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Tuberculosis Patient Says He Was Never Barred from Travel

June 6, 2007 at 6:20 PM EST
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KWAME HOLMAN: Committees of the House and Senate took up the case today of the globetrotting tuberculosis patient who set off an international health scare last week. A Senate Subcommittee on Health was the first to look into how Andrew Speaker, who is infected with extensively drug-resistant TB, was able to leave the U.S. and travel throughout Europe for his wedding and honeymoon last month.

Both federal and local health officials said they told Speaker, a 31-year-old Atlanta lawyer, early last month that he had a drug-resistant form of TB and urged him not to travel. Dr. Julie Gerberding, director of the federal Centers for Disease Control, testified that, while more aggressive measures could have been taken, officials lacked the authority to prohibit Speaker from flying.

JULIE GERBERDING, Director, Centers for Disease Control and Prevention: The local public health officials assessed the risk. They determined that it was not zero. They recommended measures to protect others. And, basically, in the vast majority of situations like this, they operate under a covenant of trust.

They give advice to the patient. They explain what needs to be done to provide protection. Patients generally cooperate. As I said, almost all of them cooperate with that experience. And, certainly, in my own experience, I’ve never been in a situation where we were as surprised to see a patient choose a different route.

In Georgia, if a patient is to be isolated in an involuntary manner, it takes a court order, and the patient must first demonstrate that he is not compliant with medical advice. So the state could not issue such an order until the patient actually did something that was against medical advice; that’s the way the laws in Georgia are written.

'I was told I was not contagious'

KWAME HOLMAN: But Speaker, who testified by telephone from a Denver hospital where he is being treated and remains under government-ordered isolation, contested Gerberding's account. He told the committee he decided to leave the country only after discussing his plans with CDC officials, Atlanta's Fulton County Health Department, and with his future father-in-law, a CDC microbiologist involved in tuberculosis research.

ANDREW SPEAKER, Tuberculosis Patient: And when I sat there on May 10th with MDR-TB, it was my father, my father-in-law, my bride-to-be, my doctor, and the health official. None of us were wearing masks. I was repeatedly told that I was not contagious, not that I was hardly contagious, but that I was not contagious, that I was not a threat to anyone. I was walking around, doing my job.

As far as I knew, from my medical advice -- and I don't think anyone is going to get up in front of you today and tell you otherwise -- I was clearly told I was not contagious. And they were letting me walk around and go about my business, so I looked to the people who I believe I should trust to tell me whether or not I'm a threat to those around me, and they told me I wasn't. No one ever told me I was a threat to my wife or my daughter.

I don't want this, and I wouldn't have wanted to give it to somebody else. CDC knew that I had it. They were aware that I was going on my travels. And, yes, I was told that, you know, Fulton County would prefer I not travel, but I was also told I was not contagious. I was told I was not a threat to anyone. I was told there's no need to sequester me.

There were conversations back and forth between my doctors, the doctors out here in Denver, CDC, Fulton County. All of this was being discussed before that meeting on the 10th. So to claim that -- everyone knew I was going. I didn't go running off or hide from people. It's a complete fallacy, and it's a lie.

Health officials' travel warnings

KWAME HOLMAN: Committee Chairman Tom Harkin of Iowa pressed Fulton County health official Steven Katkowsky as to why Speaker wasn't given a stronger warning not to travel.

SEN. TOM HARKIN (D), Iowa: It seemed to me that the average person would say, "Well, OK, I have this thing, but if I'm not contagious to all these people around me, and they know about my travel plans," but no one said that he shouldn't do this. He was told he was not contagious. Is that your recollection?

DR. STEVEN KATKOWSKY, Department of Health, Fulton County, Georgia: No, sir. First of all, I was not in the meeting, but the patient's chart indicates that he was told he was not highly contagious.

Yes, we knew of his plans to travel. The plan that we knew of was for Mr. Speaker to travel outside the United States on May 14th. We then, in this case, incorrectly assumed that we had at least four days to be able to work up a plan, be able to put plans in place, and that would have included referral to Denver, Colorado.

Yet what we found out was Mr. Speaker moved up his travel date, was not available, could not be reached, and the whole question of whether or not we could have compliance at that point and was it safe for him to travel could not even be addressed, because at that time he was out of the country.

Why Speaker moved his travel date

KWAME HOLMAN: Speaker then explained why he moved up his departure date.

ANDREW SPEAKER: I was just told that I was going to have, you know, my right upper lung taken out likely, that I was going to have two years of treatment, where I'd have daily I.V. injections, if not every other day. So I wasn't going to go anywhere for probably the next two years.

And I wasn't sleeping. And my wife said, "Look, honey, you know, everybody's going over." Why should I be worried if, you know, Fulton County never addressed it head-on, or at least I didn't hear it, but I was clearly told word for word I was not contagious?

KWAME HOLMAN: Speaker also explained why he chose to leave Europe on a commercial flight, despite a CDC warning he could endanger other passengers.

ANDREW SPEAKER: They asked me to voluntarily check myself in, that the authorities were coming in the morning, and I could be stuck there indefinitely in the Italian hospital. And I just wanted to get home. And I'm sorry for all the distress I've caused people, but I hope they understand where I was. And I hope it changes the policy, and I hope the way they handle things changes.

KWAME HOLMAN: Speaker flew from Rome to Prague, from there to Montreal, then entered the United States by car at the Canadian border on May 24th. He was allowed in, despite his name being on a security watch list.

At today's hearing, Deborah Spero, assistant commissioner of Customs and Border Protection, or CBP, acknowledged that the border officer violated protocols which are being changed.