"We need to rely on people to do the right thing" when they have TB and fear for their lives

May 30, 2007 4:20 PM

An Atlanta man caused the U.S. government to issue its first quarantine order since 1963 this weekend, knowingly exposing as many as 107 passengers on two transatlantic flights to a rare, "extensively drug-resistant" form of tuberculosis. "It's regretful that we weren't able to stop that," the CDC's Dr. Martin Cetron said of how the man fled when U.S. health officials tracked him down in Rome and told him not to get on an airplane.
posted by rkent (109 comments total)

Fortunately the guy is feeling OK and is probably a low infection risk, but he felt it necessary to become an intercontinental vector of disease because "he was afraid that if he didn't get back to the U.S., he wouldn't get the treatment he needed to survive." (from the mail.com link). Wonder where he got that idea?
posted by rkent at 4:20 PM on May 30, 2007

Also of note is the previous thread on an XDR-TB infected man in quarantine in AZ.
posted by docgonzo at 4:30 PM on May 30, 2007

As someone who has been very very ill overseas and ended up having a far worse illness due to the quality of health care available to me, I'm thinking his concerns about receiving proper medical attention probably don't have much to do with what you're alluding to.

That said, he was a jerk to put so many people at risk.
posted by miss lynnster at 4:36 PM on May 30, 2007

Odd, the first post suggests that he didn't understand how ill he was, and the second says the opposite. *scratches head*

Medically, this is interesting. The man was "strongly suggested" that he not fly - it doesn't seem like those "suggestions" did much good. Doctors can "suggest" whatever they want, but there are still people who, for whatever reason, refuse treatment all the time. It seems to me like instead of cracking down on "terror," it would make more sense to have a medical-based "no-fly" list for people with drug resistant TB or anthrax or the black death or whatever. Far fewer people to keep track of, for sure, and much harder to get accidentally placed on the list because your parents named you Afghan McPakistani.

Of course, that would raise a whole can of worms in itself WRT doctor/patient confidentiality. (In the same realm of why in terms of disease control, it would make sense to have mandatory reporting to previous partners of HIV+ patients, whereas in terms of privacy rights, it's intrusive and just not possible.) Where exactly do you draw the line between respecting privacy and recognizing a broader health risk? If 52 out of 53 patients with drug resistant TB die from the infection, is it better for public safety to start treatment in isolation from the time of diagnosis rather than let the patient wander around with the "suggestion" that they not travel?
posted by grapefruitmoon at 4:36 PM on May 30, 2007

he was afraid that if he didn't get back to the U.S., he wouldn't get the treatment he needed to survive.

So his logic was, possible pandemic or me. I pick me.

Sounds like a dick move on his part.
posted by Mr_Zero at 4:38 PM on May 30, 2007

"I'm a very well-educated, successful, intelligent person," he told the paper. "This is insane to me that I have an armed guard outside my door when I've cooperated with everything other than the whole solitary-confinement-in-Italy thing."

Christ, what an asshole.
posted by oneirodynia at 4:40 PM on May 30, 2007 [8 favorites has favorites]

According the the NYT: “I’m a very well-educated, successful, intelligent person,” the man, who declined to give his name, was quoted in the newspaper interview as saying. “This is insane to me, that I have an armed guard outside my door, when I’ve cooperated with everything other than the whole solitary-confinement-in-Italy thing.”

If my doctor told me I had TB, and really shouldn't travel, I would use my education, success, and intelligence to take that advice. Jesus.
posted by rtha at 4:40 PM on May 30, 2007 [1 favorite has favorites]

miss lynnster: While the guy may be a jerk, I'm wondering if he really knew the risk involved. If it were "strongly suggested" that he not travel, he might not have really understood that rather than being a mere bad idea, that it was the WORST IDEA EVER. Maybe he's thick in the head or maybe the "suggestion" wasn't properly communicated to him.

(I'm willing to go with the jerk theory on the angle that he was travelling for his honeymoon. Who does that? Who goes on their HONEYMOON when they've just been diagnosed with TB? I know these things take a lot of preparation, but shouldn't you be happy and joyous and not going in for medical tests? Also, TB is significantly less than sexy. Most of the time.)
posted by grapefruitmoon at 4:41 PM on May 30, 2007 [1 favorite has favorites]

Oh. Way to read.

The man told the newspaper he was aware he was placed on a no-fly list in the United States after his recent diagnosis with XDR TB, which is why he decided to fly into Canada.

Smooth, self. Just smooth.

All words about a no-fly list are hearby eaten.
posted by grapefruitmoon at 4:42 PM on May 30, 2007

I heard an interview about this on NPR yesterday. A rep from the WHO alluded several times to the fact that they had been trying to get alternate transportation for him back to the US when he flew out. She also said that they'd been notified about him, had notified various countries about him, and put him on the US no-fly list.
posted by boo_radley at 4:50 PM on May 30, 2007

Selfish prick. Think of all the ground he covered. Fingers crossed that low infection risk thing is accurate.

