Introduction

The international saga of Andrew Speaker, a traveler thought to have XDR-TB, an extensively drug-resistant form of tuberculosis, placed a spotlight on existing mechanisms to contain contagious disease threats and raised numerous legal and public health issues. This report presents the factual situation presented by Andrew Speaker, an analysis of various public health emergency measures available to contain emergent public health threats when individuals with serious communicable diseases attempt to use public transportation such as commercial aviation, and legal issues related to the use of such public health measures. Other forms of transportation, such as buses and trains, are not covered by the DNB list. Constitutional Rights to Due Process and Equal Protection

Constitutional rights to due process and equal protection may be implicated by the imposition of a quarantine or isolation order.
The international saga of Andrew Speaker, a traveler thought to have XDR-TB, a drug-resistant form of tuberculosis, placed a spotlight on existing mechanisms to contain contagious disease threats and raised numerous legal and public health issues. This report presents the factual situation presented by Andrew Speaker. It also discusses the application of various public health measures available to contain an emerging public health threat posed by an individual who ignores medical advice and attempts to board an airplane or take other forms of public transportation. These measures include quarantine and isolation authorities, the "Do Not Board" List, and application of certain provisions of the International Health Regulations. This report also examines constitutional issues relating to due process and equal protection. Legal issues which may be raised by application of federal nondiscrimination laws when emergency public health measures are used to contain emerging public health threats are also discussed.