First 2 sputum tests for TB man prove negative

[maddezmom]

Source: CNN

DENVER (CNN) -- The first two of three planned sputum test results for Andrew Speaker, the 31-year-old lawyer who has extensively drug-resistant tuberculosis, have come back negative, National Jewish Hospital said Monday in a written statement.

If the third test result, expected later Monday, also proves negative, Speaker -- whose air travel last month to his wedding in Greece set off international concerns for the safety of his fellow passengers -- would be considered "relatively non-contagious," the statement said.

Speaker is confined to his room, which is equipped with special air filters and negative air pressure to ensure he does not infect others with the drug-resistant bacteria, which can prove fatal.



Read more: http://edition.cnn.com/2007/WORLD/europe/06/04/monday/index.html

[Warpy]

1. Curiouser and curiouser

and it's beginning to smell even worse, like a publicity stunt.

[xultar]

2. They are just makin a play to curb more freedoms with this stunt. The fucks.

[hippiechick]

11. I disagree ...

... I think its possible that his FIL, a CDC dude, purposely infected him and made him into a walking experiment on how to efficiently spread "bio-terror".


Not like the US would ever consider doing something like that, though ... :eyes:

[xultar]

23. tuskegee experiment...I could go with that. I couldn't figure out why

they told him he was o.k. and not contagious.

He's been huggin and kissin on his girlfriend since he was diagnosed back in the fall. Strange now there's all this concern. I was thinkin they infected him too...kinda like an almost by accident type of thing.

[LisaL]

24. Well, never mind his own daughter would be at risk.

Please, I think it's ridiculous to suggest anything of the sort.
Furthermore, most people infected with TB do not develop the disease. TB is extremely ineffective as a bio weapon.

[hippiechick]

26. Please, I don't happen to think it's "ridiculous".

You're entitled to your opinion, I'm entitled to mine, thank you very much.

[hlthe2b]

14. Actually, no.... repeated negative sputum tests

do confirm very very low potential for spread-- even in an active TB patient. It will allow public health to make more considered decisions with respect to(and to reassure) those who have had exposure to him already and to potentially allow him more access outside his room while getting treatment.

[triguy46]

28. This is standard practice for TB

3 negative sputums and the patient is allowed back to public contact. If he completes his regimen of antibiotics, then this will be old news of one irresponsible individual.

It should be noted that one of the probs with treating MDR TB among the homeless is that they sometimes cannot be found. So this guy should not be considered to be the only active MDR patient who is on the loose.

Lastly, I recall about a month ago, some outrage expressed on this site about a public health action to incarcerate an individual who would not comply with treatment orders for his MDR TB. Many seemed to feel that it was unreasonable and heavy handed, a police state action. So for those on both sides, how do you want these handled?

[LisaL]

33. He's got XDR-TB, not MDR-TB.

It does not sound like he will be allowed back into public contact. They will let him out of his room in a mask and away from other patients.
But he is not getting out of that hospital for while. They might have to do surgery on him if his lesion does not respond to any medications.
As for that other individual, he was locked up in a cell, he was not allowed TV, or even shower.
While Mr. Speaker is in the hospital, and they gave him an exercise bike, and he will be let out of his room in a mask.
So, why is that other guy treated like a prisoner while Mr. Speaker is treated like a patient?
Maybe that other guy should join Mr. Speaker in that hospital since they both have XDR-TB.

[depakid]

18. This is one set of "freedoms" I'm willing to curb

Namely- your (or anyone else's) unfettered ability to callously risk infecting tens- then hundreds- then thousands with virulent and potentially deadly disease.

The fact that this guy got on a plane after all that supposedly happened should be a big wake up call....

[StateRed]

3. one of the

strangest news stories of the past week.

[barb162]

4. He'll then be "relatively non-contagious"

"If the third test result, expected later Monday, also proves negative, Speaker -- whose air travel last month to his wedding in Greece set off international concerns for the safety of his fellow passengers -- would be considered "relatively non-contagious," the statement said."

[soothsayer]

5. relative to what?

[hedgehog]

6. Let's put it this way - twice now they have sampled the mucus from deep in his

lungs and found no bacillus. Just how contagious can you while sitting around breathing quietly be if your deepest cooughing can't expel any bacteria?

[LisaL]

16. The smear negative patients with active TB are still contagious,

but less so compared to smear positive TB patients.
Mr. Speaker's claim however was that the Drs. told him he was not contagious or danger to anyone. I wonder why the Drs. would tell him that (if true) since from the articles I have read, smear negative TB patients are contagious.

