Just popping in quickly after I saw Klearchos' comment on the updated tuberculosis post. He notes on his website that the CDC has released additional travel information about the XDR-TB infected patient, including shorter flights made within Europe in addition to the intercontinental flights. However, Klearchos notes:
...there is a big "hole" in the information provided by the CDC since, nobody has answered yet the question about how he moved from Santorini to Mykonos. CDC doesn't say anything about that in its report!!
There is no direct flight between the two Greek islands so he must have taken a boat... By boat, the trip from Santorini to Mykonos is at least 3 hours and can be even more depending on the type of the boat. So his move from Santorini to Mykonos has to be considered a threat to public health, without mentioning that nobody knows his whereabouts on the two islands.... It has to be reminded that this period the boats from Santorini to Mykonos are crowded with tourists, many of them Americans...
I've never had the chance to go to Greece, but that's Klearchos' home, so I'd assume he knows what he's talking about. I'd also assume (or hope, anyway) that this is an active area of investigation; trying to figure out where the patient went, how long he stayed, whom he may have exposed, etc.
What a mess.
Edited to add: apparently, the patient's name has been released by law enforcement. He's Andrew Speaker, a UGA-educated personal injury lawyer, of all things. (Poor Tiffany, a UGA law school grad herself). And to make things worse, his new father-in-law carries out research on tuberculosis at the CDC. So he certainly can't say he didn't know about TB, nor can he claim he wasn't aware of the *personal injury* he may be exposing others to. Incredible.
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The problem is that - from what I know - his name is not yet announced... I saw the report of CDC and I live in Santorini... It is clear that CDC doesn't mention anything about how he moved between the two islands... There is no direct flight from Santorini to Mykonos (if there was a flight CDC would have added that in the report). Between the two islands we use high-speed catamaran and the time of travel is about 3 hours. This ships are the same like being in a plane...
When I saw the report, I wrote an e-mail to CDC explaining the situation but I do not have any feed-back.
They won't announce his name unless he allows it; it's against privacy regulations.
And what about public interest?
Generally considered trumped, for a number of reasons I won't get into. You ever want to kill a few hours (or a few days, really), you can read through all the rules and regulations at the HIPAA site.
Actually, it looks like someone leaked the name: new CNN story. He's a lawyer and his father-in-law works on TB at the CDC, fer cryin' out loud.
Has there been any movement to get UV air cleaners in
international airliners (and cruise ships) to help stop
something like this from spreading?
We already know cruise ships have a public health
problem- it seems some cruise ship has a Norwalk virus
outbreak every couple of months.
Don't count on "homeland security" to get it done if
it will cut into the shareholder's profits...
This is certainly an interesting disease. The cure rate can be up to a whole 30% of the patients. Wow!!!! Ummmm, people, anyone know what happens to the other 70% of the patients? I do know that at least some of them die.
I guess we will also find out how concordant it is between couples. It is so nice and Darwinian that his wife has volunteered.
Today i heard in the news that Italian people that have been exposed to the disease haven't been warned for a week after the case became public. The Italian medical authorities didn't contact any of the travelers not took any step in securing them and all the people they exposed.
They have been warned, later, by the czech airline they flew with.
M
Not downplaying the stupidity of the mistake the man made (and the border agents, etc., for letting him through), but isn't some of this just sensationalism from the media? I mean, if he had a highly active case of TB where he was coughing up infective sputum, that would be one thing. But without making aerosol particles, how contagious can he really be?
I am quite fascinated to see the media talking about XDR-TB. Now if only they would talk about the same disease when if affects people in KwaZulu-Natal and not just American tourists. Alas...
While I'm not downplaying the serious error of traveling in a plane while infected with XDR TB, we should remember that you can probably catch a bus in Atlanta, New York or Philadelphia and also encounter people with TB (mostly MDR or less resistant strains).
There is an interesting paper in Plos One about a MDR plasmid found in a number of common pathogens. The paper can be found here and I wrote a quick summary of it here
This still is a very rare form of TB.
The father in law, a microbiologist at the CDC, apparently is examining this very pathogen, XDR-TB, in his every day work.
A coincidence or is the father in law the source? We'll never know I guess as if so it would be a big coverup, the father in law has said he is not infected and has tested negative for TB. How and when was he tested?, if he was just tested with the skin test that means virtually nothing as the skin test is notoriously inaccuate and gives a considerable number of false positives and false negatives.
farmer