Re: Here's a much better reporter on the TB story.

[Guest guest]

Thanks, Penny, this is exactly what I was hoping some reporter would

look into.

a

>

> Now this reporter is asking much more appropriate questions:

>

>

> TB or Not TB: Isn't That the Question?

> Jordan Safirstein

> Mon Jun 4, 11:58 AM ET

>

> The only thing more confusing to me than this tuberculosis (TB)

fiasco is how I am still the first to use this line for my title. The

antagonist in the international bacterial brouhaha is a young

personal injury lawyer who either knowingly or unknowingly flew off

to his honeymoon in Greece with a multi-drug-resistant strain of TB

(MDR-TB). Actually, the Associated Press reported yesterday that he

had an even more resistant strain of Mycobacterium tuberculosis,

called extremely drug-resistant TB (XDR-TB). Infectious disease is

not my specialty but since when did we start assigning diseases cool

prefixes that make them sound like luxury cars? We have heard rumors

circulating that the 2008 model will be the YF'd-TB?

> if(window.yzq_d==null)window.yzq_d=new Object(); window.yzq_d

['lXNBDtGDJHY-']=' & U=13bmpsc7e%2fN%3dlXNBDtGDJHY-%2fC%

3d571921.10592332.11211305.1442997%2fD%3dLREC%2fB%3d4495406';

> So the story goes that an excited newlywed personal injury lawyer

goes to the doctor a few days before his honeymoon and is told that

he " has TB. " Speaker has also said that he was advised by Fulton

County, Ga., health authorities that he was not contagious or a

danger to anyone. Officials told him they would prefer he didn't fly,

but no one ordered him not to, he said.

>

> Let's stop here for a minute. There are really two kinds of " have

TB " s. There is the positive PPD test for TB in which your body has

formed antibodies to Mycobacterium tuberculosis after you have been

exposed to it but you are symptom-free and otherwise healthy, i.e.

latent TB (LTB). Then there is the " really have " TB in which you are

symptomatic, with clinical manifestations usually associated with the

pulmonary system. Patients typically present with cough, fever,

chills, night sweats, weight loss, bloody sputum, anorexia, etc. etc.

In this form, one is capable of actively spreading the infection.

>

> Many, many Americans, and even more internationals " have TB " in

the former sense and a great deal of them are probably unaware as

they have never had a PPD test to detect its presence. And if all of

those fliers with latent TB were quarantined, it would probably

require a holding room the size of Giants Stadium. But very few

Americans with dormant TB ever develop the active form of the disease

unless they become immunosuppressed, as in the case of patients with

HIV/ AIDS or chemotherapy. Moreover, these carriers are not infective

to anyone unless the disease becomes active. Lastly, his XDR-TB

status does not make his disease any more transmissable than your run-

of-the-mill TB -- it is just harder to eradicate.

> The fact that his new wife and he traveled to Greece makes you

think (and hope) that he wasn't hacking up blood-tinged hunks of

sputum during his " I do's " . Thus, we are making the assumption that

Speaker only had the presence of XDR-TB in his blood, making him no

different from thousands of other air passengers who travel with

latent TB on a daily basis. So what's the big deal? That's what we're

trying to figure out. We are guessing all the tumult is a result of

him ignoring The Man who told him not to fly.

>

> But where did he get such an uncommon strain of the mycobacteria,

that is found much more commonly in Asia and the former Soviet Union?

Several reports have claimed that he was exposed when he visited a

health clinic last year in Vietnam. We are not disputing that this is

a possibility, but it turns out his father-in-law, Cooksey, is

a microbiologist for the Centers for Disease Control ( CDC) who

actually specialized in TB. [The plot thickens...] The same CDC that

initiated Mr. Speaker's quarantine -- the first of a human being

since 1968. In medicine, we have a saying that common things happen

commonly and if we follow that theory than it seems less likely that

one week in Vietnam accounted for his infection than his chronic and

long-term exposure to his microbiological father-in-law.

>

> This is a bold call but we're betting serious money that the

wife's father will be investigated and it will turn out that he, too,

has XDR-TB (*cue the Law & Order dun-dun). Oh yeah, the father-in-law

is the source and he is going down for this in the very near future.

Or is he?

> Currently, Speaker is taking up residence in a Denver hospital

until he is given the green light to travel again. Perhaps we will

find out that he indeed does have active TB infection but that will

bring up an entire set of additional questions, like why a young,

healthy man in his thirties develops active TB infection in the

setting of a normal immune system. (Dun-dun)

>

> http://news./s/huffpost/20070604/cm_huffpost/050580

>

>

>

> Penny Houle <pennyhoule@...> wrote:

> What's so strange about this strain of TB? All I can

find is that it is resistant to 2 drugs. Omigod! must have come from

another planet. Oh wait...that's what all good bacteria do. Adapt,

migrate or DIE!!!!

>

> Don't buy all the hype, a.

>

> penny

>

>

> pjeanneus <pj7@...> wrote:

> I meant to write that the fiancee does not have TB. Yes, the

man has

> TB. As to how he got it - it is not unusual to get TB in the US -

it

> is very unusual to get the strain of TB this young, otherwise

> healthy, upper middle class man has. That is why I wonder if he got

> it by way of the CDC and perhaps some careless work coming out the

> door.

>

> I don't know, and I don't think we ever will know.

>

> a Carnes

>

> >

> > Yes, but 2 million people per year are dying of it. So which

seems

> more absurd to you, the 2 million worldwide or the 2 in the U.S?

Are

> we really that healthy in the U.S?

