Friday, June 01, 2007

International Herald Tribune Editorial - Chasing an evasive TB patient

International Herald Tribune Editorial - Chasing an evasive TB patient
Copyright by The International Herald Tribune
Published: May 31, 2007

It has been more than 40 years since the federal Centers for Disease Control and Prevention ordered anyone into quarantine or isolation, but the agency was amply justified in taking that extreme action in recent days. It was dealing with a patient infected with a very hard-to-treat form of tuberculosis who had put his own convenience ahead of the safety of others. The only question is whether health officials should have acted sooner.

The patient, who lives in the Atlanta area, has shown no overt symptoms. But laboratory tests have confirmed that he is infected with "extensively drug resistant" bacteria, a form of TB that kills a high percentage of those infected.

The patient does not appear to be highly infectious, but he has the potential to threaten the lives of those who come into prolonged contact with him. The chief concern at the moment is people who sat near him on two trans-Atlantic flights. County health officials in Georgia say that they told the patient that he should not travel abroad. In an interview with the Atlanta Journal-Constitution, the patient, who has not been named, says he thought they were only expressing a preference and that they did not flat-out order him to cancel a planned wedding and honeymoon in Europe. He left before a written directive against travel could be delivered.

Only after the man was already in Europe did laboratory tests discover that his case was the most serious kind. Officials contacted him in Rome and told him not to fly commercial airlines and to await possible isolation and treatment in Italy. Instead, he booked a flight into Canada and drove down to New York, where the CDC transferred him by government plane back to Georgia.

Health officials have long preferred to rely on infected people to behave responsibly than resort to compulsory orders. But in this case, that trust was clearly abused. Congressional oversight committees ought to examine what steps can be taken to ensure that patients infected with deadly contagious diseases protect others from infection.


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