DENVER-
Much has been made of the first federally imposed quarantine in more than 40 years, one that resulted in Andrew Speaker’s isolation in a Denver tuberculosis research and treatment facility. But states have often imposed local quarantines on TB patients to make sure they don’t infect others.
Speaker, 31, of Atlanta, has been diagnosed with extensively drug-resistant tuberculosis, also called XDR-TB, which can withstand many drugs used to treat the disease. For the next two months or so, his life in an isolation room at National Jewish Medical and Research Center will be filled with rounds of doctor visits, doses of antibiotics and workouts on an exercise bike.
Speaker seemed fine Sunday morning, said hospital spokesman William Allstetter.
Speaker isn’t under guard at National Jewish, and the Centers for Disease Control and Prevention lifted his quarantine order Saturday night. The CDC Web site said Denver health authorities issued a local quarantine order, as has been the case for previous XDR patients.
An unidentified New Mexico man has been under court-ordered quarantine there for the last two months. Texas has placed 17 tuberculosis patients into an involuntary quarantine facility this year in San Antonio, and California detained four TB patients last year.
In Phoenix, Robert Daniels has been confined to a hospital jail unit for the last 10 months after defying doctors’ instructions to wear a mask when going out in public. Maricopa County health authorities obtained a court order to lock him up as a danger to the public because Daniels, diagnosed with XDR-TB, failed to take precautions to avoid infecting others.
Last week, the American Civil Liberties Union filed a lawsuit seeking better conditions and treatment for Daniels.
Daniels said he’s seen stories about Speaker and wishes him well, but he wants better treatment for himself.
“He’s being treated like a normal person, like a human being. … I’m being treated worse than a dog,” said Daniels.
Colorado’s quarantine law was updated in 2002, partly because of the increase of multidrug-resistant tuberculosis. The state’s chief medical officer can now issue a quarantine or isolation order for any multidrug-resistant TB patient who has refused to take prescribed drugs, even if the patient is not considered contagious.
Former Sen. Peggy Reeves of Fort Collins, who sponsored the legislation, said some people may stop taking their drugs because they feel better. A normal drug regimen can last as long as two years.
“I think it was pretty responsible legislation, not overly restrictive but still allowing professionals to make some judgments. Sometimes they’re tough (judgments) but they have to be made for the protection of the general public,” Reeves said.
TB bacteria can become airborne when an infected person coughs. If another person inhales it, the bacteria can settle in their lungs but remain dormant for years. The World Health Organization estimates that 2 billion people—about one-third of the world’s population—has latent TB.
According to the U.S. Centers for Disease Control, there were 49 cases of XDR-TB reported in this country in the last 13 years. About 10 percent of cases worldwide during that time are estimated to have been of the XDR type.
Speaker was first diagnosed with multidrug-resistant tuberculosis, which can withstand mainline antibiotics used to treat the disease. While in Europe last month for his wedding and honeymoon, he learned he had XDR.
Dr. Gwen Huitt, who is helping treat Speaker, said two other XDR patients treated at the hospital were under quarantine in their home counties and then placed under quarantine in Denver once they arrived at National Jewish.
She said quarantine patients usually are driven to the hospital nonstop by family members. Speaker arrived Wednesday by private air ambulance, accompanied by air marshals.
When Speaker was diagnosed with multidrug-resistant tuberculosis, county health officials in Georgia said they told him on May 10 that he should seek specialized care in Denver. They followed up with a letter on May 11. Speaker traveled to Europe on May 12-13 and returned to North America May 24.
That may have explained why, once Speaker learned he had XDR TB, he felt so compelled to head back to the United States on his own. He told ABC’s “Good Morning America” that he believed if he didn’t get to the specialized hospital he would die.
Huitt said Speaker is glad to be at the hospital with a cure in sight and is not worried about him trying to flee.
Patients with drug resistant strains have been allowed to leave their rooms with masks if they were “smear negative,” as Speaker has so far proved to be. That means his sputum has yet to show any sign of the TB bacteria. Doctors haven’t said whether or when he will be allowed to leave his room.
With the expected side effects from the drugs, Huitt said, Speaker could also spend a lot of time sleeping.
“I think his life is going to be fairly boring as a patient,” said Huitt.
Even after Speaker is judged well enough to leave the hospital, Huitt said he would have to keep on taking drugs for another two years.
