Health officials get share of blame for handling of TB case

Senate Labor-Health and Human Services Appropriations Subcommittee Chairman Tom Harkin, D-Iowa, on Wednesday blasted the Centers for Disease Control and other health officials for bungled procedures and not moving quickly enough to stop a victim of drug-resistant tuberculosis from leaving, and then re-entering, the United States.

Harkin told CDC Director Julie Gerberding he is feeling "uneasy" about her agency's actions from May 18, when it learned of the victim's TB status, until May 22, when it finally took some action to find him abroad. "Either there was confusion or running around in circles at the CDC," he said.

But Gerberding said her agency erred on the side of "giving the patient the benefit of the doubt," trusting that he would follow medical advice and not travel. "We obviously made a mistake," she said.

However, the TB victim, Atlanta attorney Andrew Speaker, told the panel by telephone from his isolation room in Denver that he had never been told he was contagious to his family, his co-workers or anyone around him, and had met with physicians, including county officials and CDC officers May 10. So he decided to fly to Europe May 12 for his wedding and honeymoon, while physicians determined what course of treatment would be best for him.

"No one told me I was a threat to anyone," Speaker said. "Everyone knew I was going [to Europe]. I didn't go running off or hide from people -- that's a lie."

Speaker said physicians had told him it would take 30 days to determine a course of treatment, and he made arrangements to check into National Jewish Medical and Research Center in Denver, which specializes in TB treatment, when he returned. He then left the country, figuring it was better to go to be with his fiance rather than "sit around the office and go to [try cases in] court."

Once the CDC did determine that Speaker had an extremely drug-resistant form of the disease, he was already in Europe. Gerberding said they tried to find him by checking airline records and making calls to family, but were unsuccessful for days. They finally located him in Italy May 22 and told him he had a virulent form of the disease. They told him not to fly home on a commercial airliner because he was a threat to fellow passengers and tried to arrange a CDC airplane for him.

A day later, CDC officials ruled out using their own aircraft because of the potential danger to pilots. Speaker testified it would have cost him $140,000 to pay for an air ambulance. Still under the impression that he could not infect anyone, as he had initially been told by physicians, Speaker came into the United States through Canada.

Though he had by then been flagged as a biological threat, Customs and Border Protection agents at the border in upstate New York failed to stop him. Under questioning from the panel, CBP Deputy Commissioner Deborah Spero admitted her agency's mistake. "It was a failure of an inspector to follow orders," she said, and noted the agency is reviewing procedures. "There is no criticism from outside that can be harsher than the criticism we have brought on ourselves," she said.