> >

> > It is weird that his father-in-law works at the CDC but not

> because that's necessarily how he got it. I think it's interesting

> because obviously he would have a better understanding of how to

> treat it. Also interesting that his father is a lawyer. I wonder

what

> would be happening if a slightly more average citizen were dealing

> with this public hazard? Probably facing the lynch mobs.

> >

> > Also, newscasters are calling it a " rare " form of TB, which

> really irks me. All it is, is a very resistant form of the

bacteria.

> Doesn't make it rare at all. He's just like a lot of us walking

> around with resistant bacteria and the possibility of spreading it

to

> other susceptible people, but these bugs aren't seen as

threatening.

> Talk about foolish. This resistance is what a few doctors (and the

> American Academy of Pediatricians) have been trying to warn about,

> but no-one's listening.

> >

> > Also yes, the guy still has a " mass " in his lung but his tests

> are coming back negative and that makes him " probably not

> contagious " . First off, shows how wrong tests can be. And secondly,

> it illustrates what usually happens if you have an infection that

> isn't responding to abx. Surgical removal. This is why you see so

> many diabetics get their feet amputated (although they often aren't

> provided with all the treatment available because it's so costly).

> >

> > It's also why it's so frustrating when that infected mass is in

> your jaw or your sinuses, because you can't amputate those areas &

> surgical removal is very tricky. The docs/dentists who work on

those

> areas are so undertrained that you wouldn't really want them to try.

> >

> > penny

> >

> >

> >

> >

> >

> > jim davis <jimd85379@> wrote:

> > Did I miss something, I heard reports that the person

> > had a mass about the size of a golf ball, that needed

> > to be cut out. Is there a question, that he has TB?

> > --- pjeanneus <pj7@> wrote:

> >

> > > If his fiancee wasn't infected why would folks on a

> > > plane be? Also,

> > > where did he get the infection???? There have only

> > > been 2 cases

> > > diagnosed in the entire US, but father-in-law works

> > > with TB at the CDC

> > > in Atlanta. What is wrong with this picture?

> > >

> > > a

> > >

> > >

> > > >

> > > > Just heard the latest report on the TB patient. 2

> > > tests have come

> > > back negative and they're waiting for the 3rd. If it

> > > is also negative,

> > > they're saying that he can " probably be considered

> > > fairly non-

> > > contagious " .

> > > >

> > > > Cracks me up.

> > > >

> > > > Just shows you that these tests aren't 100% and

> > > even if you're

> > > infected you can test negative for a number of

> > > reasons. People

> > > shouldn't necessarily believe the first negative

> > > result they get,

> > > especially if they've got symptoms. We have to start

> > > pushing doctors

> > > for more comprehensive bacterial testing. Not just a

> > > brush off, or

> > > worse, no testing at all. It's irresponsible on the

> > > parts of doctors.

> > > >

> > > > penny

> > > >

> > >

> > >

> > >

> >

> > __________________________________________________________

> > Get the toolbar and be alerted to new email wherever

you're

> surfing.

> > http://new.toolbar./toolbar/features/mail/index.php

> >

>

[Guest guest]

See, what I'm trying to get at that the reporter briefly touched on is why are we worked up enough about this one guy to quarantine him, when so many people have this bug or similar strains? Is it maybe because the CDC isn't telling us something, like these bugs are far more serious than they're letting on and that we've got problems they don't want the public to know about? If that guy weren't related to someone at the CDC, would this have ever become the issue that it has? People are going about their lives on a daily basis carrying the TB bugs, but showing no symptoms, just like Speaker, and none of them have been quarantined since the 60s. So either they know something about his bug they aren't telling us, OR they thought they knew something about this bug which turned out to be a false alarm, OR, somebody at the CDC was looking out for one of his own, and unfortunately the only way to do that was

to let out enough info that it had to go public. Whatever the story, only the surface is being skimmed here, probably to prevent mass hysteria. Whatever it is, something is way off, and the stupid press isn't digging deeper (except for this last guy who at least is on the right track, except for the father-in-law having transmitted it, which is pretty far fetched unless he's a complete idiot). penny Penny Houle <pennyhoule@...> wrote: Now this reporter is asking much more appropriate questions: TB or Not TB: Isn't That the Question? Jordan Safirstein Mon Jun 4, 11:58 AM

ET The only thing more confusing to me than this tuberculosis (TB) fiasco is how I am still the first to use this line for my title. The antagonist in the international bacterial brouhaha is a young personal injury lawyer who either knowingly or unknowingly flew off to his honeymoon in Greece with a multi-drug-resistant strain of TB (MDR-TB). Actually, the Associated Press reported yesterday that he had an even more resistant strain of Mycobacterium tuberculosis, called extremely drug-resistant TB (XDR-TB). Infectious disease is not my specialty but since when did we start assigning diseases cool prefixes that make them sound like luxury cars? We have heard rumors circulating that the 2008 model will be the YF'd-TB? So the story goes that an excited newlywed personal injury lawyer goes to the doctor a few days before his honeymoon and is told that he "has TB." Speaker has also said that he was advised by Fulton County, Ga., health authorities that he was not contagious or a danger to anyone. Officials told him they would prefer he didn't fly, but no one ordered him not to, he said. Let's stop here for a minute. There are really two kinds of "have TB"s. There is the positive PPD test for TB in which your body has formed antibodies to Mycobacterium tuberculosis after you have been exposed to it but you are symptom-free and otherwise healthy, i.e. latent TB (LTB). Then there is the "really have" TB in which you are symptomatic, with clinical manifestations usually associated with the