I guess I can understand how a fella might freak out about catching an incurable disease. But why do I get the feeling that he figured being very well-educated, successful and intelligent exempted him from doing the right thing?
posted by EatTheWeak at 4:50 PM on May 30, 2007 [1 favorite has favorites]

Or, as Mr_Zero said : Dick move!
posted by boo_radley at 4:51 PM on May 30, 2007

Apparently he was traveling to Greece for his own wedding.

My, what a lucky gal to have him.
posted by bardic at 4:54 PM on May 30, 2007

Get a rope!
posted by mrnutty at 4:56 PM on May 30, 2007

The problem with public health is that people want Mercedes-level surveillance and prevention, and they think that it shouldn't cost more than a high mileage 1991 Hyundai Excel.

You get what you pay for. In this case, TB.
posted by dw at 4:56 PM on May 30, 2007 [1 favorite has favorites]

I hope he gets jailtime. So far he's:

1. Gotten TB and was told to stay in Italy until he got better.
2. Said "fuck you, i have a wedding to go to."
3. Was told "no, youre not flying into the US"
4. Said "fuck you, im flying to canada and driving in.

And now CDC is looking for all the passengers who set next to him. Somewhere some kid is going to get TB from this guy, die, and then I will finally see the logic in the death penalty.
posted by damn dirty ape at 5:02 PM on May 30, 2007 [2 favorites has favorites]

What a spectacle. The lesson I take from this is, obviously, that when the doctors give you advice, you should treat it as an order. Christ, the docs they had on TV today had military uniforms and all. And, uh, isolation never did anyone any harm anyway.
posted by nervousfritz at 5:03 PM on May 30, 2007

1. Gotten TB and was told to stay in Italy until he got better.
2. Said "fuck you, i have a wedding to go to."
3. Was told "no, youre not flying into the US"
4. Said "fuck you, im flying to canada and driving in.

And given that the US has abandoned the concept of providing a home to the free, I highly doubt Italy would put up with his self righteous behavior either. . .
posted by nervousfritz at 5:05 PM on May 30, 2007

Somewhere some kid is going to get TB from this guy, die, and then I will finally see the logic in the death penalty.
posted by damn dirty ape at 8:02 PM on May 30

*leaps up and down, screeches hoots and gibbers*
posted by quonsar at 5:07 PM on May 30, 2007 [1 favorite has favorites]

I've had doctors tell me I *should* weigh (as an adult woman) what I weighed when I was 10. I have laughed at these silly, silly doctors and their crazy concept of BMI.

But I have never taken a doctor's diagnosis of frickin' TB and said "oooh, I know, I'll go make the Grand Tour of Europe." Damn. I didn't leave the house (except for doctor's appointments) for more than a month this winter when I got a staph infection in a surgical wound, for fear of spreading it around.
posted by bitter-girl.com at 5:08 PM on May 30, 2007

So, this no-fly list, is it actually any good for identifying people and stoping them flying?
posted by Artw at 5:10 PM on May 30, 2007 [3 favorites has favorites]

Oh, staph! That reminds me. I was once quarantined in an Icelandic emergency room for the simple health-risk of being an American. They don't have staph over there and my presence in an environment of people with open wounds and lowered immune systems was seen as a danger, so I was put into isolation with a huge sign on the door directing visitors to wash their hands with ALCOHOL before and after leaving the room, and all doctors and nurses were wearing face masks, gloves, and orange gowns while in the room.

My illness? Epilepsy. I was hardly harking up sputum anywhere, and yet my mere breathing was seen as a hazard.

They swabbed me for staph while I was there, and no, I'm not a carrier.

Why Iceland can do this for being foreign and the US can't do the same for having FRIGGIN TUBERCUFUCKINGLOSIS is beyond me.

(Iceland also has better hospital food. I got toast with cheese and it was a fine snack.)
posted by grapefruitmoon at 5:14 PM on May 30, 2007

The next time I find a dying child in my yard that some irresponsible motherfucker's TB killed because the irrresponsible motherfucker thinks that XDR TB should be allowed to roam around the planet, I am going to kill the fucking TB and the irresponsible motherfucking cunt who's carrying it.
posted by BeerFilter at 5:14 PM on May 30, 2007 [1 favorite has favorites]

So, this no-fly list, is it actually any good for identifying people and stoping them flying?

Only if Ted Kennedy catches TB.
posted by bitter-girl.com at 5:14 PM on May 30, 2007 [1 favorite has favorites]

Considering he chose to bypass security measures taken to prevent his flying into the US with a potentially lethal disease, wouldn't that make him a "terrorist"?

At the very least, a charge of reckless endangerment seems appropriate.
posted by JaredSeth at 5:15 PM on May 30, 2007

I see but one solution. Nuke Italy from orbit.
posted by Kattullus at 5:16 PM on May 30, 2007

Note that they didn't know it was the scary XDR kind when they "suggested" he not fly.
posted by smackfu at 5:18 PM on May 30, 2007

Kattullus: eponysterical.
posted by boo_radley at 5:20 PM on May 30, 2007 [1 favorite has favorites]

Drug-resistant staph infections have spread to the urban poor, rising almost seven-fold in recent years in some Chicago neighborhoods, a new study finds.
posted by homunculus at 5:22 PM on May 30, 2007

You Can’t Stop Bullets With a Butterfly Net
posted by homunculus at 5:23 PM on May 30, 2007

if you told you where going to die if you dont get the right treatment, wouldnt you fly back to the US as fast as you can? Ya, most of you would.
posted by IronWolve at 5:25 PM on May 30, 2007

IronWolve: if you told you where going to die if you dont get the right treatment, wouldnt you fly back to the US as fast as you can? Ya, most of you would.

