TB in the air

Recent headlines have given much space to the case of Harley Speaker -- a lawyer, no less -- who traveled repeatedly while infected with a particularly dangerous strain of tuberculosis. So far, no reports of anyone else becoming infected -- in which case, the entire episode may prove to be a great benefit. If existing quarantine measures failed so badly here, with one infectious individual, what does that portend for future pandemics? Let us hope that this incident provokes the necessary reforms. As noted here:

Perhaps the most significant legal issues in Speaker's case concern the federal quarantine law, and the difficulty federal health officials had trying to learn the identities of those who were exposed to Speaker . . .

The quarantine order was the first issued by the federal government since a patient with smallpox was isolated in 1963, according to the Centers for Disease Control and Prevention.

Leave a tool unused too long, and it is bound to become unusable.

CDC officials have been requesting changes in the nation's antiquated quarantine laws to gain easier access to airline and ship passenger lists, provide patients a clearer appeals process when subjected to quarantines and give health officials explicit authority to offer vaccinations and medical treatment to quarantined people. . .

The legal rights of a quarantined person, including the right to request a hearing, are not clear under current law, Gostin said. Some legal scholars said the absence of clear guidelines could lead to a legal tangle that might stall government quarantine actions during an outbreak of pandemic flu or other contagious diseases.

Speaker can challenge the constitutionality of the quarantine order, and might even be able to seek a federal payment for damages, Gostin said.

Airlines can be slow to hand over passenger information because of concerns of violating customer privacy. It was not until late Wednesday that the CDC got full information from Air France about U.S. passengers on Speaker's May 12 flight from Atlanta to Paris.

One proposed change in the law would require airlines and cruise lines to electronically submit passenger and crew lists to the CDC upon request.

The prospect of an epidemic decimating a population unhindered while the lawyers argue is horrible yet all too believable.

FOLLOWUP in today's NY Times only confirms the problem:

When asked why the health organization (CDC) could not move more quickly and catch up with Mr. Speaker before he took more flights, Dr. Gerberding said in the press conference that much of the previous week’s activity had been spent debating issues concerning the laws and regulations that govern isolation and quarantine in the United States and internationally.

Posted by David on June 1, 2007 9:16 AM