pulmonary system. Patients typically present with cough, fever, chills, night sweats, weight loss, bloody sputum, anorexia, etc. etc. In this form, one is capable of actively spreading the infection. Many, many Americans, and even more internationals "have TB" in the former sense and a great deal of them are probably unaware as they have never had a PPD test to detect its presence. And if all of those fliers with latent TB were quarantined, it would probably require a holding room the size of Giants Stadium. But very few Americans with dormant TB ever develop the active form of the disease unless they become immunosuppressed, as in the case of patients with HIV/ AIDS or chemotherapy. Moreover, these carriers are not infective to anyone unless the disease becomes active. Lastly, his XDR-TB status does not make his disease any more transmissable than your run-of-the-mill TB -- it is just harder to eradicate. The fact that his new wife and he traveled to Greece makes you think (and hope) that he wasn't hacking up blood-tinged hunks of sputum during his "I do's". Thus, we are making the assumption that Speaker only had the presence of XDR-TB in his blood, making him no different from thousands of other air passengers who travel with latent TB on a daily basis. So what's the big deal? That's what we're trying to figure out. We are guessing all the tumult is a result of him ignoring The Man who told him not to fly. But where did he get such an uncommon strain

of the mycobacteria, that is found much more commonly in Asia and the former Soviet Union? Several reports have claimed that he was exposed when he visited a health clinic last year in Vietnam. We are not disputing that this is a possibility, but it turns out his father-in-law, Cooksey, is a microbiologist for the Centers for Disease Control ( CDC) who actually specialized in TB. [The plot thickens...] The same CDC that initiated Mr. Speaker's quarantine -- the first of a human being since 1968. In medicine, we have a saying that common things happen commonly and if we follow that theory than it seems less likely that one week in Vietnam accounted for his infection than his chronic and long-term exposure to his microbiological father-in-law. This is a bold call but we're betting serious money that the wife's father will be investigated and it will turn out that he, too, has XDR-TB (*cue the Law &

Order dun-dun). Oh yeah, the father-in-law is the source and he is going down for this in the very near future. Or is he? Currently, Speaker is taking up residence in a Denver hospital until he is given the green light to travel again. Perhaps we will find out that he indeed does have active TB infection but that will bring up an entire set of additional questions, like why a young, healthy man in his thirties develops active TB infection in the setting of a normal immune system. (Dun-dun) http://news./s/huffpost/20070604/cm_huffpost/050580 Penny Houle <pennyhoule@...> wrote: What's so strange about this strain of TB? All I can find is that it is resistant to 2 drugs. Omigod! must have come from another planet. Oh wait...that's what all good bacteria do. Adapt, migrate or DIE!!!! Don't buy all the hype, a. penny pjeanneus <pj7@...> wrote: I meant to write that the fiancee does not have TB. Yes, the man has TB. As to how he got it - it is not unusual to get TB in the US - it is very unusual to

get the strain of TB this young, otherwise healthy, upper middle class man has. That is why I wonder if he got it by way of the CDC and perhaps some careless work coming out the door.I don't know, and I don't think we ever will know.a Carnes>> Yes, but 2 million people per year are dying of it. So which seems more absurd to you, the 2 million worldwide or the 2 in the U.S? Are we really that healthy in the U.S? > > It is weird that his father-in-law works at the CDC but not because that's necessarily how he got it. I think it's interesting because obviously he would have a better understanding of how to treat it. Also interesting that his father is a lawyer. I wonder what would be happening if a slightly more average citizen were dealing with this public hazard? Probably facing the lynch mobs. > > Also, newscasters are calling it a "rare" form of TB, which really

irks me. All it is, is a very resistant form of the bacteria. Doesn't make it rare at all. He's just like a lot of us walking around with resistant bacteria and the possibility of spreading it to other susceptible people, but these bugs aren't seen as threatening. Talk about foolish. This resistance is what a few doctors (and the American Academy of Pediatricians) have been trying to warn about, but no-one's listening.> > Also yes, the guy still has a "mass" in his lung but his tests are coming back negative and that makes him "probably not contagious". First off, shows how wrong tests can be. And secondly, it illustrates what usually happens if you have an infection that isn't responding to abx. Surgical removal. This is why you see so many diabetics get their feet amputated (although they often aren't provided with all the treatment available because it's so costly). > > It's also why it's so

frustrating when that infected mass is in your jaw or your sinuses, because you can't amputate those areas & surgical removal is very tricky. The docs/dentists who work on those areas are so undertrained that you wouldn't really want them to try.> > penny> > > > > > jim davis <jimd85379@...> wrote:> Did I miss something, I heard reports that the person> had a mass about the size of a golf ball, that needed> to be cut out. Is there a question, that he has TB?> --- pjeanneus <pj7@...> wrote:> > > If his fiancee wasn't infected why would folks on a> > plane be? Also, > > where did he get the infection???? There have only> > been 2 cases > > diagnosed in the entire US, but father-in-law works> > with TB at the CDC > > in Atlanta. What is wrong with this picture?> >

> > a> > > > > > >> > > Just heard the latest report on the TB patient. 2> > tests have come > > back negative and they're waiting for the 3rd. If it> > is also negative, > > they're saying that he can "probably be considered> > fairly non-> > contagious". > > > > > > Cracks me up. > > > > > > Just shows you that these tests aren't 100% and> > even if you're > > infected you can test negative for a number of> > reasons. People > > shouldn't necessarily believe the first negative> > result they get, > > especially if they've got symptoms. We have to start> > pushing doctors > > for more comprehensive bacterial testing. Not just a> > brush off, or > > worse, no testing at all. It's irresponsible on

the> > parts of doctors.> > > > > > penny> > >> > > > > > > > __________________________________________________________> Get the toolbar and be alerted to new email wherever you're surfing.> http://new.toolbar./toolbar/features/mail/index.php>

