Since I heard the story of "TB Andy" yesterday, I have been asking how could this virulent pathogen, a novel strain of TB-a form that is "extensively drug-resistant", get past three international ports of entry into the United States and Canada?  What complicates this even more is that the human host was on the "no-fly" watch list.

According to the CDC, TB is a serious disease threat both in the US  and abroad.  Globally, more than one-third of the world's population is infected with the bacteria that cause TB, and each year approximately 9 million people become ill with the disease, and 2 million of those die (which by the way is a 22% case fatality rate!) The ability of the disease to develop resistance to treatments and to travel easily across borders makes worldwide TB control efforts critical.  Even more alarming is the XDR TB is cause for concern because it renders patients virtually untreatable with available drugs. Importantly, the emergency of MDR TB fifteen years ago was a harbinger of a pandemic; this scenario must be prevented from happening with XDR TB.

While bird flu as the prime suspect for the next pandemic has been removed temporarily from the media spotlight, the way this country is managing this single case of XDR TB should make us all ask the question: Do we have the resources and systems in place to protect our population during a massive outbreak of a novel virus?  Do we have the resources to intercept an infectious disease carrier whether human or animal from entering unimpeded into the US? 

Please read the materials posted in our Commentary section, especially the newest op-ed from Dr. Skip Burkle as we continue to monitor avian influenza as a critical public policy issue.