Wednesday, July 11, 2007

TB: The Problem With Epidemics

The problem with epidemics, besides the virulent bug, is people. As the story of the contagious Arkansan TB patient who broke a hospital window and now roams the countryside illustrates, people don't like quarantine and quarantine is the ultimate method of containment.

Once preventative measures fail, and after that, medications fail, quarantine is the last defense against disease. It is very effective and has been used for thousands of years.

But quarantine isn't effective if, like the TB escapee, it's broken. In every epidemic, there are a few carriers doing most of the damage by infecting the most people. These are people who are either ignorant of their health status or they know their health status and purposefully or apathetically infect people they come across.

In this modern world, where individual rights are so elevated, I wonder if citizens would submit to quarantine to spare their neighbors their pain. The demonstration by the two American men infected with TB don't give me much hope.

More on the alarming spread of drug resistant TB worldwide.

How it might be dealt with:

"Holding the patient against their will is not ideal but may have to be considered in the interest of the public," Green-Thompson said in a statement issued by the South African Department of Health.

In the 1990s, New York City health authorities authorized the forcible detention of people who rejected TB treatment, some for as long as two years, ultimately leading to a significant dip in cases.

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