How many cases of XDR TB have been reported in the United States?The newest case is Andrew Speaker, whose story has generated intense news coverage. The main theme has been that he was diagnosed with tuberculosis, advised not to travel, did so any way, and exposed many airline passengers to the potentially deadly disease.
In the United States, 49 cases of XDR TB have been reported between 1993 and 2006.
XDR TB stands for extensively drug-resistant tuberculosis. This drug-resistance makes it a potentially serious pandemic and lethal agent, especially if it were to mutate (or be bioengineered) into a highly virulent strain.
One part of the story that has not been adequately pursued is the oddly coincidental fact that Speaker's fiance's father is Dr. Robert C. Cooksey, an XDR TB researcher at CDC:
First and foremost, I am concerned about the health and well being of my son-in-law and family, as well as the passengers on the affected flights.There are many problems associated with Dr. Cooksey's statement.
I am the father-in-law of Andrew Speaker, who was recently publicly identified as a person infected with extensively drug resistant tuberculosis. I do work at the Centers for Disease Control and Prevention. I have worked at the CDC for 32 years. I´m a research microbiologist in CDC´s Division of Tuberculosis (TB) Elimination, and my work does involve working with a wide range of organisms, including TB. As a research microbiologist, my laboratory work involves identifying the characteristics and features of bacteria.
As part of my job, I am regularly tested for TB. I do not have TB, nor have I ever had TB. My son-in-law´s TB did not originate from myself or the CDC´s labs, which operate under the highest levels of biosecurity.
I wasn´t involved in any decisions my son-in-law made regarding his travel, nor did I ever act as a CDC official or in an official CDC capacity with respect to any of the events of the past weeks.
As a parent, frequent traveler, and biologist, I well appreciate the potential harm that can be caused by diseases like TB. I would never knowingly put my daughter, friends or anyone else at risk from such a disease....
The first, and one that alerts us to question the rest of his claims, is the idea that Speaker would not have immediately conferred with his soon-to-be father-in-law TB expert upon learning that he had a baseball-sized TB lesion in one of his lungs.
Cooksey says, "I wasn´t involved in any decisions my son-in-law made regarding his travel." He let his daughter go off with a TB patient, jet around the world, and yet says, "First and foremost, I am concerned about the health and well being of my son-in-law and family, as well as the passengers on the affected flights."
Something smells very rotten here.
Second, the coincidence of Speaker's rare disease and his father-in-law's research strains credulity. Forty-nine cases in the US in 13 years, and one just happens to be the fiance of the daughter of scientist studying this rare disease.
Third, the fact that Cooksey has never tested positive for TB is not necessarily proof that he wasn't the carrier. TB is member of the genus Mycobacteria, known for its unusually tough cell wall. Mycobacteria can take years to culture, and Mycobacteria tuberculosis, the causative agent of TB, can take four weeks to culture, and remains viable for hours in its airborne state.
Even if TB spores were inhaled by Dr. Cooksey, he might not have become infected. Exposure is not a guarantee of infection. Given the toughness of the organism it isn't impossible that he might have carried the spores in his lungs and out of the lab.
Fourth, Cooksey's claim that CDC's labs operate "under the highest levels of biosecurity" is not reassuring. CDC has made erroneous claims in the past such as the claim that the animals in its labs are well cared for. Other labs operating "under the highest levels of biosecurity," like Plum Island, have been somewhat less than secure and may have been the source of significant public health risks.
Something doesn't add up.