Jim Dundon
via Internet

Thank you, Amy Silverman, for your article about Earl P. Hopper Sr. (and Jr.). My family and theirs were among the first to buy property near 31st Avenue and Camelback in the early '50s. (We've all since relocated.) Earl Jr. was four to six years older than me, but I do remember him and his brothers (one of whom is my age, 50).

I continue to wear Earl Jr.'s POW/MIA bracelet, and when asked (unfortunately, seldom), "Who is that? Or, "What is that?" I say, "He was a neighbor of mine."

I was present three or four years ago when one of Earl Sr.'s sons (a retired officer) swore his sons into the military. Afterward, the young man came up to me, saw the bracelet and said, "Is that our uncle?" I felt both choked up and old at that point.

Part of me says to Colonel Hopper, "Let go." But another says, "Go for it." I wish all of the Hoppers every kindness and courtesy and hope our government will give them satisfaction and peace of mind--someday.

Bruce Stenhouse

Germ of Truth
I am writing this letter in regard to the July 16 article "TB or Not TB?" by Patti Epler. I am pleased that New Times was interested enough in this problem to interview me and write about it. I do, however, wish to clarify some medical information so as not to confuse readers of the article. Ms. Epler wrote that I stated that the drug INH causes liver cancer. I do not believe I ever said that, and I certainly agree with Dr. Lee Reichman when he stated in the article that INH is not known to cause liver cancer. Further in the article I stated that it was odd that not a single Phoenix firefighter with a positive TB skin test had developed an active case of TB. Dr. Reichman commented that this was not odd if everyone had taken INH to prevent active TB. Actually, only about half the firefighters with a positive TB skin test had ever taken INH, so it is still odd that not one has developed active TB. The high number of positive TB skin tests in Phoenix firefighters is still a problem and an unsolved mystery. More research should lead to a solution.

Richard Gerkin, M.D., medical director
Phoenix Fire Department Health Center

While Dr. Gerkin's bird-poop theory on the unusually high rate of positive TB skin tests among Phoenix firefighters may seem rather quirky, it does pose a more broad and important question of the efficacy of TB diagnostics. The TB skin test had been around for decades, yet its inaccuracy continues to be ignored. Catching fewer than two-thirds of TB-positive cases, the test leaves many TB victims in the dark until they become symptomatic. In the meantime, it allows an infectious patient to spread the airborne disease to 10 to 15 more people each year. On the other hand, anyone who has ever had a tuberculosis vaccination, which is also of variable effectiveness, will test positive to a skin test, deeming this diagnostic technique completely worthless.

The answer to whether 20 percent of the Phoenix Fire Department had TB lies not in exploring different types of mycobacterium for bird poop or water, but investing our resources to create better diagnostic methods and tools. Countries worldwide, excluding the United States, seem to have realized the urgency of combating this plague and have committed to major TB control efforts. TB is the world's number one infectious killer, claiming three million lives each year. Technological advances must be made not only in diagnostics, but also better drugs and an effective vaccine. Multidrug-resistant TB, which is virtually impossible to cure, was present in only 13 states in 1991 but is now found in 42 states and the District of Columbia.

Not knowing whether people do or do not have TB has become a critical problem that needs to be solved soon. After all, how do you control something that you can't diagnose properly? In a matter of years, diagnostics may not be the only problem as the TB epidemic, deemed a global TB emergency by the World Health Organization four years ago, spreads on to our shores and across our borders.

Christoph Lee, project manager
Princeton Project 55 Inc.
Tuberculosis Initiative
Washington, D.C.

Your article "TB or Not TB?" raises too many questions.
First, you don't mention that a TB skin test can have a high rate of false positive results in a healthy population, especially if there is not uniform application of the testing procedure by experienced staff. Maybe we would be better off calling the TB test a diagnostic aid or indicator so as not to suggest that the test is even close to perfect.

Second, you state that Arizona has high TB rates because we have drug-resistant forms of the disease. There is no evidence to suggest that a drug-resistant germ spreads easier than a non-drug-resistant germ. Furthermore, the spread of TB is dependent upon prolonged exposure and is very unlikely to be passed on in an ambulance ride.

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