TB patient may get to go outside
Vail, CO Colorado
DENVER ” The Atlanta attorney quarantined with a dangerous tuberculosis strain is considered to have a relatively low chance of spreading the disease, and he could be allowed to briefly leave his isolation room as soon as next week, one of his doctors said Tuesday.
A third test of Andrew Speaker’s sputum turned up negative for the presence of TB bacteria, confirming the results of earlier sputum tests at National Jewish Medical and Research Center.
The results mean there’s a relatively low possibility that Speaker could spread the disease by sneezing or coughing, but there’s still a chance, said Dr. Charles Daley.
Tuberculosis is transmitted by air in nearly all cases.
“No one who was in contact with him or any other patient with tuberculosis is out of the woods,” Daley said at a news conference.
Authorities are trying to contact passengers who were on two trans-Atlantic flights Speaker took last month.
A different kind of test performed in Atlanta, before Speaker arrived in Denver on Thursday, showed evidence of TB bacteria in Speaker’s saliva and phlegm.
Normally, TB patients with three negative sputum tests who have undergone at least two weeks of treatment are allowed to leave their isolation rooms for short periods as long as they wear a mask. Additional precautions are advised for patients, like Speaker, with drug resistant strains of the disease.
If his drug regimen is established and if he wears a face mask, Speaker could be allowed outside on hospital grounds with an escort as early as next week, Daley said.
“I think it’s important for people’s treatment … to get outside,” Daley said.
However, given the attention Speaker’s case has gotten, Daley said it’s possible hospital officials or Speaker himself could decide against outside walks to protect his privacy.
Speaker’s TB was accidentally detected with a chest X-ray in January. He hasn’t shown any symptoms such as coughing or a fever.
He is confined to a small hospital room with a television, an exercise bike, some dumbbells and a laptop, as well as an exhaust fan that hums as it sucks out and kills bacteria in the room with an ultraviolet light.
Doctors hope Speaker’s tuberculosis can be cured because it is not widespread, he is otherwise healthy and young, and National Jewish has extensive experience in treating drug-resistant infections with a combination of drugs and surgery.
Daley said doctors could decide as early as this week whether Speaker should undergo surgery.
Speaker, 31, originally was found to have multidrug-resistant TB, which can withstand two mainline drugs used to treat tuberculosis. While he was in Europe on his honeymoon last month, tests revealed he had extensive drug-resistant tuberculosis, or XDR-TB, which can withstand more drugs.
A smear test is one way to test for the presence of TB bacteria and requires patients to inhale an irritating salt water solution, producing a deep cough. Their mixture of saliva and phlegm is then smeared on a slide and placed under a microscope.
A negative result means there were no germs visible. But a culture test of Speaker’s sputum ” considered the “gold standard” in TB testing ” has yielded TB bacteria.
A recent study suggested that 20 percent of new TB cases could be traced back to contact with smear-negative patients, hospital spokesman William Allstetter said.
Speaker’s strain has so far resisted at least 10 of 14 drugs available for treating TB, according to Dr. Michael Iseman of National Jewish. On Tuesday, Dr. Mario Raviglione of the World Health Organization said there were only two drugs that are effective against Speaker’s strain.
Daley declined to comment on Raviglione’s remark but said National Jewish could use five or six drugs on Speaker that aren’t normally used to treat TB, a common practice with previous drug resistant patients.
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