[Guest guest]

Yes, but read it all. There's way more to the story than his father-in-law also being a possbile carrier. If he were infectious, then he'd also be quarantined, since it was his own agency which quarantined Speaker. penny pjeanneus <pj7@...> wrote: Thanks, Penny, this is exactly what I was hoping some reporter would look into. a>> Now this reporter is asking much more appropriate questions:> >

> TB or Not TB: Isn't That the Question? > Jordan Safirstein > Mon Jun 4, 11:58 AM ET> > The only thing more confusing to me than this tuberculosis (TB) fiasco is how I am still the first to use this line for my title. The antagonist in the international bacterial brouhaha is a young personal injury lawyer who either knowingly or unknowingly flew off to his honeymoon in Greece with a multi-drug-resistant strain of TB (MDR-TB). Actually, the Associated Press reported yesterday that he had an even more resistant strain of Mycobacterium tuberculosis, called extremely drug-resistant TB (XDR-TB). Infectious disease is not my specialty but since when did we start assigning diseases cool prefixes that make them sound like luxury cars? We have heard rumors circulating that the 2008 model will be the YF'd-TB? > if(window.yzq_d==null)window.yzq_d=new Object();

window.yzq_d['lXNBDtGDJHY-']=' & U=13bmpsc7e%2fN%3dlXNBDtGDJHY-%2fC%3d571921.10592332.11211305.1442997%2fD%3dLREC%2fB%3d4495406'; > So the story goes that an excited newlywed personal injury lawyer goes to the doctor a few days before his honeymoon and is told that he "has TB." Speaker has also said that he was advised by Fulton County, Ga., health authorities that he was not contagious or a danger to anyone. Officials told him they would prefer he didn't fly, but no one ordered him not to, he said.> > Let's stop here for a minute. There are really two kinds of "have TB"s. There is the positive PPD test for TB in which your body has formed antibodies to Mycobacterium tuberculosis after you have been exposed to it but you are symptom-free and otherwise healthy, i.e. latent TB (LTB). Then there is the "really have" TB in which you are symptomatic, with clinical

manifestations usually associated with the pulmonary system. Patients typically present with cough, fever, chills, night sweats, weight loss, bloody sputum, anorexia, etc. etc. In this form, one is capable of actively spreading the infection.> > Many, many Americans, and even more internationals "have TB" in the former sense and a great deal of them are probably unaware as they have never had a PPD test to detect its presence. And if all of those fliers with latent TB were quarantined, it would probably require a holding room the size of Giants Stadium. But very few Americans with dormant TB ever develop the active form of the disease unless they become immunosuppressed, as in the case of patients with HIV/ AIDS or chemotherapy. Moreover, these carriers are not infective to anyone unless the disease becomes active. Lastly, his XDR-TB status does not make his disease any more transmissable than your

run-of-the-mill TB -- it is just harder to eradicate.> The fact that his new wife and he traveled to Greece makes you think (and hope) that he wasn't hacking up blood-tinged hunks of sputum during his "I do's". Thus, we are making the assumption that Speaker only had the presence of XDR-TB in his blood, making him no different from thousands of other air passengers who travel with latent TB on a daily basis. So what's the big deal? That's what we're trying to figure out. We are guessing all the tumult is a result of him ignoring The Man who told him not to fly.> > But where did he get such an uncommon strain of the mycobacteria, that is found much more commonly in Asia and the former Soviet Union? Several reports have claimed that he was exposed when he visited a health clinic last year in Vietnam. We are not disputing that this is a possibility, but it turns out his father-in-law, Cooksey, is

a microbiologist for the Centers for Disease Control ( CDC) who actually specialized in TB. [The plot thickens...] The same CDC that initiated Mr. Speaker's quarantine -- the first of a human being since 1968. In medicine, we have a saying that common things happen commonly and if we follow that theory than it seems less likely that one week in Vietnam accounted for his infection than his chronic and long-term exposure to his microbiological father-in-law.> > This is a bold call but we're betting serious money that the wife's father will be investigated and it will turn out that he, too, has XDR-TB (*cue the Law & Order dun-dun). Oh yeah, the father-in-law is the source and he is going down for this in the very near future. Or is he?> Currently, Speaker is taking up residence in a Denver hospital until he is given the green light to travel again. Perhaps we will find out that he indeed does have

active TB infection but that will bring up an entire set of additional questions, like why a young, healthy man in his thirties develops active TB infection in the setting of a normal immune system. (Dun-dun)> > http://news./s/huffpost/20070604/cm_huffpost/050580> > > > Penny Houle <pennyhoule@...> wrote:> What's so strange about this strain of TB? All I can find is that it is resistant to 2 drugs. Omigod! must have come from another planet. Oh wait...that's what all good bacteria do. Adapt, migrate or DIE!!!! > > Don't buy all the hype, a.> > penny> > > pjeanneus <pj7@...> wrote:> I meant to write that the fiancee does not have TB. Yes, the man has > TB. As to how he got it - it is not unusual to get

