The most interesting bit of information in a Tucson Citizen article about the man with "extreme" TB living in an Arizona jail was found in paragraph 6: Robert Daniels was diagnosed with "extreme multi drug resistant tuberculosis" while living in Russia with his wife and son. Daniels, who has dual citizenship, came back to the United States to get treatment.

When he sought treatment, doctors realized the strain he carried was drug-resistant and also mutating within him. Only 15 other people in the country carry this strain. Daniels agreed to live in a halfway house and follow rules to protect the community, including continuing treatment and wearing a mask in public. Not surprisingly he failed to comply.

The article does not provide information about the origins of the other 14 people with multiple drug resistant TB, however the World Health Organization (WHO) has warned of a growing problem in China, Mongolia and the Philippines. As early as 1998, doctors were warning of an impending crisis related to resistant TB, also called "Ebola with Wings" in Russia.

According to the WHO, only 4% of TB cases in America are drug resistant. In Latvia the number is 19%. In September of 2006, the WHO reported on a study completed in South Africa: 221 out of 544 patients had multi-drug resistant TB. Of those cases, 53 people had extensive drug resistant TB. 44 of the 53 people tested positive for HIV. 52 out of the 53 people died within 25 days of diagnosis.

These numbers are terrifying. People with HIV are particularly vulnerable to all varieties of TB. Those infected become a breeding ground for the virus to mutate and strengthen. While right now, the average healthy person is not particularly vulnerable to these strains of TB, over time these strains will strengthen. Like with other viruses, elderly people and children will be the most at risk. Eventually we either develop vaccines or the general population becomes increasingly at risk. As these strains mutate, developing vaccines lose their effectiveness. This is why the flu shot is given every year.

It is human nature to push limits. Most people will not take the initiative to protect others. Most people when left unsupervised will make decisions that are convenient for themselves. Daniels is not unique in his decision to knowingly expose other people to his virulent condition.

These drug-resistant strains of TB should be of concern to people in the U.S. While we can all feel for those who are quarantined, the government has a duty to protect the country from public health threats. Daniels should remain in quarantine as long as he tests positive for this strain of TB.

Our government should begin testing all immigrants who want to enter our country for communicable diseases. Those people who test positive should not be allowed to enter our country. Any illegal alien who is discovered to carry a communicable disease should be deported immediatly to their home country. Americans who have lived abroad, particularly in countries known to have high rates of these communicable diseases, should also need a medical clearance before returning to the States.

U.S. citizens who have acquired a communicable disease abroad should be treated before returning to the U.S. If that is not possible, they should be brought back in the safest manner possible for other travelers and then quarantined until they are medically cleared. (Would you want to sit next to a person with drug-resistant TB on your flight home from vacation?)

Requiring medical verification of good health is a reasonable expectation for those who want to travel to the United States. Quarantine is a responsible, reasonable requirement for those people who would knowingly place innocent people in their communities at risk.