Actually, I wouldn't:

As far as health care is concerned, Italy ranks among the World Health Organization's top 10 countries for quality health care services (by contrast, the U.S. only holds 37th place, despite being the highest spender.)

Basically, it would have probably been more expensive for him to stay in Italy (if you aren't part of the health care system, you are expected to pay), but his treatment would have been better over there.
posted by Joey Michaels at 5:30 PM on May 30, 2007

Iceland doesn't have staph at ALL, grapefruitmoon? Seriously? This casts some pretty wicked doubt on some of the things I was told by the doc who operated on me...hmm.
posted by bitter-girl.com at 5:31 PM on May 30, 2007

Don't worry. Punishment will not be long in coming. For every American sitting on the plane within 40 rows of this guy, or even anyone who was at the same airport, there should be around 27 lawyers flailing their arms and whooping with glee, chasing the gravy train.

I hope this particular infectious newlywed registered at Corks 'R Us, cuz he's gonna need to keep his asshole airtight to keep the forthcoming gang of predatory lawyers from crawling up in there and camping out. And if he's not rich enough, I'm sure the doctors, hospitals, and CDC will be ample targets.

Ugh. Knowing how the DHS' thought process works, this doesn't bode well for those of us who need to fly to get to any other state...
posted by krippledkonscious at 5:34 PM on May 30, 2007

I hope he gets jailtime.

Er, he didn't break any laws. From the Forbes piece:

Still, the man didn't violate any laws and faces no charges, CDC said.

"There's a whole body of public health law that's going to be closely scrutinized and redefined with this case," said Michael Osterholm, an infectious disease expert who advises the government. "It's going to be looking back at what do you do when you have a non-compliant carrier of some infectious agent that is border-hopping?"

And, you know, I'm gonna side with rkent and maybe go a little further: I sympathize with the guy, probably not least because we don't know the whole story yet, but mainly because I find it easy to imagine U.S. health and travel bureaucrats fucking this up and giving him good reason to think they were going to keep him out of the country for good.

I'd come home, too.
posted by mediareport at 5:34 PM on May 30, 2007

NBC Nightly News: Missed Communications | How Did Infected Man Return to U.S. Undetected? Questions for the Department of Homeland Security.
posted by ericb at 5:42 PM on May 30, 2007

Well last year when I ruptured my ear in Turkey, I went to five doctors/specialists in four countries before I felt safe to fly. The second to last specialist told me it was okay, but I didn't trust him so I found a fifth that seemed to know a lot more of what he was talking about. Prior to that, I was trying to figure out how long I could live on my friend's couch in Vienna & how I might be able to make a living there if I couldn't go back when I had planned.

Now mind you, my reasoning behind not flying was that I was trying to prevent the air pressure from damaging my ear even worse. But I know myself... and if a doctor had said I shouldn't fly because I was contagious to others I would've taken the exact same precautions. Harm is harm, it doesn't matter whether it's happening to me or I'm endangering someone else. Actually, I'm far more likely to worry about hurting other people than myself most of the time.

So I agree... the guy's a ginormous self-absorbed asshat who really needs to stop bragging about what an intelligent and cooperative guy he is.
posted by miss lynnster at 5:46 PM on May 30, 2007

Why don't you get a little more self-righteous with only half the facts, miss lynnster?
posted by mediareport at 5:48 PM on May 30, 2007

So far, it seems that MDR-TB and XDR-TB, while resistant, are less infectious, so catching them is harder.

However, there's a current outbreak of XDR-TB in South Africa that is frankly frightening in terms of mortality. Since September 2006, there has been some 315 cases reported, and over 200 deaths -- a mortality rate approaching 2/3rds.

This particular beast is said to resistant to *all* first and second line TB drugs -- I don't know if this represents the drugs available only in South Africa, or if it represents all known therapy.

This is a nightmare for South Africa, a poor nation already rocked by HIV/AIDS. Worse, TB treatment is expensive, involving multiple drugs for many months, and MDR/XDR-TB involves far longer courses, easily reaching two year, of at least five drugs. There are several dangerous side effects (mostly involving the liver) to the standard course of treatment, and the second and third line drugs are either less effective, more dangerous, or both.

If this selfish SOB happens to have a more virulent variety of TB, we could have a real problem.
posted by eriko at 5:52 PM on May 30, 2007

What do you expect? He's a typical American. I'm sure Europe is glad he left and took his nasty XDR TB with him.

Americans. The New Plague Vector.
posted by daq at 5:56 PM on May 30, 2007 [1 favorite has favorites]

This was big news in Canada because he came through Montreal and, of course, no one told us anything until he was back in the US.

