Border alert on TB patient disregarded

The Atlanta man defied instructions to stay put overseas after doctors realized he had a deadly strain of the disease.
By Jia-Rui Chong, Stephanie Simon and Nicholas Riccardi, Times Staff Writers
June 1, 2007


DENVER — A man infected with an extremely dangerous strain of tuberculosis was waved into the United States at a border crossing even after a routine check of his passport set off an urgent warning, authorities said Thursday.

Andrew Speaker, 31, a personal-injury lawyer from Atlanta, arrived at the Canadian border May 24 after disregarding explicit instructions from the Centers for Disease Control and Prevention to remain in Italy — where he was on his honeymoon — for fear of spreading his potentially deadly strain of TB.
Speaker's father-in-law is a microbiologist at the CDC in the Division of Tuberculosis Elimination. Robert Cooksey issued a statement Thursday saying that he "wasn't involved in any decisions my son-in-law made regarding his travel, nor did I ever act as a CDC official or in an official CDC capacity with respect to any of the events in the past weeks…. I would never knowingly put my daughter, friends or anyone else at risk from such a disease."

Cooksey also said that he had never tested positive for TB and was certain that Speaker did not contract the lung ailment from him or from the CDC's labs.

Speaker knew he had a severe strain of TB before departing to marry Cooksey's daughter, Sarah, on a Greek island in mid-May. He only found out later, when he was in Rome, that it was the rarest and most lethal of TB strains, resistant to most antibiotics.

Very few hospitals in the U.S. are equipped to handle that strain of TB; early Thursday morning, Speaker and his wife were flown by private air ambulance to one of them, National Jewish Medical and Research Center in Denver. He looked tanned and fit upon arrival — he has never exhibited any symptoms of TB infection — but he wore a blue mask, as did his entourage of doctors and nurses.

Speaker will remain in an isolation room in Denver for months as a medical team tries to wipe out the bacteria in his lungs with powerful antibiotics and, if necessary, surgery.

He will not be able to take his customary jogs. He'll have few visitors. His only view of the outside world will be a patch of grass and a few patio chairs. The antibiotics used to treat him may cause severe nausea, seizures, hearing loss and kidney problems. Still, his attending physician, Dr. Gwen Huitt, said Speaker was in good spirits.

"He's very relieved to be in Denver and moving on to the next stage in his life," she said.

Speaker has said his desire to get treated in Denver — where he'd been told the best specialists worked — compelled him to rush back to the U.S. from his honeymoon, taking a secretive, circuitous route to avoid being flagged as a health risk at American airports.

His defiance potentially exposed hundreds of airline passengers and crew to tuberculosis. It also could expose Speaker to lawsuits from those fellow travelers, should they become infected.

"There's a general duty not to put any [others] at undue risk," said Gregory Keating, a law professor at the University of Southern California. "I think he's got a problem."

Authorities said Speaker did not break any laws because at no point during his international travel was he under a court order to stay put.

From Rome, Speaker and his wife flew to Prague and then to Montreal. They drove to the border crossing at Champlain, N.Y. At the checkpoint, both their passports set off warnings when scanned into a computer. The alerts instructed the guard to isolate and detain Speaker, and immediately call health authorities.

But the inspector, who has since been removed from border duties, apparently concluded that the travelers looked healthy. They spent no more than two minutes at the checkpoint before crossing into the U.S., said Homeland Security Department spokesman Russ Knocke.

The lapse at the border outraged Sen. Charles E. Schumer (D-N.Y.), who called for a federal investigation.

"Today it was one sick and very irresponsible person who slipped through, but tomorrow could bring much worse," Schumer said. "There is just no excuse for this. God forbid this was someone bent on doing us harm."

As soon as Speaker crossed the border, he moved to comply with federal authorities. On May 25, as he and his wife drove south from Albany, he answered a cellphone call from the CDC, which had been frantically trying to reach him, and agreed to check himself into an isolation unit in a New York City hospital. From there, he was transferred to his hometown of Atlanta, where he was kept in a hospital room under armed guard.

When he arrived in Denver on Thursday morning, U.S. Marshals escorted his ambulance to the hospital. His is the first federal government-ordered isolation since 1963.

Speaker's medical odyssey began in January, when he injured a rib and went in for a chest X-ray. The picture showed a lesion in his lung. His physician suspected TB, even though Speaker had none of the classic symptoms: no fever, no night sweats, no coughing up blood.


by:www.latimes.com