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The efforts ''weren't fast enough,'' Dr. [Martin S. Cetron] said, adding that ''we certainly will be learning lessons and looking to improve'' current systems. ''It's irresponsible in active tuberculosis for anyone to be on an airplane -- whether it's multi-resistant or not,'' said Dr. [Richard P. Wenzel], an infectious disease expert at Virginia Commonwealth University in Richmond. At a time when airline passengers have to discard shampoo bottles in the airport security line, Dr. Wenzel said, ''We don't have a simple sort of wand at the airport to wave to say, 'You have tuberculosis.' It really counts on the responsibility of the individual.''

The man, who declined to be identified in the newspaper article because of the stigma attached to his diagnosis, said he and his wife had decided to sneak back into the United States via Canada rather than have him be treated in isolation in Italy. 'I'm a very well-educated, successful, intelligent person,' he told the paper. 'This is insane to me that I have an armed guard outside my door when I've cooperated with everything other than the whole solitary- confinement-in-Italy thing.' That appraisal was based on tests showing that the number of tuberculosis bacteria in the man's sputum were too low to be detected but still enough to infect others. [Julie Gerberding] said her agency was erring on the side of caution because the form of tuberculosis, known as XDR TB, is often fatal and is a growing public health threat in many countries. The advisory applies only to crew members on the man's flight and to his fellow passengers, particularly those who were seated next to him and in the two rows behind him and the two rows in front of him. 'We're not concerned about a generic threat to travelers,' Gerberding said

That appraisal was based on tests showing that the number of tuberculosis bacteria in the man's sputum were too low to be detected but still enough to infect others. Dr. [Julie L. Gerberding] said her agency was erring on the side of caution because the form of tuberculosis, known as XDR TB, was often fatal and a growing public health threat in many countries. ''We're not concerned about a generic threat to travelers,'' Dr. Gerberding said. Dr. Gerberding said doctors had not determined the source of the man's infection. Molecular fingerprints used to distinguish among bacterial strains so far do not match that of any other known case, she said. People who think they may have been exposed to TB or XDR TB can call (800) CDC-INFO for more information

Epidemiologists from the Centers for Disease Control and Prevention have linked the acanthamoeba keratitis outbreak to AMO Complete Moisture Plus Multi-Purpose Solution. Advanced Medical Optics of Santa Ana, Calif., manufactures the solution, which is used to clean and store soft contact lenses

The outbreak resembles one last year that was linked to a different manufacturer's lens solution and a different microbe. In both instances, the cornea, the eye's transparent outer covering, is at risk. But why two different microbes caused the outbreaks is not known. ''It is beyond comprehension,'' said Dr. Dan B. Jones, the chairman of ophthalmology at Baylor College of Medicine in Houston, who detected a case of acanthamoeba keratitis, which is behind the current outbreak, on Friday. Acanthamoeba infections have been reported in many countries. Dr. Jones's team is credited for first identifying a corneal infection from acanthamoeba in the United States, in a rancher who was injured in an accident in Texas in 1973. That case did not involve contact lenses: while the rancher was working in a field, a piece of wire and hay hit his eye

Epidemiologists from the Centers for Disease Control and Prevention have linked the acanthamoeba keratitis outbreak to AMO Complete Moisture Plus Multi-Purpose Solution. Advanced Medical Optics of Santa Ana, Calif., manufactures the solution, used to clean and store soft contact lenses

The authorities said that the link was ''preliminary'' and that it had not determined precisely how the patients became infected. But investigators found that the risk of developing the infection was at least seven times greater for those people who used the AMO product than for those who did not. The company said, ''There is no evidence to suggest that the voluntary recall is related to a product contamination issue and this does not impact any of AMO's other contact lens care products.'' Acanthamoeba infection usually develops slowly and can be difficult to diagnose and treat. Doctors often attribute Acanthamoeba infections at first to a virus, herpes simplex, that is treatable. But the drugs for herpes do not help Acanthamoeba patients. Doctors advise treating the infection as early as possible

As [Kevin Moretti] gets ready to transfer the patient to the ICU, an X- ray reveals that she has 'air under the diaphragm,' an indication that the bowel has perforated, leaking bacteria into the abdomen, the cause of the sepsis. The patient is rushed to the OR for surgery then moved to the ICU. She sustains a cardiac arrest, leading to brain damage. Gram-positive cocci are usually pathological staph or strep bacteria. [Greg Pratt] is wasting time in thinking a blood contaminant is a possibility in an unstable patient. It is also likely that a careful physical exam would have revealed a highly tender 'surgical abdomen,' which, with an X-ray, would have located the infection source and expedited surgery. As for cardiac arrest, it can lead to inadequate blood and oxygen flow to the brain, a type of brain damage called 'hypoxic encephalopathy.'