So, christ, asshole, etc. Hangin's too good for him.
posted by GuyZero at 6:04 PM on May 30, 2007 [1 favorite has favorites]

Odd, the first post suggests that he didn't understand how ill he was, and the second says the opposite. *scratches head*

TB, or not TB: that is the question.
posted by brain_drain at 6:07 PM on May 30, 2007 [2 favorites has favorites]

dw writes "You get what you pay for. In this case, TB."

Nah, you often get overpriced treatements that you could have paid 1/100 , but you don't know better and are afraid to get ill or die or both ! Welcome to unregulated market, in which your ignorance and financial irrilevance work together to make you another number on a list.

Therefore, even if I would have probably shot him unconscious from 100 yards, I sympathize with him, he was afraid. And given the incredible amounts of solidarity and practical help we can abundantly find these days, in a "market" concerned with making yourself feel safe, one easily would have said "fuck you all"
posted by elpapacito at 6:08 PM on May 30, 2007 [1 favorite has favorites]

Yeah, but when they start turning to zombies, at least we'll have guns.
posted by chlorus at 6:09 PM on May 30, 2007

Don't worry. Punishment will not be long in coming. For every American sitting on the plane within 40 rows of this guy, or even anyone who was at the same airport, there should be around 27 lawyers flailing their arms and whooping with glee, chasing the gravy train.

That's absurd. No one has ever been sued for passing on a disease, and certainly no one has been sued for simply potentially infecting someone. I think it's pretty unlikely that anyone got infected.

And even if it was highly contagious, a bunch of lawyers would never go after an individual like that, because there's not much money to be had. There would be no point.
posted by delmoi at 6:22 PM on May 30, 2007

So what if the guy wanted to fly home? Whether he wanted medical treatment here or not, he still didn't have to go on commercial airlines and risk infecting other passengers.

It would have been cheaper to fly the jerk back home on a chartered plane than the alternative of armed guards, security and quarantine, and having to locate and test the people he come into contact with. He should, at the very least, have to pay monetary damages for what this is now going to cost the CDC. I bet some of the other passengers get together anyway, ours being the litigious society it is, and file a class-action suit.
posted by misha at 6:23 PM on May 30, 2007

In other health news: U.S. government fights to keep meatpackers from testing all slaughtered cattle for mad cow
posted by homunculus at 6:27 PM on May 30, 2007

That's not a very good containment strategy if it only monitored flights to the US.
posted by smackfu at 6:28 PM on May 30, 2007

even if it was highly contagious, a bunch of lawyers would never go after an individual like that, because there's not much money to be had.

You do get that it's a bunch of hungry clients that go after people, right? With lawyers in tow? There aren't packs of hungry client-less lawyers going around suing people for things they had no personal involvement in.

Back on topic, I look forward to using the *dies* gesture.
posted by dreamsign at 6:32 PM on May 30, 2007

I've been kind of sympathizing with the guy, especially because we don't know the whole story, and nobody seems to have straight what is known.

Talking about "hanging's too good for him" is over the top imho.
posted by maggiemaggie at 6:33 PM on May 30, 2007

No one has ever been sued for passing on a disease

Really? I know I've read stories about ex-girlfriends (or boyfriends) suing their exes for passing on HIV. And there's at least one guy in NY who was convicted of knowingly transmitting HIV to his partners. If I were the TB guy, I'd lawyer up.
posted by rtha at 6:36 PM on May 30, 2007

Transcript of CDC press release on the subject.

He was smear negative, and 17% of TB infection comes from smear negative patients. TB supposedly requires extensive time in contact to infect all but the most immuno-compromised, but I agree that this guy is an asshole.

XDR TB has a relatively high fatality rate from what I've heard, even with the best treatment.
posted by BrotherCaine at 6:36 PM on May 30, 2007

also, I first heard about this on FOX, so my skeptical defenses were on high. The anchors were yelling...

Then they had a doctor on who said the chances of anyone being infected were low, and the anchors seemed disappointed.
posted by maggiemaggie at 6:39 PM on May 30, 2007

I may be wrong but I think people have been sued for knowingly passing on AIDS. While it is different I don't see why, theoretically, a suit could be brought on the basis that he (seemingly) knew he posed a public health risk and put others in needless jeopardy. Course, weither anyone would litigate it is another matter.
posted by edgeways at 6:41 PM on May 30, 2007

yes, he knew he had TB. no, he wasn't expressly told he couldn't travel. however, he was notified that his TB was highly drug resistant, and he had no way of knowing how infectious he was. yet the selfish asshole actively avoided authorities and sneaked back into the US, potentially exposing and endangering hundreds of people.

no, he didn't break any laws, but they should write some just for this motherfucker. if the CDC wants to have any credibility in the future, it needs to come down hard on this guy.
posted by killy willy at 6:53 PM on May 30, 2007 [1 favorite has favorites]

Ugh, we had someone like this in my county.
He was told what he had and they gave him a voluntary quarantine and he would walk down to the store for smokes or go visit his family in mexico until they just locked him up.
He is better now and out but who knows who he spread it to.
And only the lazy say TB, the cool kids call it consumption.
posted by Iron Rat at 7:03 PM on May 30, 2007

Why don't you get a little more self-righteous with only half the facts, miss lynnster?

