Wednesday, June 6, 2007

Canary in a Cold Mine...

First to fall over when the atmosphere is less than perfect
Your sensibilities are shaken by the slightest defect
You live you life like a canary in a coalmine
You get so dizzy even walking in a straight line...

I think The Police sum up our current state of affairs quite succinctly. From what I've read Andrew Speaker was neither unhealthy nor particulary contagious and certainly not a case for reopening sanatoria. Extensively Drug Resistant Mycobacterium tuberculosis (XDR-TB) is not incurable, nor is it any more transmissable or virulent than non-resistant strains. In fact, Isoniazid-resistant strains pay a fitness cost of lowered virulence in return for higher resistance.

Granted, it would suck to be immune compromised in the middle seat next to a productive cougher on a flight to Europe, but that is not what happened. According to the WHO XDR-TB FAQ...

The majority of healthy people with normal immunity may never become ill with TB, unless they are heavily exposed to infectious cases who are not treated or who have been on treatment for less than about one week. Even then, 90% of people infected with TB bacteria never develop TB disease. This applies to XDR-TB as well as to “ordinary” TB. People with HIV infection, however, in close contact with a TB patient, are more likely to catch TB and fall ill. The TB patients whom they meet should be encouraged to follow good cough hygiene, for example, covering their mouths with a handkerchief when they cough, or even, in the early stages of treatment, using a surgical mask, especially in closed environments with poor ventilation. The risk of becoming infected with TB is very low outdoors in the open air. Overall, the chances of being infected with XDR-TB are even lower than with ordinary TB because cases of XDR-TB are still very rare.

So to me, this whole tempest is not so much about Andrew Speaker and his personal cache of XDR-TB as about the current zeitgeist of disproportionate pseudo-rational fear, the relatively unplumbed depths of public health legislation, and the seemingly inevidable consequence of high density poverty. Perhaps, I'll expand on these notions as and if time permits...

...Now if I tell you that you suffer from delusions
You pay your analyst to reach the same conclusions
You live your life like a canary in a coalmine
You get so dizzy even walking in a straight line

No comments: