An Irony of Epidemic Proportions

Finally, my preaching to the fiance’ all day and night yesterday about the huge medical implications of this Atlanta fellow traipsing all over Europe with extremely drug-resistant Tuberculosis has been underscored by today’s proper fury in the media.

The amazing irony is that this fellow, the first person quarantined in the US under these circumstances in 44 years and who has contaminated many hundreds of people on two continents, is a 31-year-old personal injury attorney.  Wow.

That’s handy, since he probably faces a large number of personal injury lawsuits to come internationally, as well as domestically, when some of the 1,500 or so folks he has personally potentially infected finally test positive in a few months.  Heck, I doubt they wait that long.  Of course, if he is worth his weight in salt as an attorney, his assets are well shielded and his judgement exposure would be low. 

Since you can’t sue the Federal Government, the CDC, Homeland Security, the TSA are all safe, regardless of whether they bungled this case or not. 

But the airlines…  If they failed to restrict this fellow from travel and possessed the No-Fly lists with his name on it, ouch.  I’m sure we’ll see suits filed regardless.

What I don’t know (yet) and am curious about is whether there are international laws governing travel with known infectious diseases.  The US can restrict people entering our country if they are known to be diseased or if they haven’t received certain immunizations and the like.  I’m betting some, if not all of the affected sovereignties have similar regulations.

Another irony is that all of the people on these two trans-Atlantic flights that can be found are being contacted right now by other personal injury attorneys and being informed of their legal options now and in the future.

Allow me to introduce you to Mr. Andrew Harley Speaker, duly licensed to practice law in the State of Georgia on October 27, 2004.   He joined his father, Theodore A. Speaker, Esq. in his personal injury and family law firm soon after receiving his juris doctorate from the University of Georgia, and after a very brief stint as an assistant district attorney in Fulton County.

 Here is his bio on the website for The Speaker Law Firm in Atlanta (currently besieged with unprecedented web hits…):

Andrew Speaker is a licensed member of the State Bar of Georgia. He attended the United States Naval Academy and went on to receive his undergraduate degree in Finance from the University of Georgia as well as his law degree from the University of Georgia School of Law. After working with the Fulton County District Attorney’s Office and the Oconee County District Attorney’s office, he chose to go into private practice so that he could represent injured people in personal injury cases. He concentrates his practice in personal injury litigation and family law.

Special Recognition
• Shepherd Spinal Center Junior Committee Volunteer of the Year Award – 2001
• American Bar Association National Criminal Mock Trial Champion – 2003
• American Trial Lawyers Association Regional Finalist – 2003 Inn Of Court Representative for University Of Georgia School Of Law
• American Trial Lawyers Association Nominee for University of Georgia Law
• University of Georgia Mock Trial Competition Finalist

Speaker’s bride, by the way, is Sarah Spence Cooksey, the daughter of Dr. and Mrs. Robert C. Cooksey of Roswell, GA.  Here is their Engagement Announcement from April 24, 2007 that mentions their upcoming May wedding in Santorini, Greece and European honeymoon. 

The irony in this story only grows greater!  Dr. Robert C. Cooksey is a microbiologist who works with Dr. Moises Hernandez, et al, in the Tuberculosis Laboratory at the Centers for Disease Control in Atlanta, GA.  No kidding.  He wrote this paper on Microbacterium cosmeticum sp. in the International Journal of Systematic and Evolutionary Microbiology, if you care to meet some heavy, but quick reading.  

Wow.  Double-Barreled Wow!  Gee, I wonder if he knew about this young man’s disease? 

When this story of this couple’s trans-Atlantic exposures first broke yesterday, the then anonymous traveler, who described himself as an educated man, claimed that his physicians never told him he couldn’t travel with his disease.  And that is when I started preaching to the fiance’ that there’s something very, very wrong there.  I knew that couldn’t be the case.  Based upon my medical experience and knowledge of TB cases as a nurse, anyone diagnosed with tuberculosis, moreover its extremely virulent and deadly mutant child XDR-TB, has been clearly briefed with very specific cautions, precautions and basic rules of living henceforward, however latent their disease may be.

Today’s story from The Atlanta Journal Constitution relates Speaker’s initial downplaying of the instructions given him by physicians, as well as offering statements suggesting he bloody-well KNEW not to travel, but did it anyway so they could have that Greek wedding and honeymoon tour of Italy they’d been planning and had paid for.

Think that deliberacy, that choice (if proven) that was made to ignore medical advice and international law will go unnoticed or unpunished?  One of two scenarios must be true:  either Sparks intentionally ignored medical advice, or his doctors are guilty of malpractice in not clearly stating the precautions he must take to protect others.

If this young attorney hasn’t single-handedly begun an epidemic, only God can be thanked for His grace.

Tuberculosis is the leading cause of death in the world, especially among third world countries, infecting more than 9,000,000 annually, of whom more than 2,000,000 die each year.  Of those 2,000,000 annual deaths are 100,000 children.  We have witnessed a tremendous decline in this disease in the US over the last 50 years with our modern, clean living, great healthcare and immunization requirements. 

The CDC has stringent requirements for physicians and hospitals and health departments to report any and all cases they diagnose and/or treat.  In 2005, there were less than 14,000 cases in total.  Of those, 6,376 cases were reported in people who were born in the US.  A larger number of  7,656 TB cases were reported in people born outside of the US and more than half (56%) of these foreign-born cases were reported in persons from Mexico (1,930), the Philippines (826), Vietnam (526), India (563) and China (389)  See the entire statistics from the CDC in their annual report on the Trends in Tuberculosis – United States, 2005 

In the United States, in my personal and limited experience, Tuberculosis pops up most typically in our public schools and is usually in high schools at that.  A Fort Worth suburb is testing 500 students and teachers at Bowie High School right now, who were exposed “earlier in the month.”  

Since the incidence rate of tuberculosis is relatively very low, tests are not required by law for school children.  Only if there has been an exposure or fear of one are children administered tuberculosis testing.  However, before just about every college in the land will let you in their doors, students must have a PPD test using the Mantoux technique.   As for adults, every one must have tuberculosis tests ever ten years if they are county, state or federal employees, work anywhere in healthcare, daycare, elderly care, food preparation and many other industries.

While, by generalized medical statistics in the US, only 10% of those exposed to latent or active TB carriers actually develop the disease, reality screams that the incidence of contraction depends upon an individual’s age and personal health.  Young to middle-aged adults who are healthy and have no underlying medical conditions are relatively safe, while the very young and the very old, as well as anyone with any of a myriad of immune deficiencies (like diabetes, for example) are at exceptional risk.  People with HIV/AIDS tend to develop the disease through the normal course of HIV/AIDS.  They are the most vulnerable of all. 

Everything you wish to know about the clinical aspects of Tuberculosis can be found here at the CDC’s FAQs on TB. 

Read and learn well.  This non-clinical made-for-the-public text will tell you the disease is transmitted by coughing or sneezing.  That’s very true.  But the clinical reality is that talking also transmits the disease, which is an airborne virus that resides in the respiratory tract.  Simply breathing out is a potential transmission, hence the required use of specialized filtration masks by patient and healthcare workers alike.

But Mr. Speaker doesn’t have regular tuberculosis.  He has XDR-TB, which is much worse and an emerging mutation of TB worldwide.  Of the precious few drugs effective at all against tuberculosis, his type is resistant to nearly every one.  A medically renown group called Doctors Without Borders has been treating folks all over this world for decades for a myriad of infectious diseases and know tuberculosis intimately.  Please read Don’t Tell Me TB Is Under Control, because folks it is absolutely not. Not even here.

I have three questions I want answered:  When exactly and where was Mr. Speaker exposed to XDR-TB?  When was he diagnosed with XDR-TB?  And where has he been, who has been exposed in the interim and since?  I’m guessing the CDC and the governments of France, Greece, Italy, Czechoslovakia and Canada are wondering the same.

I feel sorry for this young couple.  Not a way in which anyone would see a marriage begin.  Mr. Speaker’s prognosis is dark and arduous over the next many, many months, if not a few years…if he survives, and precious few with this disease do.  And certainly no one has had the level of exposure to his disease as his bride.

I feel more sorry for all of those trusting and innocent folks exposed between Atlanta, Paris, Greece, Italy, Prague and Montreal — and many will never be discovered — who will not be able to be officially ruled as negative for the disease for several months.  And those who are found positive will face the same exhausting and debilitating treatments that are Mr. Speaker’s current worries.  The very mildest cases that develop will spend the remainder of their lives on medication and they’re to be the lucky ones.

Indeed, being a personal injury attorney is, to me, an irony of epidemic proportions.  I doubt even Tom Clancey would have conceived of this scenario.

We should all pray for this young man, his family and absolutely for the hundreds, if not ultimately thousands of people potentially impacted by their amazing arrogance and selfishness. 

I hope they enjoyed a beautiful wedding and honeymoon.  I hope the unmarried folks they exposed along the way will have that same opportunity.

You can expect to hear a TON more about this case in the days ahead.

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5 responses to “An Irony of Epidemic Proportions

  1. I can understand that this matter is not considered a criminal offense, although I wish there was a way to create one.
    What redeeming value this potential tragedy presents, is the myriad lawsuits that may haunt this “intelligent” (?) young man for years.
    I hope he re-evaluates the value for the dough he spent on his honeymoon, vis a vis the innocent folks involved.

  2. Pardon me if I don’t shake hands with this chap’s father-in-law, the one “studying TB at CDC” without a latex mitt…

  3. good post….I am wondering the same things you are …

    “When exactly and where was Mr. Speaker exposed to XDR-TB? When was he diagnosed with XDR-TB? And where has he been, who has been exposed in the interim and since?”

    …exactly…imagine the amount of people he infected…like a walking weapon of mass destruction…I don’t feel sorry for him though…being a personal injury lawyer he would know the implications of travelling abroad with TB, so I don’t buy it one bit…he “knew” he was infecting people and obviously didn’t care…neither does his wife (who may have TB also) or father in law.

    Something just doesn’t add up here.

  4. Chief Blue Feather

    Let’s see, this all-american guy somehow contracts a rare form of TB and his father in law just happens to work as a prominent TB researcher at the CDC. Put 2 & 2 together people! This is an intelligence operation of some sort. Young Mr. Speaker went to the US Naval Academy — a well known spook recruitment school. Results of this operation: Lock down the borders! Mandatory medical testing for immigrants! Let’s bomb Iran while were at it! Another backward step in our Culture of Fear.

    EheavenlyGads: Bless your heart. Methinks you might find Valium to be of assistance here. Insofar as “lock down the borders” and “mandatory medical testing for immigrants” is concerned, I concur. The latter is highly improbable, unfortunately…

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