No Confidence In American Medical Practices

The case of Andrew Speaker, who flew halfway around the world with a particularly severe strain of TB, reminded me of my own experiences after arriving on American soil.

Like most British schoolkids I received a BCG vaccination against tuberculosis when I was about twelve or thirteen years old. Although the vaccine is considered 70%-80% effective against the tuberculin bacillus, for reasons known only to the US government, it was not generally administered in America.

As part of my US immigration medical, I was given a Mantoux test to determine if I was infected by the tuberculin bacillus. The test returned a positive result.

So-called medical experts disagree about the effectiveness of Mantoux tests on those who have been vaccinated using BCG. In the US, never in favor of BCG vaccination, opinion favors the idea that BCG vaccinations do not interfere with the effectiveness of the Mantoux test, and a positive response should be interpreted similarly to a positive response in a non-vaccinated person. The UK opinion is exactly opposite. British medical experts insist that BCG vaccinated individuals are likely to show a positive response, and consequently the Mantoux test is of little use in determining infection.

Just to complicate the issue, “experts” disagree as to how long the BCG vaccination affects any response to the Mantoux test. Some say the effects will wear off after five years; others, that it may be twenty-five years or more before a positive Mantoux test can be assumed not to be due to previous BCG vaccination.

I was fifty-six when the pinprick in my arm produced a large red weal indicative of TB infection, some forty-three years after being vaccinated. I knew I didn’t have TB. First, I had not been anywhere, or with anyone from whom I could have contracted it, and, second, I had had a Mantoux test in the UK some dozen or so years previously, and that had been equally as positive as its US equivalent.

The simple fact so-called experts refuse to accept, is that in some people a BCG vaccination will produce a positive Mantoux test for the rest of their lives, even sixty or more years after vaccination.

Of course, trying to explain this to US immigration doctors is rather like throwing pebbles at the Statue of Liberty and expecting it to fall over. No, I needed treatment, and if I wished to remain on American soil, treatment was what I was going to get.

I was referred to my local health clinic – the TB department – where I was prescribed an antibiotic called Rifampin. Unknown to me at the time, Rifampin is one of the strongest antibiotics known to man. Also, one of the most dangerous. It is used in the treatment of leprosy and AIDs. It’s effects on the liver can be catostrophic, and it can cause death.

Here’s part of Wikepedia’s description of Rifampin:

“Adverse effects are chiefly related to the drug’s hepatotoxicity, and patients receiving rifampicin often undergo liver function tests including aspartate aminotransferase (AST). The most common unwanted effects are fever, gastrointestinal disturbances, rashes and immunological reactions. Liver damage, associated with jaundice, has also been reported and in some rare cases has led to death.

“Hepatotoxicity” is a fancy medical term for liver poisoning. Within three weeks of taking this “medicine” I felt like I was dying. I had no energy, could scarcely drag myself out of bed in the morning. My appetite became non-existent, my stomach churned, and I truly wanted to die. Part of the treatment involved liver function tests, originally monthly but transferred to weekly when I complained of symptoms. After my third liver function test I was told by the TB nurse to stop the Rifampin forthwith. The results showed I was in danger of complete liver failure.

Thankfully, I recovered and, so far as I know, am no worse for the ordeal. As for my alleged TB, no-one ever worried about that anymore. I’m sure, were I to take another Mantoux test today it would be as positive as the one I had five years ago. I don’t have TB. I never have had TB. I was another victim of political medicine.

What has all this to do with Andrew Speaker?

Simply this. I didn’t choose to fly during the time I was supposedly “infected”. If I had, it’s conceivable I may have found myself in a similar position to Andrew Speaker. Admittedly, my TB was never considered to be drug-resistant, but nevertheless the media can pick up on such stories and their ability to press the American public’s panic button is legendary.

Andrew Speaker today apologized for any upset he may have inadvertently caused, but insists he was told he wasn’t contagious and was only advised not to travel, not forbidden from so doing.

I sympathize with him. Whether he was a victim of political medicine, as I was, or merely the vagaries of a vulturous media, their are many in this country and around the world who have been persuaded he was at best irresponsible, and at worst, an inhuman demon.

My own opinion is that he was merely another victim of the US medical system. In his case, the diagnosis is not in doubt, but it seems any clarification by the medical profession as to how it should be dealt with, and treated, has been sadly lacking.

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4 Replies to “No Confidence In American Medical Practices”

  1. I don’t know when your situation occurred, but it is quite common for people to have reactions like you had. All they do is a chest x-ray to confirm that there is no TB present. If TB is present, treatment is necessary, but that only happens one in one thousand.

  2. PM – at the time, that’s exactly what I assumed would be the case. Unfortunately, after having a clear chest X-ray, the Immigration lot decided I had to take the Rifampin – just to be “on the safe side”. Of course, I was in no position to argue. One year after 9/11, they were quite specific, “Do as we say, or you’re on the next flight out.”

  3. I so agree with you. Strange day when I find myself defending a personal injury lawyer but there it is ;).

    I worked in the state health system for many years, apparently California is less retarded than US immigration. We never used the Mantoux on anyone who had ever had the BCG and it was required we ask the patient if they had had it and document their answer in their medical record. It also cannot be used on anyone with an HIV infection or who is being treated with immunosuppressive drugs because someone with a suppressed immune system will test negative even if they are infected.

    This whole affair was much ado about nothing. I’d have felt perfectly safe sitting next to this man.

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