TB in the US - it > is very unusual to get the strain of TB this young, otherwise > healthy, upper middle class man has. That is why I wonder if he got > it by way of the CDC and perhaps some careless work coming out the > door.> > I don't know, and I don't think we ever will know.> > a Carnes> > >> > Yes, but 2 million people per year are dying of it. So which seems > more absurd to you, the 2 million worldwide or the 2 in the U.S? Are > we really that healthy in the U.S? > > > > It is weird that his father-in-law works at the CDC but not > because that's necessarily how he got it. I think it's interesting > because obviously he would have a better understanding of how to > treat it. Also interesting that his father is a lawyer. I wonder what > would be happening if a slightly more average citizen were dealing

> with this public hazard? Probably facing the lynch mobs. > > > > Also, newscasters are calling it a "rare" form of TB, which > really irks me. All it is, is a very resistant form of the bacteria. > Doesn't make it rare at all. He's just like a lot of us walking > around with resistant bacteria and the possibility of spreading it to > other susceptible people, but these bugs aren't seen as threatening. > Talk about foolish. This resistance is what a few doctors (and the > American Academy of Pediatricians) have been trying to warn about, > but no-one's listening.> > > > Also yes, the guy still has a "mass" in his lung but his tests > are coming back negative and that makes him "probably not > contagious". First off, shows how wrong tests can be. And secondly, > it illustrates what usually happens if you have an infection that > isn't

responding to abx. Surgical removal. This is why you see so > many diabetics get their feet amputated (although they often aren't > provided with all the treatment available because it's so costly). > > > > It's also why it's so frustrating when that infected mass is in > your jaw or your sinuses, because you can't amputate those areas & > surgical removal is very tricky. The docs/dentists who work on those > areas are so undertrained that you wouldn't really want them to try.> > > > penny> > > > > > > > > > > > jim davis <jimd85379@> wrote:> > Did I miss something, I heard reports that the person> > had a mass about the size of a golf ball, that needed> > to be cut out. Is there a question, that he has TB?> > --- pjeanneus <pj7@> wrote:> > > > > If his

fiancee wasn't infected why would folks on a> > > plane be? Also, > > > where did he get the infection???? There have only> > > been 2 cases > > > diagnosed in the entire US, but father-in-law works> > > with TB at the CDC > > > in Atlanta. What is wrong with this picture?> > > > > > a> > > > > > > > > >> > > > Just heard the latest report on the TB patient. 2> > > tests have come > > > back negative and they're waiting for the 3rd. If it> > > is also negative, > > > they're saying that he can "probably be considered> > > fairly non-> > > contagious". > > > > > > > > Cracks me up. > > > > > > > > Just shows you that these tests aren't 100% and> > > even

if you're > > > infected you can test negative for a number of> > > reasons. People > > > shouldn't necessarily believe the first negative> > > result they get, > > > especially if they've got symptoms. We have to start> > > pushing doctors > > > for more comprehensive bacterial testing. Not just a> > > brush off, or > > > worse, no testing at all. It's irresponsible on the> > > parts of doctors.> > > > > > > > penny> > > >> > > > > > > > > > > > > __________________________________________________________> > Get the toolbar and be alerted to new email wherever you're > surfing.> > http://new.toolbar./toolbar/features/mail/index.php> >>

[Guest guest]

Does the father have to be infected to have carried it home? The

daughter doesn't have it. I read somewhere the young man who is

infected got it in Vietnam. I'm just curious and don't trust the

government at all anymore.

a

>

> Yes, but read it all. There's way more to the story than his father-

in-law also being a possbile carrier. If he were infectious, then

he'd also be quarantined, since it was his own agency which

quarantined Speaker.

>

> penny

>

>

>

> pjeanneus <pj7@...> wrote:

> Thanks, Penny, this is exactly what I was hoping some

reporter would

> look into.

>

> a

>

> >

> > Now this reporter is asking much more appropriate questions:

> >

> >

> > TB or Not TB: Isn't That the Question?

> > Jordan Safirstein

> > Mon Jun 4, 11:58 AM ET

> >

> > The only thing more confusing to me than this tuberculosis (TB)

> fiasco is how I am still the first to use this line for my title.

The

> antagonist in the international bacterial brouhaha is a young

> personal injury lawyer who either knowingly or unknowingly flew off

> to his honeymoon in Greece with a multi-drug-resistant strain of TB

> (MDR-TB). Actually, the Associated Press reported yesterday that he

> had an even more resistant strain of Mycobacterium tuberculosis,

> called extremely drug-resistant TB (XDR-TB). Infectious disease is

> not my specialty but since when did we start assigning diseases

cool

> prefixes that make them sound like luxury cars? We have heard

rumors

> circulating that the 2008 model will be the YF'd-TB?

> > if(window.yzq_d==null)window.yzq_d=new Object(); window.yzq_d

> ['lXNBDtGDJHY-']=' & U=13bmpsc7e%2fN%3dlXNBDtGDJHY-%2fC%

> 3d571921.10592332.11211305.1442997%2fD%3dLREC%2fB%3d4495406';

> > So the story goes that an excited newlywed personal injury lawyer

> goes to the doctor a few days before his honeymoon and is told that

> he " has TB. " Speaker has also said that he was advised by Fulton

> County, Ga., health authorities that he was not contagious or a

> danger to anyone. Officials told him they would prefer he didn't

fly,

> but no one ordered him not to, he said.

> >

> > Let's stop here for a minute. There are really two kinds of " have

> TB " s. There is the positive PPD test for TB in which your body has

> formed antibodies to Mycobacterium tuberculosis after you have been

> exposed to it but you are symptom-free and otherwise healthy, i.e.

