concern when we almost eliminated TB from the domestic animal population. As we lose control of livestock infections, it will become a much greater concern for humans. It amazes me that the press seems so fixed on antibiotic-resistant bacteria supposedly arising from feed-additive antibiotics (which, by the way, is a shell game if I've ever seen one) and chooses to ignore the real human health threat from food animals.
In a kosher slaughterhouse, in the US, can TB of the lun be visualized with the naked human eye?
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