TB Scare Spotlights Need for Faster Diagnosis

May 31, 2007 — -- The case of the globe-trotting tuberculosis patient, now being kept in isolation, has touched off concern all around the world.

But while some, especially those who flew with the still unidentified patient, worry about potentially contracting the potentially deadly disease, ABC News medical editor Dr. Tim Johnson said the risk of anyone coming down with TB is very low.

"We have learned from the CDC that the risk appears to be low because the patient is asymptomatic and is not coughing and spewing out germs. He is also smear-negative, which means when you put a sputum sample under a microscope, it is not teeming with bacteria," Johnson said on "Good Morning America." "The risk is not zero but it is low which ought to be reassuring."

Johnson explained that the patient has XDR-TB, otherwise known as extensively drug resistant TB. It is very difficult to treat, and its mortality rate can be as high as 50 percent. But, according to Johnson, XDR-TB is also extremely rare.

"There are about 14,000 cases of TB in the U.S. every year. But there have been only 49 cases of extensively drug-resistant TB reported between 1993 and 2006," he said.

For the medical community, the TB scare should serve as a wake-up call to speed up diagnosis, Johnson said. The patient learned he had TB in January. Only in May did doctors realize his strain was extensively drug-resistant. Johnson said America has the technology to diagnose more rapidly but not enough hospitals have access to it.

"We need to spend more money on solving this problem," he said. "We have really learned a lesson about how to handle these kinds of public health threats and I worry about what would have happened if this was a more dangerous disease such as SARS or smallpox."

Time in Isolation Ahead

Within the next 48 hours, the patient will be transferred to Denver and treated at National Jewish Hospital, which specializes in TB treatment. If drugs fail, the man could undergo surgery to remove the diseased tissue.

In Denver, he will remain in isolation. Doctors say isolation is one of the only ways to stop the spread of highly infectious diseases like TB. But for the sick, it can be lonely, frustrating and terrifying.

In an isolation room, air is sucked out of the room using special ducts and filters. Patients are monitored on video surveillance. Anyone entering the room, including doctors and loved ones seeking contact, must wear protective suits, masks and gloves.

"I am sure that it is difficult for a patient emotionally to think that they have some kind of horrible thing that no one can touch you or breathe the air that you are breathing," said Peggy Pass, an infection control epidemiologist at Johns Hopkins Hospital.

Robert Daniels, 27, knows the feeling all too well. He suffers from the same strain of TB as the newest patient and was forced into solitary confinement in Arizona last July.

"I feel worse than a criminal," he said from his isolation room. "I feel worse than a person that is about to be sentenced to death."

In the United States, a person can be ordered into quarantine if they have been exposed to nine infectious diseases. For those infected, voluntary isolation is rare, but not unheard of: At Johns Hopkins, there are currently more than 10 patients in some form of isolation.

The length of isolation depends on the disease, but it can range from two weeks to much longer. Daniels has been in isolation for nine months and counting.