Interesting clarifications on TB man. One key point is that he has active TB.

[snagglepuss]

Personally I have found news coverage of this issue to be appalling especially the health aspect.
Many reports state that Speaker as having only negative smear tests but none of the reports i've read have explained what that means. I have been under the impression that Speaker had latent not active TB. The following information clearly puts that notion to rest:

"Speaker does *not* have latent TB. If it was latent, it would never had given a culture to grow up to do the susceptability testing on it.

His sputum was 'smear negative' which simply means the bacillary load was low enough not to be obviously seen under a microscope. The culture though *did* grow up with TB which by definition is an 'active case' of TB.

Most certainly he knew he had at least mulit-drug resistant TB (which in and of itself is a *huge* deal) by the time he left. He should never have gotten on that plane even if it was suscept. TB. But since he was smear negative, they probably didn't make a big deal of it. Generally epi people don't panic once the bacillary load gets low enough.

It's when the XDR diagnosis came in that the bells rang of the hook.

And, yes there is a documented case of TB transmission on a plane ride:


Only one investigation has documented transmission of Mycobacterium tuberculosis (TB) from a symptomatic passenger to six other passengers who were seated in the same section of a commercial aircraft during a long flight (>8 hours). These six passengers were identified by conversion to a positive tuberculin skin test; none had evidence of active tuberculosis. The HEPA filters used in newer commercial aircraft (described above) are able to filter out TB bacteria from the recycled air and are used in hospital respiratory isolation rooms to prevent the spread of TB within the hospital setting.

I don't know everything about this case (other than the abysmal health reporting!) but I have worked on TB for 15 years so am familiar with much of the background being discussed."


Also interesting is "Doctors said Speaker was not especially contagious, but 17 percent of cases of tuberculosis have been transmitted by people not identified as highly contagious.

"CDC will be undertaking a number of reviews related to this XDR TB case. One aspect of this review will be looking at how the CDC employee who is related (Speaker's father-in-law) to the patient was involved in this matter," the CDC said.

Tuberculosis infects about a third of the world's population and kills 1.6 million a year. Most cases are latent, and even people with active disease can show no symptoms of illness, such as Speaker.

But any person with active TB can spread the bacteria to others."






http://news.yahoo.com/s/nm/20070603/hl_nm/tuberculosis_usa_dc;_ylt=AiMTtHHhEwueTvmrmMsSsb8Q.3QA

[pnwmom]

1. Thanks for all the info, snagglepuss.

And welcome to DU!

[snagglepuss]

2. Your welcome.

And thanks for the welcome.

[LisaL]

3. That's exactly right. He had active TB.

By definition, active TB is: the presence of Mycobacterium tuberculosis infection and a positive chest X-ray.
His chest X-ray was positive because he has a tennis ball size lesion in his lung. That is how he was diagnosed with TB-by chest X-ray.
So, he most definitely has active TB and not latent TB. People with latent TB are not infectious, but Mr. Speaker certainly has active TB.

[snagglepuss]

8. I initially thought as much than some friends said I was wrong and

I like sheeple believed them. Living thru the SARS crisis in Toronto, I am very interested in this story but I have found the initial coverage of this very poor. None of the initial reports I read or saw mentioned that his TB was active and nothing I saw clarified the significance of a negative smear.

[LisaL]

10. If he had latent TB no one would care because

people with latent TB can not infect others.
But since he had positive chest X-ray (that is how his TB was diagnosed) he has active TB.
Apparently he is not very contagious but he is still contagious nonetheless.

[LisaL]

4. Also, the fact that someone is smear negative DOES NOT

mean that person can not infect others.
In fact studies show smear negative TB patients do infect others, but at lower rates than smear positive TB patients.

[judaspriestess]

5. welcome snagglepuss

are you a laughalympics fan? I love snagglepuss

[snagglepuss]

9. Thanks for the welcome.

laughalympics? Sorry never heard of it but if snagglepuss is part of it i am a fan.

[peacetalksforall]

6. Ever wonder how many times he went to the aircraft 'bathroom' and

whether he went to a different one each time? Did he sneeze, cough, blow his nose? How many times did he use the bathrooms in all the places he passed through? How many times did he touch hard objects? Did he ever wear a mask?

Did they ever find out whether the father-in-law knew in advance that the TB guy was going to sneak in?

[snagglepuss]

11. The problem is that he didn't wear a mask. If he had flight attendants

would have been suspicious. The question of whether his FIL knew he was sneaking back to the US is the big question. I'm surprised that he's so nonchalant about about any kind of active TB. The article from yahoo states that 17% of TB patients who have what's considered low infectivity end up infecting others!

[LisaL]

12. Yea, I know.

Mr. Speaker claims the Drs. told him he was not contagious. Yet the literature says smear negative but culture positive TB patients are still contagious, although less so than smear positive TB patients. His father in law works for CDC and with TB. One would think he should know this.
Mr. Speaker also left for Europe 2 days early when he found out his TB was multi drug resistant.
And then of course even though he was told not to fly back on a commercial flight he did it anyway.

[benld74]

7. 2 words for this guy-DUMB ASS