> latent TB (LTB). Then there is the " really have " TB in which you

are

> symptomatic, with clinical manifestations usually associated with

the

> pulmonary system. Patients typically present with cough, fever,

> chills, night sweats, weight loss, bloody sputum, anorexia, etc.

etc.

> In this form, one is capable of actively spreading the infection.

> >

> > Many, many Americans, and even more internationals " have TB " in

> the former sense and a great deal of them are probably unaware as

> they have never had a PPD test to detect its presence. And if all

of

> those fliers with latent TB were quarantined, it would probably

> require a holding room the size of Giants Stadium. But very few

> Americans with dormant TB ever develop the active form of the

disease

> unless they become immunosuppressed, as in the case of patients

with

> HIV/ AIDS or chemotherapy. Moreover, these carriers are not

infective

> to anyone unless the disease becomes active. Lastly, his XDR-TB

> status does not make his disease any more transmissable than your

run-

> of-the-mill TB -- it is just harder to eradicate.

> > The fact that his new wife and he traveled to Greece makes you

> think (and hope) that he wasn't hacking up blood-tinged hunks of

> sputum during his " I do's " . Thus, we are making the assumption that

> Speaker only had the presence of XDR-TB in his blood, making him no

> different from thousands of other air passengers who travel with

> latent TB on a daily basis. So what's the big deal? That's what

we're

> trying to figure out. We are guessing all the tumult is a result of

> him ignoring The Man who told him not to fly.

> >

> > But where did he get such an uncommon strain of the mycobacteria,

> that is found much more commonly in Asia and the former Soviet

Union?

> Several reports have claimed that he was exposed when he visited a

> health clinic last year in Vietnam. We are not disputing that this

is

> a possibility, but it turns out his father-in-law, Cooksey,

is

> a microbiologist for the Centers for Disease Control ( CDC) who

> actually specialized in TB. [The plot thickens...] The same CDC

that

> initiated Mr. Speaker's quarantine -- the first of a human being

> since 1968. In medicine, we have a saying that common things happen

> commonly and if we follow that theory than it seems less likely

that

> one week in Vietnam accounted for his infection than his chronic

and

> long-term exposure to his microbiological father-in-law.

> >

> > This is a bold call but we're betting serious money that the

> wife's father will be investigated and it will turn out that he,

too,

> has XDR-TB (*cue the Law & Order dun-dun). Oh yeah, the father-in-

law

> is the source and he is going down for this in the very near

future.

> Or is he?

> > Currently, Speaker is taking up residence in a Denver hospital

> until he is given the green light to travel again. Perhaps we will

> find out that he indeed does have active TB infection but that will

> bring up an entire set of additional questions, like why a young,

> healthy man in his thirties develops active TB infection in the

> setting of a normal immune system. (Dun-dun)

> >

> > http://news./s/huffpost/20070604/cm_huffpost/050580

> >

> >

> >

> > Penny Houle <pennyhoule@> wrote:

> > What's so strange about this strain of TB? All I can

> find is that it is resistant to 2 drugs. Omigod! must have come

from

> another planet. Oh wait...that's what all good bacteria do. Adapt,

> migrate or DIE!!!!

> >

> > Don't buy all the hype, a.

> >

> > penny

> >

> >

> > pjeanneus <pj7@> wrote:

> > I meant to write that the fiancee does not have TB. Yes, the

> man has

> > TB. As to how he got it - it is not unusual to get TB in the US -

> it

> > is very unusual to get the strain of TB this young, otherwise

> > healthy, upper middle class man has. That is why I wonder if he

got

> > it by way of the CDC and perhaps some careless work coming out

the

> > door.

> >

> > I don't know, and I don't think we ever will know.

> >

> > a Carnes

> >

> > >

> > > Yes, but 2 million people per year are dying of it. So which

> seems

> > more absurd to you, the 2 million worldwide or the 2 in the U.S?

> Are

> > we really that healthy in the U.S?

> > >

> > > It is weird that his father-in-law works at the CDC but not

> > because that's necessarily how he got it. I think it's

interesting

> > because obviously he would have a better understanding of how to

> > treat it. Also interesting that his father is a lawyer. I wonder

> what

> > would be happening if a slightly more average citizen were

dealing

> > with this public hazard? Probably facing the lynch mobs.

> > >

> > > Also, newscasters are calling it a " rare " form of TB, which

> > really irks me. All it is, is a very resistant form of the

> bacteria.

> > Doesn't make it rare at all. He's just like a lot of us walking

> > around with resistant bacteria and the possibility of spreading

it

> to

> > other susceptible people, but these bugs aren't seen as

> threatening.

> > Talk about foolish. This resistance is what a few doctors (and

the

> > American Academy of Pediatricians) have been trying to warn

about,

> > but no-one's listening.

> > >

> > > Also yes, the guy still has a " mass " in his lung but his tests

> > are coming back negative and that makes him " probably not

> > contagious " . First off, shows how wrong tests can be. And

secondly,

> > it illustrates what usually happens if you have an infection that

> > isn't responding to abx. Surgical removal. This is why you see so

> > many diabetics get their feet amputated (although they often

aren't

> > provided with all the treatment available because it's so

costly).

> > >

> > > It's also why it's so frustrating when that infected mass is in

> > your jaw or your sinuses, because you can't amputate those areas

&

> > surgical removal is very tricky. The docs/dentists who work on

> those

> > areas are so undertrained that you wouldn't really want them to

try.

