Health Trends: Contagious and Selfish

Andrew Speaker could have been a modern-day Typhoid Mary.

By Robert W. Lash, M.D.|Friday, June 29, 2007

There’s been a lot of talk recently about being contagious. But what does"contagious" really mean and what’s the responsibility that goes along with being contagious? There are some people who wade fearlessly into a room full of sneezing, coughing, snotty children and others who use antibacterial lotion after any contact with solid matter.

Back in the day, when a child in the neighborhood came down with chicken pox, all of his friends were sent to visit. Our moms knew that getting chicken pox as a child was a better deal than getting it as an adult.

At the other extreme is Ebola virus—highly contagious and frequently lethal. No one will be dropping by to pick this up. Putting yourself at risk for Ebola would border on lunacy, and exposing someone to Ebola would be reprehensible.

Somewhere in between falls Andrew Speaker—the lawyer from Atlanta who flew to his wedding on commercial flights despite having tuberculosis—a man who’s had more than his 15 minutes of fame (or infamy).

I’m still not sure what upsets people most about this. Was it that he had drug-resistant TB? If so, does that mean that we’d all be OK sharing row 16 with someone who had regular TB? Was it that he was putting hundreds, if not thousands, of people at risk with his careless globetrotting? Well, in real life people don’t get TB from a handshake or a shared bathroom. TB is spread by coughing and sneezing, and then only by people with relatively advanced disease. Media reports indicate that Speaker was neither coughing nor sneezing and his disease was not advanced.

What bothers me most about this incident is our protagonist’s willingness to put others at risk (albeit a small one) when he probably knew, at some level, it wasn’t the right thing to do. It’s easy to do the right thing when it’s easy. It’s harder to tell your fiancée that you’re getting married at the Elvis chapel, instead of in Europe, because you’re just not sure how contagious you are.

Robert W. Lash, M.D. is an associate professor of internal medicine at the University of Michigan Medical School. His clinical interests include thyroid disease, diabetes, endocrine disorders in pregnancy, osteoporosis and metabolic bone disease, and medical education. A member of the LLuminari team of experts, a board certified internist and endocrinologist, Dr. Lash has an active clinical practice at the University of Michigan.

Every month Dr. Lash answers questions from Discover readers, so if you're confused about health information, email him at DrLash@LLuminari.com.

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