Officials Admit Errors in TB Case
Officials, Patient at Odds Over Travel Warnings
June 6, 2007 -- Federal officials acknowledged mistakes Wednesday in their
handling of an Atlanta man who traveled to and from Europe last month while
infected with a highly drug-resistant form of tuberculosis.
Meanwhile, Andrew Speaker, the patient at the center of the incident,
continued to contradict officials by maintaining they never told him his travel
could endanger other people.
Officials said they should have acted more quickly to notify American border
police and European health authorities once it became apparent Speaker had
flown out of the United States.
But they were also quick to point out that their efforts were hampered by
Speaker, who they say defied the advice of doctors and health officials when he
flew to Europe for his wedding and when he flew back to North America.
That move in theory put hundreds of people who flew with Speaker at
potential risk for contracting extensively drug-resistant tuberculosis, also
known as XDR TB.
Could Have Moved Faster
Julie Gerberding, MD, director of the CDC, told members of a Senate
committee that her agency could have acted faster between May 18, when they
first became aware Speaker had drug-resistant TB, and May 24 when he was placed
on a no-fly list and Italian health authorities were notified of their
“I think we can do that faster, I think we should have done it faster, and I
think we’ll be able to accelerate this next time. In retrospect that was a
mistake, and I wish we had done it differently.”
Lawmakers questioned why days elapsed between officials' receiving of
Speaker's positive test results and notification of European authorities.
“It seems to me that this time frame should have been collapsed to just a
few hours,” said Sen. Tom Harkin (D-Iowa), who chairs the appropriations
subcommittee with jurisdiction over CDC.
But officials, doctors, and Speaker continued to give different accounts of
what happened at a May 10 meeting between them.
Health officials have acknowledged that they were aware at the meeting that
Speaker, a 31-year-old attorney from Atlanta, intended to fly to Greece four
days later. Local officials approached a county prosecutor in Fulton County,
Ga., to inquire about the steps that would be needed to bar Speaker from
flying, said Steven Katkowsky, MD, the district health director of the Fulton
County health department.
But Speaker abruptly moved up his travel date by two days. By the time a
court order was drawn up, the patient had already left the country, Katkowsky
“The plan that we knew was for Mr. Speaker to travel outside the United
States on May 14,” he said.
No Benefit of the Doubt
Though officials knew Speaker carried a drug-resistant TB strain, tests
confirming he had an extensively drug-resistant -- and more dangerous -- form
were not completed until May 22, they said.