Reported by George Brown
Two Mid-Southerners have been exposed to Tuberculosis. They were on the same flight as the Atlanta attorney who's quarantined with tuberculosis.
Dr. Helen Morrow watches over cases for Shelby County.
"Tuberculosis isn't really that uncommon. Infact, last year here in Shelby County, there were 107 cases reported," says Morrow.
Right now, Morrow is dealing with the two people who may have been exposed to a strong strain of TB.
Those two people, just like anyone else, have undergone a TB skin test. Results come back in 48-72 hours.
Those results aren't conclusive so they'll be tested again a few weeks later and possibly longer.
In 2006, 13,767 cases of TB were reported in the United States. That number is down although the drop isn't as significant as in previous years.
Ethnic minorities in urban areas have the highest rates of TB.
What is now the Adams Pavillion at the MED used to be a hospital dedicated to TB. It was closed in the 70's as TB cases fell.
Health officials say not to overreact to this most recent case, instead stay vigilant and realize how serious Tuberculosis can be.
Morrow adds, " you're not given a bottle of medicine and expected to take it. We bring the medicine to you and watch you take it. It's called directly observed therapy. That's how important it is to get this disease directly."
In extreme situations, people with TB, if they're not following orders from the Health Department, can be jailed.
In-fact right now, several people are sitting in jail with Tuberculosis.
Quarantined TB patient: 'I hope they forgive me'
The Atlanta lawyer quarantined with a dangerous strain of tuberculosis apologized to fellow airline passengers in an interview aired Friday, and insisted he was told before he set out for his wedding in Europe that he was no danger to anyone.
"I've lived in this state of constant fear and anxiety and exhaustion for a week now, and to think that someone else is now feeling that, I wouldn't want anyone to feel that way. It's awful," Andrew Speaker, speaking through a face mask, told ABC's "Good Morning America" from his hospital room in Denver.
Meanwhile, questions arose as to whether the wedding even took place. The mayor of the island of Santorini in Greece, Angelos Rousso, told The Associated Press: "There was no wedding. They came for a marriage but they did not have the required papers."
He said the couple stayed in a hotel for three days and then left. In Denver, Speaker's doctors said he could be in the hospital for up two months, and if antibiotics fail to knock out the extremely drug-resistant infection, he may have to undergo surgery to remove infected lung tissue.
Surgery to remove pieces of the lung was a more common practice before the advent of sophisticated drugs in the 1960s.
But surgery is coming back as a treatment because of the development of strains resistant to those drugs.
Speaker is the first infected person quarantined by the U.S. government since 1963. In the TV interview, Speaker, wearing street clothes, repeatedly apologized to the dozens of airline passengers and crew members now anxiously awaiting the results of their TB tests.
"I don't expect for people to ever forgive me. I just hope that they understand that I truly never meant to put them in harm," he said, his voice cracking.
Speaker, 31, said he, his doctors and the federal Centers for Disease Control and Prevention all knew he had TB that was resistant to front-line drugs before he flew to Europe for his wedding and honeymoon last month.
But he said he was advised at the time by Fulton County, Ga., health authorities that he was not contagious or a danger to anyone. Officials told him they would prefer he didn't fly, but no one ordered him not to, he said.
Speaker said his father, also a lawyer, taped that meeting. "My father said, `OK, now are you saying, prefer not to go on the trip because he's a risk to anybody, or are you simply saying that to cover yourself?' And they said, `We have to tell you that to cover ourself, but he's not a risk,"' Speaker said.
Speaker was in Europe when he learned tests showed he had, not just TB, but an especially dangerous, extensively drug-resistant strain. "He was told in no uncertain terms not to take a flight back," said Dr. Martin Cetron, director of the CDC's division of global migration and quarantine.
Cetron said Wednesday that in conversations between health officials and Speaker before the flight, "they clearly told him not to travel," but "there were no legal orders in place preventing his travel, and no laws were broken."
Speaker, his new wife and her 8-year-old daughter were already in Europe when the CDC contacted him and told him to turn himself in immediately at a clinic there and not take another commercial flight.
He said he felt as if the CDC had suddenly "abandoned him." At that point, he said, he believed if he didn't get to the specialized clinic in Denver, he would die. If doctors in Europe tried to treat him and it went wrong, he said, "it's very real that I could have died there."
Speaker's new father-in-law, Robert C. Cooksey, is a CDC microbiologist whose specialty is TB and other bacteria.
But he said neither he nor his CDC lab was the source of Speaker's TB. On Friday, CDC director Dr. Julie Gerberding said that Cooksey was "extremely helpful" in tracking down the couple during their honeymoon in Europe by providing cell-phone and other numbers.
She also said Cooksey may have been involved in preparing one of the lab tests that determined what type of TB Speaker had contracted.
But she declined to provide more details on Cooksey's involvement in the case, and would not comment on the propriety of his actions, which included flying to Europe himself to be there at his daughter's wedding.
"We're not privy to any conversations that he might have had with his family, so we're not going to comment on that," Gerberding said. But she also said: "The father-in-law's role was limited to what was expected of a father-in-law."
Gerberding defended the CDC's move to quarantine Speaker, and said the agency had been exploring options - including hiring an air ambulance or a ship - so that Speaker could return to the U.S. without having to board a commercial airliner.
"That's another thing we'll be focusing on in the future: Can we create a protocol so that if such a thing happens again, we don't have to invent a solution?" she said.
She said it is one of several things the CDC hopes to look into over the next few weeks. "The CDC and many others have learned a lot from this process," she said.
Doctors hope to determine where Speaker contracted the disease, which has been found around the world and exists in pockets in Russia and Asia.