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Future in-law helped reach TB diagnosis

It's not clear whether the CDC doctor, or the agency, knew the patient was Andrew Speaker, officials say.

June 02, 2007|Nicholas Riccardi and Jia-Rui Chong | Times Staff Writers

DENVER — A man whose transatlantic journey may have exposed dozens of airline passengers to a virulent, drug-resistant tuberculosis strain had his disease diagnosed in part through the work of a doctor who is now his father-in-law, a TB expert with the Centers for Disease Control and Prevention, officials said Friday.

Dr. Julie L. Gerberding, director of the CDC, said Dr. Bob Cooksey had helped with the bacteriological test. But she said it was not clear whether he or the agency had been aware at the time that the patient in question was Andrew Speaker.

Gerberding said Cooksey was not involved in deciding whether to quarantine Speaker, 31, who left for his wedding in Greece on May 12 knowing he had tuberculosis and who flew back less than two weeks later despite pleas from health officials that he remain in Europe.

Cooksey helped the agency reach Speaker during his honeymoon in Rome. But the CDC could not persuade the personal injury attorney to turn himself in to medical authorities there. Instead, Speaker flew to Montreal and was able to reenter the U.S. -- even though a check of his passport produced an order that he be detained.

In an interview Friday on ABC's "Good Morning America," Speaker apologized to airline passengers whom he might have exposed to TB.

"I don't expect for people to ever forgive me," Speaker said from his isolation room at National Jewish Medical and Research Center in Denver, his voice shaking. "I just hope that they understand that I truly never meant to put them in harm."

He stressed that he had not had any symptoms, and that health officials told him before his trip that he was not especially contagious. His wife has not tested positive for tuberculosis, and doctors reiterated Friday that Speaker does not appear to be highly infectious.

Speaker said that his father, who also is an attorney, had tape-recorded discussions he had with Fulton County officials in his hometown of Atlanta after he was diagnosed. Health authorities, he said, cautioned Speaker not to fly to Greece, but they did not forbid it.

Doctors have said Speaker probably contracted tuberculosis years ago during his extensive world travels, but the disease did not become evident until January, when a chest X-ray turned up a baseball-sized lesion in one of his lungs. Because tuberculosis cultures can take a long time to analyze, Speaker was not told that he was infected with a drug-resistant strain until May 10.

He left for Europe on May 12. A little more than a week later, the CDC determined that Speaker had the most deadly strain of TB. Gerberding said that officials on May 23 told Speaker they did not want him flying back into the U.S. and asked him to turn himself in to Italian health authorities.

The CDC called the Department of Homeland Security to place Speaker on the "no-fly" list and issue an alert to detain him at border crossings. But a U.S. Customs and Border Protection agent in Champlain, N.Y., let him into the country May 24.

Jayson P. Ahern, a top official with Customs and Border Protection, said Friday that people should not overreact to the agent's error. "The system worked effectively," he said. "Just because we had a breakdown by an individual [agent] doesn't mean we should throw the system out."

Gerberding said the CDC was reviewing its actions and would seek revisions to the law allowing it to quarantine infectious patients. "We acknowledge that, certainly, CDC and many others have learned a lot in this process," she said. "If we are ever in this situation in the future, hopefully it will be easier for everyone involved."

Speaker's physician, Dr. Gwen Huitt, told reporters that other patients at the Denver hospital had canceled appointments for fear of contracting the rare strain of tuberculosis -- which is cured in about 30% of patients, as opposed to the 95% rate for the most common form.

"We are all very thankful and very positive that this is an exceedingly low-risk situation," Huitt said. "We are very hopeful that this will have a very good outcome."

Riccardi reported from Denver and Chong from Los Angeles.

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