TB, Emerging Diseases and the Role of Personal Responsibility
J. Wiant, M.P.H. Ph.D.
recently reported story of a man with multi-drug resistant
tuberculosis should sensitize us to the fact that
what many think is an eradicated disease is really
quite prevalent in certain countries of the world
and remains potentially deadly. More importantly,
this case demonstrates how easily diseases more contagious
than TB could be spread around the world in a very
short time. What are the lessons that should be learned
from this incident to reduce the chance of a more
deadly outbreak of disease?
most important way to prevent the spread of many diseases
is for each of us to assume personal responsibility.
For example, the major source of disease outbreaks
associated with food products is contamination resulting
from failure to wash hands or improperly cleaning
and sanitizing food contact surfaces. Drug resistant
strains of many diseases evolve as a result of the
failure to complete the prescribed course of treatment.
Colds and influenza are transmitted as a result of
failure to practice good personal hygiene (e.g. washing
hands or covering a cough). Good personal hygiene
is the first line of defense against transmitting
disease to others.
If we are faced with an outbreak of avian flu in humans
that reaches the U.S., as many fear is inevitable,
there will not be adequate vaccine available for timely
use in preventing the disease from spreading. A government
ordered quarantine of the general public to prevent
person-to-person contact is unlikely to be effective
or enforceable. Neither the medical community nor
the government will be able to intervene effectively
to stop the spread of the disease without cooperation
from the public.
as individuals possess the most potent weapons against
becoming victims of a pandemic flu outbreak. Public
health officials and others will provide the public
with strategies that can be very effective in limiting
exposure to the disease and, therefore, reducing the
magnitude of the outbreak. Those recommendations,
such as hand washing, disinfection of contaminated
surfaces and objects and other personal hygiene measures
can all be easily implemented by individuals.
it will require voluntary action by all of us to make
these non-pharmaceutical remedies effective. One individual
who decides to ignore the recommendations, board a
plane and fly to another city or country will potentially
infect people who will not know they are at risk.
How many of your friends, neighbors and coworkers
would demonstrate this behavior? They can then become
carriers of the virus and begin a new generation of
the disease by exposing others. This multiplying effect
can quickly create an unmanageable outbreak.
the recent TB case demonstrates, even with proper
medication and sound medical advice, the most important
factor in disease management is the willingness of
patients to heed the advice and take personal responsibility
for protecting themselves and others.
Wiant is President and CEO of Caring for Colorado
Foundation in Denver Colorado and chairman of the
Water Quality & Health Council.