Traveler's TB Not As Severe As Thought

Feds: Georgia Attorney Diagnosed With XDR-TB Actually Has Less Drug-Resistant Strain Of Disease

(AP)  The globe-trotting American lawyer who caused an international health scare by traveling while infected with tuberculosis has a less severe form of the disease than previously diagnosed, a Denver hospital official said Tuesday.

Andrew Speaker was diagnosed in May with extensively drug resistant TB, based on an analysis of a sample taken in March by the U.S. Centers for Disease Control and Prevention. The XDR-TB, as it is called, is considered dangerously difficult to treat.

But three later tests have all shown Speaker's TB to be a milder form of the disease, multidrug-resistant TB, a federal health official said on condition of anonymity before a news conference in Denver.

Multidrug-resistant TB can be treated with some antibiotics that the more severe form resists.

"Laboratory tests conducted at National Jewish Medical and Research Center indicate that patient Andrew Speaker's tuberculosis is susceptible to some of the medication previously thought ineffective against his disease," the hospital said in a written statement.

An about-face on the XDR diagnosis would be a major embarrassment for the CDC. The diagnosis was a key factor in issuing a quarantine order on Speaker, who had traveled to Greece to be married in May despite warnings from health officials that he shouldn't travel.

On Tuesday, the CDC did not immediately clarify whether they were wrong in the earlier diagnosis or whether there are two conflicting results.

In Denver, hospital spokesman William Allstetter said doctors would announce changes in Speaker's treatment at a news conference.

Speaker's case was an international public health story and even raised questions about U.S. border security. Congress held a hearing on the CDC's handling of the case and Speaker's father-in-law, a TB researcher who works for the CDC, also came under scrutiny.

Speaker's family appeared on TV news talk shows to argue that health officials in Georgia had given confusing advice about whether he could travel.

The young lawyer was originally diagnosed with multidrug-resistant tuberculosis — which can withstand mainline antibiotics used to treat TB — before he left for a wedding and honeymoon in Europe. While there, he was told he had the more dangerous form.

The XDR-TB diagnosis stemmed from a sample taken in March through a bronchoscopy, in which samples are removed through a tube, is pushed down a patient's throat. Other tests analyze sputum that a patient simply coughs up.

There are different lab techniques used to test samples, and it's not clear how the analysis at National Jewish hospital differs from the CDC's methods. However, a CDC official said the agency analyzed one of the three sputum samples and came up with the same result as the hospital — that Speaker had the more treatable form of the disease.

Federal health officials said Speaker ignored their warnings to seek help in Europe. Instead, Speaker and his wife crossed the border into the United States after taking a commercial flight to Canada and he was briefly placed under federal quarantine.

The incident prompted a hunt for passengers on the cross-Atlantic flights taken by Speaker so they could be tested for the disease.

Doctors at National Jewish had previously announced Speaker would undergo surgery in July to remove infected lung tissue, a practice sometimes used when drugs can't completely kill a TB infection. Allstetter would not say if the surgery was still planned.

[connapa]

It doesn't matter whether it Multi- or Extreme- drug resistant. Both strains are resistant to the 2 most common medications used to treat TB- INH and Rifampin. If anyone was unknowingly exposed by a patient with either form, they would have been put on a treatment course which would be completely ineffective, in which case THEY would also unknowingly spread the disease to others and thus perpetuate resistant strains. Mr. Speaker was STILL in the wrong by traveling after having been advised explicitly not to so.

[talkingham]

Advaceus they did not tell the guy he couldn't travel until he was ready to come back which is absurd. The media has created this flap thanks to misinfo from the govnerment and they are are the ones who need to put-up, fess-up and shut-up!

There was so much entertainment value in the misnfo that the media gloated like a pack of wild dogs over a carcass on this story and they along with the CDC (which under Bush has become a riduculous agency) are more at fault than the guy who only wanted to go home.

[advanceus]

It doesn't matter what kind of drug-resistant disease he has. He still is a self centered SOB and needs to pay!

[blackbug99]

Wrongful confinement is still wrongful. I smell a lawsuit.

[mercyme884]

Why don't you jerks give it a rest.You are like a pack of mad dogs.Attacking anything that moves. The government screwed up....AGAIN. So leave this poor guy alone, he's just human like the rest of us. Jump on the stupid saps working for the government, They made the mistake.

[erasmus6]

Actually ZykrCosmos is right.

No matter what, Speaker was in the wrong. At the time he was classified as being contagious, that is all that matters. He got on those planes while he was classified as CONTAGIOUS.

And for you people that think that Speaker did no wrong or that the CDC lied etc., it is because of your stupidity that we are going to have major problems when a real pandemic hits us.

[gramto7]

Initially he was told it was very contagious.
Posted by tomch52

He was not told it was 'very contagious', he wa told it was drug-resistant! There is a big difference.

[zykracosmos]

It is hard to fathom why bloggers would be vigorously attacking the CDC in this case, even if they did err on a diagnosis. I would much rather know that one of our first lines of defense against a pandemic is erring on the side of public safety than refusing to cause a stir over a potentially devaasting disease being spread around the world. The case stands today, as it did before, as a red flag on our current inability to limit exposure to the general public in a situation where a lethal disease may be circulating. It shouldn't be up to the CDC to advise anybody on their travel plans. Homeland Security should have a plan in place in which to act as necessary to intercept and quarantine individuals who have been identified as grave risks to the general public. That is where individual rights give way to the health and security of the public. CDC's role should be no greater than to idenitify such individuals to Homeland Security, and notify the individual of that referral. CDC is not an enforcement agency. Homeland Security is. When the pandemic comes (as seems inevitable), the CDC will be the agency that everyone looks to for advice and guidance, so give them the respect they deserve.

[greeneyes222]

Sure the government screwed up. But two wrongs don't make a right. Mr. Speaker's behavior still showed callous disregard for the public, and the man needs to be called to account for his own behavior.

[rudy654-2009]

The media lied, the government screwed up, the lawyer was right, those who accused him were wrong. Why is any of that seem unusual or maddening? And if you are mad, try to find a reasonable object for your rants; it ain't the lawyer.
Posted by andor3 at 12:21 AM : Jul 04, 2007

Well said andor3! When this first broke as news I knew that all the outrage was unwarranted from the first, knowing how the media runs with something before really knowing the facts. It was amazing that people just wanted to make so much out of this to the point that they were hysterical. I wondered why they weren't more afraid of someone out there that they didn't know about??? At least they were aware of this fellow and he was controlled. I didn't even see this hysteria when anthrax spores made from an American lab were being sent through the mail and people were actually dieing. AND that case hasn't ever been solved!! But I'm more afraid of hysterical people than I am of anything else.