Good call. 'Cuz your need to snap me into my place didn't sound self-righteous at all. And of course you assumed also that I am stupid and only read half of the facts. Cuz durrrr I don't read so gud but I like to purtend I'm intellekshul sumtimes. YA CAUGHT ME! Damn you're good, mediareport. You told me! Serves me right.

I was just saying that I went through a lot of efforts to not fly based upon doctors orders & so I find it hard to relate to what he did. And I'm agreeing with other people who, previous to me, said he was an asshole... and I'll quote... that he made a dick move. Oh, but they also said he should be nuked & I didn't go that far, I just thought I'd use some variety and call him a self-absorbed asshat instead.

Mediareport, if you don't like my personality & felt like calling me a name because my comments annoy you, then fine. I'll just ignore you, I don't care. But if you're going to try to make me rethink my position on something then DO so. Don't just insult me for agreeing with other people and just sharing my own experience. I was just attempting to participate in the conversation, and I did so in a much less vitriolic or self-rightous way than a lot of people do on here.
posted by miss lynnster at 7:06 PM on May 30, 2007 [1 favorite has favorites]

at airports we focus on shoes and bottled water and carry-on toiletries. the entire incidence makes the government and health officials look like fools. what a bunch of dopes.
posted by brandz at 7:09 PM on May 30, 2007

I sincerely hope that there's some way to prosecute this guy for wanton negligence. His attitude just infuriates me beyond words.
posted by teferi at 7:13 PM on May 30, 2007

Maybe they could put this guy in a cell next to the guy in Arizona, who isn't even allowed to watch TV or take a shower. That would make the next XDR-Lunger more likely to cooperate.
posted by homunculus at 7:54 PM on May 30, 2007

Iceland doesn't have staph at ALL, grapefruitmoon? Seriously?

I am not an expert, but it's along the lines of what I was told by a doctor wearing an orange face mask while I was in an isolated room. Perhaps I missed something in the translation, but that was the jist of it.
posted by grapefruitmoon at 8:46 PM on May 30, 2007

you assumed also that I am stupid and only read half of the facts

No, we don't *have* all the facts. How are you deciding between the competing versions of events coming from the CDC and the patient, for instance?

& felt like calling me a name

Oh, please. You and a lot of other folks here are rushing to judgment in a hilariously self-righteous way, based on initial reports that offer at least some competing sets of facts. Waiting a bit for the tar and feathers might be a good idea.
posted by mediareport at 9:17 PM on May 30, 2007

WE DID IT.
posted by carsonb at 9:34 PM on May 30, 2007

You and a lot of other folks here are rushing to judgment in a hilariously self-righteous way, based on initial reports that offer at least some competing sets of facts.

Here are some facts which everyone can agree upon:

- The dude has drug-resistant TB.
- His doctors suggested that he not travel, due to communicability of disease.
- He went on his honeymoon anyway.
- The CDC now has him in isolation and is contacting passengers from his transatlantic flights because they may be at risk.

And how exactly would YOU judge that situation? Would YOU put yourself on an airplane if you had just been diagnosed with drug-resistant TB?

If the answer is "No," give miss lynnster and others who think the guy was an ass for putting others in danger in that way a break.

If the answer is "Yes," remind me to check for you in airports and never, ever board a flight that you're on.
posted by grapefruitmoon at 10:00 PM on May 30, 2007 [1 favorite has favorites]

I am not an expert, but it's along the lines of what I was told by a doctor wearing an orange face mask while I was in an isolated room. Perhaps I missed something in the translation, but that was the jist of it.

You missed something in the translation. Staphylococci are Gram-positive spherical bacteria that occur in microscopic clusters resembling grapes. Bacteriological culture of the nose and skin of normal humans invariably yields staphylococci.

On the other hand, if you had a gram-negative bacterial infection, those Islandic doctors had good reason to treat you with caution. An increasing number of gram-negative infections are highly drug resistant . Not as infectious as TB, but pretty damned dangerous - especially in a hospital environment.
posted by three blind mice at 10:47 PM on May 30, 2007

three blind mice: Could be that was it, but the odd part of it all is that I wasn't being treated for any infection whatsoever. I was put in isolation just for being a foreigner. Anyhow, my point being that if doctors in Iceland could lock me down in such a way just under the presumption that I might be a carrier of an infectious agent, why couldn't doctors where this guy was diagnosed immediately place him in isolation?

(Not to say that I think handling with me with orange gloves just for being American wasn't a bit extreme, but I don't blame them a bit. We are a toxic bunch.)
posted by grapefruitmoon at 11:26 PM on May 30, 2007

I'm feeling a bit ashamed here that my prime interest in this story is derived from the several House parallels I can see. < /fangirl>

That said, I'm with the "the guy's an asshat" camp. I get that he was scared, and yes, we don't have his POV, but honestly, an intelligent and educated man couldn't have figured out that there might have been a reason for him being put on the no-fly list after being diagnosed with TB? I mean, it's a little bit of a stretch to attribute having his entry into his country barred occurring so soon after finding out he has this horrible-sounding disease to coincidence, isn't it?

