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    Officials Admit Errors in TB Case

    Officials, Patient at Odds Over Travel Warnings

    Early Flight

    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 said.

    “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.

    Gerberding suggested officials hesitated to inform the World Health Organization and European governments until it was clear Speaker was positive for XDR TB. But she suggested that a bigger mistake was not moving more swiftly to detain Speaker in Europe when he had already traveled against medical advice and was likely to do so again.

    “What we have learned is that when a patient is not willing to cooperate, we cannot give that person the benefit of the doubt any more,” Gerberding said.

    Speaker, who testified by phone from quarantine at National Jewish Hospital in Denver, Colorado, maintained that doctors at the May 10 meeting did not tell him he could be a risk to others.

    “None of us were wearing masks. I was repeatedly told I was not contagious. Not that I was partly contagious, but that I was not contagious,” he said.

    Officials contradicted that claim. Katkowsky told lawmakers that Speaker's medical record and a follow-up letter issued the next day both indicate Speaker was told that he could be a danger to others.

    Gerberding told lawmakers that the CDC became aware of Speaker’s drug-resistant diagnosis on May 18, and that tests confirming XDR TB were completed four days later.

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