> > >

> > > penny

> > >

> > >

> > >

> > >

> > >

> > > jim davis <jimd85379@> wrote:

> > > Did I miss something, I heard reports that the person

> > > had a mass about the size of a golf ball, that needed

> > > to be cut out. Is there a question, that he has TB?

> > > --- pjeanneus <pj7@> wrote:

> > >

> > > > If his fiancee wasn't infected why would folks on a

> > > > plane be? Also,

> > > > where did he get the infection???? There have only

> > > > been 2 cases

> > > > diagnosed in the entire US, but father-in-law works

> > > > with TB at the CDC

> > > > in Atlanta. What is wrong with this picture?

> > > >

> > > > a

> > > >

> > > >

> > > > >

> > > > > Just heard the latest report on the TB patient. 2

> > > > tests have come

> > > > back negative and they're waiting for the 3rd. If it

> > > > is also negative,

> > > > they're saying that he can " probably be considered

> > > > fairly non-

> > > > contagious " .

> > > > >

> > > > > Cracks me up.

> > > > >

> > > > > Just shows you that these tests aren't 100% and

> > > > even if you're

> > > > infected you can test negative for a number of

> > > > reasons. People

> > > > shouldn't necessarily believe the first negative

> > > > result they get,

> > > > especially if they've got symptoms. We have to start

> > > > pushing doctors

> > > > for more comprehensive bacterial testing. Not just a

> > > > brush off, or

> > > > worse, no testing at all. It's irresponsible on the

> > > > parts of doctors.

> > > > >

> > > > > penny

> > > > >

> > > >

> > > >

> > > >

> > >

> > > __________________________________________________________

> > > Get the toolbar and be alerted to new email wherever

> you're

> > surfing.

> > > http://new.toolbar./toolbar/features/mail/index.php

> > >

> >

>

[Guest guest]

I believe the guy knew in January that he had TB.

These tests take weeks to get back. Plus DNA test on

the bug should tell us just where it came from.

--- pjeanneus <pj7@...> wrote:

> Does the father have to be infected to have carried

> it home? The

> daughter doesn't have it. I read somewhere the young

> man who is

> infected got it in Vietnam. I'm just curious and

> don't trust the

> government at all anymore.

>

> a

>

>

> >

> > Yes, but read it all. There's way more to the

> story than his father-

> in-law also being a possbile carrier. If he were

> infectious, then

> he'd also be quarantined, since it was his own

> agency which

> quarantined Speaker.

> >

> > penny

> >

> >

> >

> > pjeanneus <pj7@...> wrote:

> > Thanks, Penny, this is exactly what I

> was hoping some

> reporter would

> > look into.

> >

> > a

> >

> > >

> > > Now this reporter is asking much more

> appropriate questions:

> > >

> > >

> > > TB or Not TB: Isn't That the Question?

> > > Jordan Safirstein

> > > Mon Jun 4, 11:58 AM ET

> > >

> > > The only thing more confusing to me than this

> tuberculosis (TB)

> > fiasco is how I am still the first to use this

> line for my title.

> The

> > antagonist in the international bacterial brouhaha

> is a young

> > personal injury lawyer who either knowingly or

> unknowingly flew off

> > to his honeymoon in Greece with a

> multi-drug-resistant strain of TB

> > (MDR-TB). Actually, the Associated Press reported

> yesterday that he

> > had an even more resistant strain of Mycobacterium

> tuberculosis,

> > called extremely drug-resistant TB (XDR-TB).

> Infectious disease is

> > not my specialty but since when did we start

> assigning diseases

> cool

> > prefixes that make them sound like luxury cars? We

> have heard

> rumors

> > circulating that the 2008 model will be the

> YF'd-TB?

> > > if(window.yzq_d==null)window.yzq_d=new Object();

> window.yzq_d

> >

>

['lXNBDtGDJHY-']=' & U=13bmpsc7e%2fN%3dlXNBDtGDJHY-%2fC%

> >

>

3d571921.10592332.11211305.1442997%2fD%3dLREC%2fB%3d4495406';

>

> > > So the story goes that an excited newlywed

> personal injury lawyer

> > goes to the doctor a few days before his honeymoon

> and is told that

> > he " has TB. " Speaker has also said that he was

> advised by Fulton

> > County, Ga., health authorities that he was not

> contagious or a

> > danger to anyone. Officials told him they would

> prefer he didn't

> fly,

> > but no one ordered him not to, he said.

> > >

> > > Let's stop here for a minute. There are really

> two kinds of " have

> > TB " s. There is the positive PPD test for TB in

> which your body has

> > formed antibodies to Mycobacterium tuberculosis

> after you have been

> > exposed to it but you are symptom-free and

> otherwise healthy, i.e.

> > latent TB (LTB). Then there is the " really have "

> TB in which you

> are

> > symptomatic, with clinical manifestations usually

> associated with

> the

> > pulmonary system. Patients typically present with

> cough, fever,

> > chills, night sweats, weight loss, bloody sputum,

> anorexia, etc.

> etc.

> > In this form, one is capable of actively spreading

> the infection.

> > >

> > > Many, many Americans, and even more

> internationals " have TB " in

> > the former sense and a great deal of them are

> probably unaware as

> > they have never had a PPD test to detect its

> presence. And if all

> of

> > those fliers with latent TB were quarantined, it

> would probably

> > require a holding room the size of Giants Stadium.

> But very few

> > Americans with dormant TB ever develop the active

> form of the

> disease

> > unless they become immunosuppressed, as in the

> case of patients

> with

> > HIV/ AIDS or chemotherapy. Moreover, these

> carriers are not

> infective

> > to anyone unless the disease becomes active.