Rather than elaborately circumventing rules and changing airplane tickets and whatnot (which, in my experience, is a bitch to handle), he couldn't have found any wayside internet cafe and maybe looked up the dangers of TB and the potential pandemic it could cause? Self-diagnosis is annoying on the best of days, but dude, your doctor told you what you had, it wouldn't have killed you to find out a bit more about it before traveling across four countries.

Just sayin'.
posted by Phire at 1:08 AM on May 31, 2007

Understanding how someone could react fearfully =! absolving them of responsibility to their fellow human beings.

"Oh wait, he didn't break the law. What responsibility?" <--- if this is you, go fuck yourself.

Also: smear negative? awesome band name. (photo processing or moviehouse, not so much)
posted by dreamsign at 1:55 AM on May 31, 2007 [1 favorite has favorites]

so i'm in italy on my honeymoon, and some doctor in the states says i shouldn't be flying.

oh-kayy, if this is sufficiently serious to warrant your concern, fly me and my bride back to the us of ay on a chartered jet, with doctors, champagne and prosciutto canapes. it's up to you to make the offer. it's not up to me to surrender myself to an indefinite period of italian solitary confinement. otherwise, go fuck yourself, and if you try to kill me (as some mefites have suggested), i'll try to take you with me.
posted by bruce at 2:38 AM on May 31, 2007

Basically, it would have probably been more expensive for him to stay in Italy (if you aren't part of the health care system, you are expected to pay),

IIRC, emergency care is free for all. And if you're not paying taxes locally or not an EU citizen, 400€ + a small percentage calculated on your income gives you coverage for a year.
posted by romakimmy at 3:05 AM on May 31, 2007

follow the arrow, bruce.
posted by dreamsign at 3:49 AM on May 31, 2007 [1 favorite has favorites]

no dreamsign, you follow the arrow. if you want my cooperation in such a matter with potential life-or-death implications, you must treat me with respect in two crucial ways. first, absolute full disclosure from the gitgo. not "you have tb" but "you have an untreatable form of tb which can kill people you come in contact with." second, due solicitude for my comfort and wellbeing, not "report to dr. corleone's clinic in naples immediately" but "we'll fly you and your wife home in comfort right now to the hospital of your choice, everything on us." because i react much better to reason from strangers than i do to orders. because if it isn't worth it to you to make this effort, why should it be worth it to me, on my honeymoon?

i have sympathy for both sides in this matter, i'm generally anti-statist, but recognize that there are a few instances like this one where some state authority may constrain an individual's right in order to protect thousands of people from dying of tb. even so, the state has to treat the individual with respect, and this record shows that the state failed in this instance.

i wouldn't have flown back in through canada. i would have looked at 1) a small boat west across the atlantic, or 2) trans-siberian railway, then puddle-jumpers across the bering strait and then southeast. this would have made for a much better story.
posted by bruce at 4:38 AM on May 31, 2007

I see no reason why the state should barter for decency, aside from the fact that people are asshats and so apparently was this one.

It's being reported now that he knew he had TB when he flew to Europe in the first place. Fuck him.
posted by dreamsign at 4:46 AM on May 31, 2007

Yeah, and I saw a doctor yesterday telling a reporter that wearing a mask on the flight would probably have been more than enough to protect everyone else. Did the CDC tell the guy *that* when they "suggested" he not go to his own wedding? We don't know. In fact, we don't know anything about what those early conversations were like, and have conflicting reports about them. That's a key bit of information to have down before running for the pitchforks and torches.
posted by mediareport at 5:42 AM on May 31, 2007

"Hi honey, I'm going to miss our storybook wedding in Italy that cost thousands of dollars and that all the relatives flew out for because the CDC says they prefer I wouldn't fly. Oh yeah, no honeymoon either."
posted by smackfu at 5:53 AM on May 31, 2007

Is that before or after he tells her he's got drug-resistant tuberculosis, smack? Cause it appears to me that whatever the CDC recommendation, this much he knew.
posted by dreamsign at 6:11 AM on May 31, 2007

Have you met brides?
posted by smackfu at 6:17 AM on May 31, 2007

Meanwhile in Boston an Indian student has brought measles to her University...
posted by Gungho at 6:20 AM on May 31, 2007

If I was told that I carried a very dangerous strain of TB that was resistant to most forms of treatment, my wedding probably wouldn't be at the top of the ol' priority list, no matter how many layers the cake had.

I'm know, I'm not a romantic person; I guess that's just my cross to bear.
posted by Alvy Ampersand at 6:26 AM on May 31, 2007 [2 favorites has favorites]

Hi Honey, I've got a possibly-fatal communicable disease! But don't worry -- there's up to a 30% chance of a cure! Did I mention that it's communicable?

Ok, can't wait to see you. Bye!
posted by dreamsign at 6:30 AM on May 31, 2007

Meanwhile in Boston an Indian student has brought measles to her University...

