Return of the White Plague

Aside from the disagreements over which health officer said what, arguments about the loopholes between federal, state and local health regulations, or the media ruckus over whether Speaker was just a guy trying to have a nice wedding or a modern-day Typhoid Mary with a law degree, one obvious point demands our attention. Tuberculosis is a bad disease, and it's contagious. International air travel poses real risks in the spread of tuberculosis. Coughing, sneezing, singing, yelling and even laughing can spread TB germs. People contract tuberculosis after prolonged exposure (eight hours or more) to someone with the illness. This is the same length of time as most transoceanic flights, where passengers breathe re-circulated air for hours on end.

Those infected have a moral imperative not to put others in harm's way, even though it may mean postponing a wedding and a honeymoon. This has been a truism since Roman times. Salus populi suprema lex esto, went their saying: Let the public's health be the supreme law.

So, if you're confronted with the slightest chance of spreading a terrible infection (and with tuberculosis, that determination can take many weeks), assume that you are contagious until proven otherwise. Failure to follow that simple rule eats away at the foundation of public health surveillance and modern medical care. One only wishes that before Speaker embarked upon the first of many flights last month, he had recalled an admonition he must have heard from his mother or kindergarten teacher: If you are sick, stay home.

Someone's life may depend on it.

howard@umich.edu

Howard Markel, a professor of communicable diseases and the history of medicine at the University of Michigan, is the author of "When Germs Travel."