> Lastly, his XDR-TB

> > status does not make his disease any more

> transmissable than your

> run-

> > of-the-mill TB -- it is just harder to eradicate.

> > > The fact that his new wife and he traveled to

> Greece makes you

> > think (and hope) that he wasn't hacking up

> blood-tinged hunks of

> > sputum during his " I do's " . Thus, we are making

> the assumption that

> > Speaker only had the presence of XDR-TB in his

> blood, making him no

> > different from thousands of other air passengers

> who travel with

> > latent TB on a daily basis. So what's the big

> deal? That's what

> we're

> > trying to figure out. We are guessing all the

> tumult is a result of

> > him ignoring The Man who told him not to fly.

> > >

> > > But where did he get such an uncommon strain of

> the mycobacteria,

> > that is found much more commonly in Asia and the

> former Soviet

> Union?

> > Several reports have claimed that he was exposed

> when he visited a

> > health clinic last year in Vietnam. We are not

> disputing that this

> is

> > a possibility, but it turns out his father-in-law,

> Cooksey,

> is

> > a microbiologist for the Centers for Disease

> Control ( CDC) who

> > actually specialized in TB. [The plot thickens...]

> The same CDC

> that

> > initiated Mr. Speaker's quarantine -- the first of

> a human being

> > since 1968. In medicine, we have a saying that

> common things happen

> > commonly and if we follow that theory than it

> seems less likely

> that

> > one week in Vietnam accounted for his infection

> than his chronic

> and

> > long-term exposure to his microbiological

> father-in-law.

> > >

> > > This is a bold call but we're betting serious

> money that the

> > wife's father will be investigated and it will

> turn out that he,

> too,

> > has XDR-TB (*cue the Law & Order dun-dun). Oh

> yeah, the father-in-

> law

> > is the source and he is going down for this in the

> very near

> future.

> > Or is he?

> > > Currently, Speaker is taking up residence in a

> Denver hospital

> > until he is given the green light to travel again.

> Perhaps we will

> > find out that he indeed does have active TB

> infection but that will

> > bring up an entire set of additional questions,

> like

=== message truncated ===

________________________________________________________________________________\

____

Fussy? Opinionated? Impossible to please? Perfect. Join 's user panel and

lay it on us. http://surveylink./gmrs/_panel_invite.asp?a=7

[Guest guest]

> that will bring up an entire set of additional questions, like why a

young, healthy man in his thirties develops active TB infection in the

setting of a normal immune system. (Dun-dun)

There's not much of a question there. TB is a virulent agent.

Otherwise-healthy people in their 30s have been dying of it like flies

for ages.

[Guest guest]

The textbook information (caveat lector!) is that you need to be

actively ill to transmit it. If you are latently infected with TB you

cannot spread it. I'm sure this is at least generally true; what I'm

not sure of is whether there could ever be any exception.

> Does the father have to be infected to have carried it home? The

> daughter doesn't have it. I read somewhere the young man who is

> infected got it in Vietnam. I'm just curious and don't trust the

> government at all anymore.

>

> a

[Guest guest]

The reason they are worried about it is because it's highly drug

resistant TB. We don't have that here and we don't want it. If you end

up getting a TB so resistant that it can't be eradicated, people have

to have expensive surgeries, complex supervised treatments, and may

die anyway. People in poor countries get these hyperresistant TBs a

lot, and they die like it's 1925 and streptomycin was never invented.

Without the drugs there's not much you can do. The CDC does not want

this to happen in the USA.

Whereas, if you or I went to Africa and came back with ordinary TB

(which happens), it would be vaporized by INH and rifampin within a

few months. The total cost would be a few thousand bucks and the odds

of cure would be 99.9%, assuming you comply with therapy. Not a problem.

> See, what I'm trying to get at that the reporter briefly touched on

is why are we worked up enough about this one guy to quarantine him,

when so many people have this bug or similar strains? Is it maybe

because the CDC isn't telling us something, like these bugs are far

more serious than they're letting on and that we've got problems they

don't want the public to know about?

[Guest guest]

I think this is probably incredibly naive to believe that we don't have a lot more cases of this "highly resistant" form of TB being carried around here. Especially considering it's a lot more common in Asia, with it's bazillion people who travel to the U.S. all the time. This guy isn't even sick, so how many others just like him are walking around, flying on airplanes, etc? Maybe the upside is that fear of a more resistant TB outbreak will force more research and better antimicrobial treatments that bugs can't develop resistance to so easily. penny <usenethod@...> wrote: The reason they are worried about it is because it's highly drugresistant TB. We don't have that here and we don't want it. If you endup getting a TB so resistant that it can't be eradicated, people haveto have expensive surgeries, complex supervised treatments, and maydie anyway. People in poor countries get these hyperresistant TBs alot, and they die like it's 1925 and streptomycin was never invented.Without the drugs there's not much you can do. The CDC does not wantthis to happen in the USA. Whereas, if you or I went to Africa and came back with ordinary TB(which happens), it would be vaporized by INH and rifampin within afew months. The total cost would be a few thousand bucks and the oddsof cure would be 99.9%, assuming you comply

with therapy. Not a problem.> See, what I'm trying to get at that the reporter briefly touched onis why are we worked up enough about this one guy to quarantine him,when so many people have this bug or similar strains? Is it maybebecause the CDC isn't telling us something, like these bugs are farmore serious than they're letting on and that we've got problems theydon't want the public to know about?