This is why most universities have serious immunization standards. For instance. Not sure how they apply to summer sessions though.
posted by smackfu at 6:31 AM on May 31, 2007

While wondering about the "can you sue" angle, found the following interesting tidbit about negligent HIV transmission at this link:

The infecting partner must engage in unprotected vaginal or anal sex (oral is excluded).

While I know the infection rate is quite a bit lower for oral contact than anything else, is that really a reason to exclude it? And how would this apply to our TB-pal? If it's difficult to spread this form to the average person with normal contact, how could any lawyers be salivating over the case?
posted by bitter-girl.com at 8:04 AM on May 31, 2007

Not a USian and not intimate with their legal system, but in Canada you'd require actual harm, not merely risk of harm, to get anything other than a truly token award (plus a withering look from the court, for free). I seriously doubt there's any oral-communication connection here, in case that's what you're going for. The real element would be foreseeability.

So "best case" scenario for the lawyer/client: Mr. TB knew the risks and they were high; airline somehow implicated; Mr. TB coughs in face of passenger; passenger gets TB; passenger dies and your actual client, the family, sues both Mr. TB and airline. "Worst case": Mr. TB didn't know the risks or worse, was actively misled as to the risks; client suffered some kind of "emotional distress" at having been exposed to the risk; spends costly week in spa; seeks damages.

This is not legal advice.
And I've had a few stiff drinks.
posted by dreamsign at 8:41 AM on May 31, 2007

Yeah, and I saw a doctor yesterday telling a reporter that wearing a mask on the flight would probably have been more than enough to protect everyone else. Did the CDC tell the guy *that* when they "suggested" he not go to his own wedding?

"One official says the man had a supply of masks to wear during the flights, but it's not clear whether he used them."
posted by oneirodynia at 10:02 AM on May 31, 2007

What's the controversy? I say if the fucking CDC is telling you not to go anywhere because there's even a tiny chance that you might give others a multi-drug-resistant form of TB and you decide not to listen, you're a huge fucking asshole. Sorry for the profanity but what's not to understand? And the "I'm an educated, intelligent man..." comment just drips with self-righteous borderline racism. "Now, I could understand if I were some filthy, colored, poor person, but come on: I'm a white personal injury lawyer! That's probably the most ethical job one can have!"
posted by inoculatedcities at 10:09 AM on May 31, 2007

I'm feeling a bit ashamed here that my prime interest in this story is derived from the several House parallels I can see. < /fangirl>

I hadn't even thought of it, but since you mentioned it... *swoons*

Gregory House, you're so dreamy, even though you hate everyone. And are drugged up. And have a cane.
posted by grapefruitmoon at 11:18 AM on May 31, 2007 [1 favorite has favorites]

Here's an interesting twist: Father-in-law of patient works for CDC on TB.
posted by MissNefertiti at 11:41 AM on May 31, 2007

Oh, and they've already identified the patient.
posted by MissNefertiti at 11:43 AM on May 31, 2007

That's one well-tanned asshole.
posted by Alvy Ampersand at 11:57 AM on May 31, 2007

Oh, and he's a lawyer. How precious. So much for him being judgment proof! Still, I imagine no one could prevail in a law suit against him unless someone gets infected.
posted by rkent at 12:08 PM on May 31, 2007

So what is the deal with TB? They found it in January due to an unrelated chest x-ray for injured ribs, and he still hasn't gotten any symptoms yet. For a "usually fatal" disease that's not bad.
posted by smackfu at 12:13 PM on May 31, 2007

He clearly knew what he was doing if his father-in-law is a CDC TB Specialist and his FIL spoke with him about the situation. I'm voting for his being a self-absorbed, selfish asshole.

(He's a personal injury lawyer. Interesting.)
posted by jeanmari at 12:32 PM on May 31, 2007

ConspiracyFilter...Father in law is a scientist who handles TB strains...You do the math.
posted by Gungho at 12:36 PM on May 31, 2007

(if you aren't part of the health care system, you are expected to pay),

not really, not for emergency services.


IIRC, emergency care is free

you're correct.
posted by matteo at 12:49 PM on May 31, 2007

Why would his fiance go anywhere with him? Did he tell her he has drug resistant TB?
posted by Megafly at 1:11 PM on May 31, 2007

I just saw the bit about Andrew Speaker's father-in-law being a TB researcher for the CDC. The father-in-law has released a statement basically saying that there's no way his son-in-law got this from him or his work. I don't know. Speaker has traveled extensively over the past 6 years, but it seems a wild coincidence that he's got TB and it's completely unrelated to the father-in-law. I'm not thinking conspiracy theories, I'm just thinking that accidental exposure via his father-in-law is the simplest explanation. It's also entirely possible that I'm wrong, not being familiar with the CDC's policies or the rates of Americans contracting TB from foreign travel. This is just my layperson's take.

Oh, and yeah, he's a jerk. I get that one's wedding is a big deal special event, and there are unrefundable costs associated with it. None of this takes precedence over country-hopping with a drug-resistant, contagious, often fatal disease. What a selfish, selfish man. I feel sorry for his wife - clearly, he didn't even care about her exposure.
posted by booksherpa at 1:20 PM on May 31, 2007

So what is the deal with TB? They found it in January due to an unrelated chest x-ray for injured ribs, and he still hasn't gotten any symptoms yet. For a "usually fatal" disease that's not bad.

