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Benjamin Spillman

TOURISM: Disease deemed Las Vegas threat

7 June 2007

LAS VEGAS, Nevada -- Andrew Speaker's jet-setting itinerary didn't include Las Vegas. But the Atlanta lawyer who made headlines traveling despite a tuberculosis diagnosis exposed public safety risks that could cost Southern Nevada's economy billions of dollars.

Speaker, 31, traveled between Europe, Canada and the United States in May even though his diagnosis with a drug-resistant strain of tuberculosis landed his name in government databases that should have alerted authorities to prevent him from traveling.

Speaker isn't known to have transmitted the disease to anyone else, but his exploits highlighted how easily someone with a contagious disease can move around the globe. This issue is important in Nevada, where the resort economy would be especially vulnerable if an outbreak hinders global travel.

"Imagine McCarran Airport with no flights coming in," said Mark Rothstein, director of the Institute for Bioethics, Health Policy and Law at the University of Louisville. "I think it would be devastating for a city like Las Vegas."

Rothstein participated in a 2003 report that included 30 recommendations for the government to reduce the risk of a disease outbreak in the United States. He said the Speaker incident suggests many of the flaws that the report identified four years ago remain present today.

That means simple steps to reduce the risk of an epidemic in the United States that could wreak havoc on Nevada's economy still haven't taken place.

"We don't have the laws in place that are essential," Rothstein said.

Among recommendations Rothstein said are yet to be enacted are federal laws to protect the jobs and wages of people who follow quarantine rules and give health officials instant access to information on travelers that law enforcement authorities use to hunt terrorists. Only eight states have anti-quarantine discrimination laws, and Nevada is not among them, Rothstein said.

A 2003 outbreak of severe acute respiratory syndrome (SARS) in Asia and Canada prompted the report and illustrates potential risk for Las Vegas. The outbreak killed 44 people in Canada and sickened 375. It also prompted warnings against travel to Toronto and cost the city an estimated $1 billion in economic losses related to tourism.

Rothstein said it was fortunate for Americans that a female airline passenger from Hong Kong carried SARS to Canada and not the United States, where the economic impact could have been even greater.

"We've been lucky. It is that simple," he said. "She could have flown to Las Vegas and there would have been a SARS outbreak in Las Vegas."

There are two recent reports to suggest the Las Vegas economy is especially vulnerable to a disease outbreak.

One report in January by the Center for Business and Economic Research at the University of Nevada, Las Vegas looked at how an outbreak of avian flu would affect the local economy.

The report, which authors characterized as conservative, estimated a sharp drop in tourism prompted by a pandemic would cost the local economy 39,000 jobs and $2.3 billion.

A shortage of tourists would ripple through the economy in the form of decreased demand for everything from hotel rooms to meals, cab rides and entertainment, the report stated. The subsequent layoffs would reverberate even further in the form of less local spending, unpaid bills and lower tax revenue.

Keith Schwer, a UNLV professor who worked on the report, said a pandemic would have twice the economic impact of the Sept. 11, 2001, terrorist attacks against the United States.

"That was a relatively short-lived event. But travel and tourism really didn't recover until 2003," Schwer said. "People stop coming. And when they stop coming, then you are going to lay people off."

The second report published in March and focused on Nevada and the United States as a whole. The report by the Trust For America's Health, stated Nevada stands to lose more than any other state in a pandemic.

The state's dependence on tourism would cost it more than 8 percent of its economy in a pandemic. That translates to a loss of $9 billion from Nevada's gross domestic product, almost as much money as the combined win of every casino in Clark County last year.

Jeff Levi, director of the group that did the national report, said the recent tuberculosis incident highlights how easy global travel that makes places like Las Vegas successful also contributes to the risk of uncontrolled spread of disease.

"It is very easy in a society like ours for someone to disappear into the woodwork for at least a short period of time," Levi said. "We spend a lot of time thinking and worrying about bioterrorism agents. But some of the old-fashioned threats like tuberculosis are still out there."

Locally health officials are working to prevent disease outbreaks. A recent drill in Las Vegas tested how government agencies and major resorts could react to a contagious disease outbreak.

The local response would depend on the disease in question. If it were highly contagious, like a deadly flu strain, the response would focus on isolating the sick from healthy people. If it were a slow developing, less contagious disease, like drug-resistant tuberculosis, the response would involve tracking down and alerting people who were potentially exposed.

In 2005, a man who didn't know he had hepatitis A served ice cream to conventioneers. The Southern Nevada Health District worked to alert 26,000 people who had attended the convention.

Hundreds of people received preventive treatment after health officials tracked them down.

"We had to get the message out right away," said Brian Labus, senior epidemiologist for the district. "That is one of our focuses. We have millions of people coming in every month and it is our job to prevent them from getting sick."