Traveling while infected

It isn't an absolute right

Published June 3, 2007 at midnight

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Atlanta attorney Andrew Speaker, who's getting treatment for a virulent, drug-resistant strain of tuberculosis at National Jewish Medical and Research Center, quickly became a Rorschach test for activists pushing various causes.

Before Speaker was even identified on Thursday as the patient, he was cited by opponents of the president's immigration reform package, by advocates of tougher border security, by fans of a massive boost in spending on public health, and by those who believe health authorities should act more aggressively to stop new strains of infectious diseases, to support their cause.

Time to slow down. Yes, medical authorities may indeed need more leeway to isolate travelers who carry extremely dangerous infectious diseases. Affordable overseas travel has placed more tourists at risk of both contracting communicable diseases and bringing their illnesses home.

But where to draw the line between freedom to travel and protecting public health? In this case, the Centers for Disease Control and Prevention may have done all it could.

Speaker's TB was identified by a chest X-ray earlier this year. He resisted requests from Georgia health officials to not fly to Europe for his wedding and honeymoon. Speaker said he felt fine and ignored the appeals because he was under no "legal order" to remain home.

Georgia officials notified the CDC. It urged them to get a state court order, which is the protocol in such cases. Before the order was served, Speaker and his fiance had left.

While in Europe, the CDC confirmed that Speaker had an extremely drug-resistant strain of TB. Yet he disregarded a CDC demand to check into a hospital in Rome. Instead, the couple flew to Canada, rented a car, and then entered the U.S. A border inspector ignored a directive to detain Speaker - reportedly, because he looked healthy.

All this shows that even the strictest public-health measures may not work if patients are stubborn and enforcement agents negligent.

In this case, however, it's difficult to second-guess the CDC's actions.

And what about patients who have infectious diseases but aren't cured? Consider Robert Daniels, a 27-year-old Arizona man who's been quarantined in a Phoenix jail since July. Daniels contracted tuberculosis while living in Russia about six years ago. Doctors there let him stop taking medication when he felt better.

Daniels' TB returned, so he went back to Arizona. By then, he had contracted the same strain that afflicts Speaker. Daniels refused a court order to wear a surgical mask in public. That's why he's being treated in jail.

A delicate balance must be struck between protecting the public and freedom to travel, which has long been recognized as a constitutionally protected liberty.

Meantime, the noxious notion that a crackdown on illegal immigration, primarily from Mexico, would prevent outbreaks of infectious diseases needs to be debunked.

The CDC reports that Hispanics are more likely than non-Hispanic whites to suffer contagious illnesses. So are African-Americans. Suggesting that closing the borders would eradicate tuberculosis is less than convincing.

Besides, Andrew Speaker and Robert Daniels are U.S. citizens who have the wherewithal to fly abroad. They don't fit the profile so prevalent on the talk-show circuit. And because they don't, it suggests that many simple solutions may simply be ineffective.

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