In people with healthy immune systems, TB can remain asymptomatic for a long time. I don't know about these drug-resistant strains, but I think people can act as carriers for regular strains - they may not get sick, and just pass it along to others. Which was the danger here - not that he'd drop dead at the altar, but that he'd pass a very bad strain along to others.

Hmmm...maybe his father-in-law really didn't want this wedding to happen.
posted by rtha at 1:46 PM on May 31, 2007

"A globe-trotting Atlanta lawyer with a dangerous strain of tuberculosis was allowed back into the U.S. by a border inspector who disregarded a computer warning to stop him and don protective gear, officials said Thursday. The inspector has been removed from border duty.

The unidentified inspector explained that he was no doctor but that the infected man seemed perfectly healthy and that he thought the warning was merely 'discretionary,' officials briefed on the case told The Associated Press. They spoke on condition of anonymity because the matter is still under investigation."^*
posted by ericb at 3:10 PM on May 31, 2007

And there's at least one guy in NY who was convicted of knowingly transmitting HIV to his partners.

Today: Dutch arrest 4 for intentionally infecting others with HIV.
posted by ericb at 3:24 PM on May 31, 2007

Wow, it just keeps getting worse and worse.

They must be such a happy couple - so concerned for the welfare of others!

(Also, I doubt the father-in-law has any connection whatsoever because even if he really does hate the guy, I would think that giving him drug-resistant TB would be a little too obvious in the "ZOMG! Conspiracy!" department. If I were in his position and I wanted to rid my daughter of this slimeball, I would use good old fashioned rat poison. Or something. Old fashioned. Not that I think about offing other people. Right.)
posted by grapefruitmoon at 3:31 PM on May 31, 2007

Interesting details about where he is being treated:

"Andrew Speaker, 31, arrived at Denver’s National Jewish Medical and Research Center on Thursday....In the 19th and early 20th centuries, thousands flocked to Denver and Colorado Springs, believing their illness could be cured in part by the state’s fresh air. Tuberculosis went by the name 'consumption' in those days, presumably because its symptoms consumed those who had it. Denver’s first hostel for TB patients opened in 1860, a year after the city’s founding.

The need to treat these patients, especially those who spent their last pennies on a one-way ticket, eventually led to National Jewish’s opening. The hospital has since treated patients with lung diseases from around the world, including survivors of a World War II concentration camp who contracted TB.

TB patients who sought a Colorado cure included gunslinger Doc Holliday, who died of the disease in 1887. In the early 20th century, many TB patients — including those at National Jewish and other hospitals — slept on porches.

....In the 1800s, Colorado competed with other western states to lure TB patients and their families, seeing them as a way to boost their populations and economies, said Dr. Charles Scoggin of the Center of the American West.

Colorado gained an edge in part because the railroads advertised it widely, Scoggin said. 'It was classic Western boosterism,' said Scoggin, formerly of the University of Colorado Health Sciences Center.

Over the years, National Jewish came to specialize in respiratory, immune and allergic disorders. Once supported by the national Jewish orgnanization B’nai B’rith, the hospital is not affiliated with any religion. U.S. News & World Report has ranked it the nation’s top respiratory hospital for nine straight years."

posted by ericb at 7:41 PM on May 31, 2007 [1 favorite has favorites]

In the 19th and early 20th centuries, thousands flocked to Denver and Colorado Springs, believing their illness could be cured in part by the state’s fresh air.

Yep, e.g. Hygiene.

And as I said in a comment I'm too lazy to dig out, the University of Colorado was able to establish itself academically in the 1890s-1920s by attracting TB-ridden East Coast profs.
posted by dw at 9:53 PM on May 31, 2007

I'm not sure if I missed it in this thread or not, but here he is... TB Guy & his hot wife. Looks like he'll be on GMA in the morning.
posted by miss lynnster at 11:25 PM on May 31, 2007

I don't understand. Wedding? Honeymoon? Kissy kissy? Isn't he going to infect his wife at this rate?
posted by slf at 3:05 AM on June 1, 2007

Doesn't anyone wonder why this guy is being treated so differently than the guy in Arizona? I mean he was flying around the world.....the guy in Arizona walked into a local convenience store.
posted by tami3_3 at 11:24 AM on June 1, 2007

Also from GMA -- TB Patient's Wife Defends Decision to Travel.
posted by ericb at 11:26 AM on June 1, 2007

The wife seems to be saying that it was the CDC's responsibility to figure out a way to get them back to the United States and that since they didn't it was the CDC's fault that she and her husband had to sneak in through Canada. It must be wonderful going through life believing that someone else HAS to solve your problems.
posted by rdr at 7:26 PM on June 1, 2007

Apparently they can prove that before he left the U.S., the guy really was told he wasn't contagious. Of course, that doesn't change the fact that he apparently was told not to travel after he was in Italy.
posted by dilettante at 8:46 AM on June 7, 2007

Superbug: Nearly 5% of the nation’s patients may be infected with staph germ
posted by homunculus at 11:57 AM on June 25, 2007