[barb162]

9. Hell if I know.

I hope that means he wasn't contagious enough to give it ANY people he met or was near on that European trip.

[SlipperySlope]

7. The whole thing is a set-up

The whole thing is a set-up, just a stunt, to teach the sheep how they are "supposed" to act when the government quarantines them.

Of course, quarantine is just a cover story for "locked up without habeas corpus".

[StateRed]

13. you want

to sit beside a man with deadly TB on an airplane?? If not, I wouldn't talk so big if I were you. How deep is the rabbit hole?

[treestar]

17. Why would anyone mind it if they're not going to catch it?

I'd really rather know what the odds were first, rather than being hysterical about it. We know it's not the 19th century any more, too.

So we need facts about this, which is precisely what the media does not give us, at least, not until after they have engaged in scaremongering.

[LisaL]

19. Well, here is the study.

According to this, smear negative but culture positive TB patients appear to be responsible for 17 % of TB infections. Assuming Speaker is smear negative but culture positive he still would be contagious.
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=9989714&dopt=AbstractPlus&holding=f1000%2Cf1000m%2Cisrctn

[kestrel91316]

8. They do not specify WHICH sputum test is coming back negative......

Are they referring to a sputum SMEAR or a sputum CULTURE???? The first looks at sputum smears in a microscope, and can be expected to have a significant number of FALSE NEGATIVES. The second tries to grow the TB bacillus in culture, and has a much lower (but not zero) incidence of false negatives.

Given that he has a tennis-ball-sized pulmonary mass, I have to assume they are referring to smears rather than culture. He HAS pumonary TB and therefore is NOT, by definition, 100% safe to breathe around.

[seafan]

10. Yes, it's probably the smear that's testing negative. The culture may take as long as 6 weeks.

The TB bacillus is a slow-grower, and it wouldn't have been a sufficient length of time yet to be seen on a culture that was taken on this man so recently.



A positive sputum smear would indicate a much higher risk of exposure to those around him, as the TB organism would be present in droplets of his coughs/sneezes.


If he's smear negative, as is being reported, it's a very good piece of news for those flight passengers.

[kestrel91316]

12. IIRC, they had already done the smear (it was neg) prior to

his trip. But the CULTURE of his sputum revealed the XRD TB. Jewish Hospital is just in CYA mode repeating all the tests that have been done already, being VERY thorough probably because TB Andy's lawyer dad has secretly taped at least one conversation with doctors, and can be expected to do it again.

A negative smear is no reason to let one's guard down. There have been documented cases of TB spread via the air FROM A SMEAR NEGATIVE PATIENT. They are low risk, which is quite different from zero risk. Any risk of respiratory spread in a case of XDR TB is a BAD THING, and that's why when they confirmed it was XDR they called him in Rome and said STAY OFF COMMERCIAL PLANES.

[LisaL]

15. Yes, they have known already he was smear negative.

From the articles I have read, smear negative patients with active TB can still infect others, but at lower rates than smear positive TB patients.

[flamingyouth]

21. Thanks for this info

I have a friend who was on the Paris-Atlanta flight last month. His first test came back negative and he is going in for another in eight weeks.

[kestrel91316]

27. He's at low risk and probably will be just fine. But he MUST get those

tests, on exactly the schedule the doctors tell him. No fooling around.

[triguy46]

30. More important, this guy needs to be on DOT: Directly observed therapy...

A public health nurse handing him the pills daily and observing him ingest them. He has proven to be somewhat of a nonreliable patient and DOT is the standard in these cases.

[LisaL]

31. If you are talking about Andrew Speaker, the problem is

pills probably won't work for him, since he got XDR-TB.

[Kagemusha]

25. Thank you - VERY informative as to what went down here.

And low risk vs. zero risk is what I assumed but I didn't have the specific knowledge to swear by it. I make a point of thanking those who advance the cause of reasoned debate.

[Kali]

20. where did you get the "tennis ball" sized mass?

(pardon if it is explained further down the thread) I read it was a very small mass.

[flamingyouth]

22. It was in another thread here (I think it was yesterday)

I believe the NY Times referenced it (though I could be wrong; there have been so many threads/articles on this).

[triguy46]

29. Generally, aren't they doing an acid fast stain and searching...

some defined statistically number of fields?

I agree however, that something is odd. Last week we were told he had MDR TB but now after one week of therapy, he's negative. If he had run of the mill TB, I think I could buy into this.

[LisaL]

32. He is smear negative. Which we were told before this.

The week of therapy has nothing to do with him being smear negative-he had always been that way. And he actually has XDR-TB, not MDR-TB.