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2007 tuberculosis scare

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The 2007 tuberculosis scare occurred when a personal-injury lawyer from Atlanta, Andrew "Drew" Speaker, while infected with multidrug-resistant tuberculosis (MDR-TB), flew on several international flights bound for France, Greece, Italy, Czech Republic and Canada, before returning to the United States.[1][2] The Centers for Disease Control and Prevention believed at the time that Speaker was suffering from extensively drug-resistant tuberculosis (XDR-TB), but failed to inform Speaker of this worsened sickness before his travels abroad. The incident sparked a debate in Congress on the failure of federal customs agents to stop him.[2] Upon Speaker's return to the United States, the CDC placed him under involuntary isolation (similar to quarantine) using a provision of the Public Health Service Act.[3] With this action, Speaker became the first individual subjected to a CDC isolation order since 1963.[4]

Background

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In January 2007, Speaker suffered a fall and went to the doctor, concerned that he had bruised a rib. Doctors X-rayed his chest and found an abnormality that required further testing.[5]

On March 28, 2007, his doctors and the health department believed the tuberculosis (TB) strain that Speaker had was a resistant one and communicated this to the CDC. On May 1 the apparent MDR TB infection was discussed with the CDC lab by his doctors and they discussed discontinuing the treatment he was on at that time. On May 9 the suspicion of MDR TB was confirmed. A meeting was held with Fulton County Health Officials, his doctors, his fiancée, as well as his father and father-in-law on May 10, 2007. During this meeting, Speaker was informed that while he was not considered contagious or a threat to other, he would need to travel to Denver for treatment.[5] After weeks of arranging this, he was still advised—or in some accounts—strongly recommended, not to travel.[5]

Travel sequence

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On May 12, 2007, Speaker flew from the U.S. to Paris. On May 14, he flew on to Athens and, two days later, flew to the Aegean holiday island of Santorini for his wedding. Speaker then flew to Rome for his honeymoon.

Doctors say that only after Speaker left the United States did they realize he likely had XDR-TB. Speaker says that he was informed of MDR TB before leaving the country, and that while officials preferred him not to fly, they said that he was not a threat and was not required to wear a mask.[6] Once Speaker was in Europe, however, test results showed his strain of tuberculosis was even rarer than originally thought, leading public health officials to try to persuade Speaker to turn himself in to Italian health authorities.[7][8] The CDC informed him that there were no options for the CDC to get him home, and that he would have to arrange private transportation. Speaker instead flew by commercial jet to Prague and then on to Montréal.[9] Both Speaker and his new wife claimed that, had they been offered transport, they would have accepted it and would have waited in Rome.[10] Speaker has also said that the CDC told him they were going to send officials to put him in Italian quarantine for up to two years, and that he was not told special transportation was arranged.[10]

Once in Montréal, Speaker rented a car and drove across the Canada–United States border. A Customs and Border Protection Officer, after passing Speaker's passport through the Treasury Enforcement Communications System (TECS),[2] failed to detain him at the frontier despite a warning to hold the traveler, wear a protective mask when dealing with him, and call health authorities, stating that Speaker "did not look sick".[11]

Flight itinerary

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According to the CDC, Speaker flew on the following flights:[12]

Flight Itinerary of U.S. Traveler
Airlines Flight# Aircraft Date Departing Scheduled Departure Calculated Scheduled Duration Arriving Number of Passengers Patient Seat Row Number
Air France / Delta 385 / 8517 Boeing 747-400 2007-05-12 Atlanta, Georgia 8:45 PM Local 8 Hr 27 Min Paris, France 433 30
Air France 1232 Airbus A320 2007-05-14 Paris, France 7:35 AM Local 3 Hr 11 Min Athens, Greece not more than 172 unknown
Olympic Air 560 ATR 72-202 2007-05-16 Athens, Greece 7:25 PM Local 0 Hr 40 Min Thira Island, Greece not more than 74 unknown
Olympic Air 655 ATR 72-202 2007-05-21 Mykonos Island, Greece 1:45 PM Local 0 Hr 40 Min Athens, Greece not more than 74 unknown
Olympic Air 239 Boeing 737-400 2007-05-21 Athens, Greece 5:30 PM Local 2 Hr 05 Min Rome, Italy not more than 168 unknown
Czech Airlines 727 Boeing 737-400 2007-05-24 Rome, Italy 8:50 AM Local 1 Hr 55 Min Prague, Czech Republic not more than 168 unknown
Czech Airlines 0104 Airbus A310 2007-05-24 Prague, Czech Republic 12:25 PM Local 8 Hr 25 Min Montreal, Canada 191 12

Tuberculosis case notes

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On May 31, 2007, Speaker was moved from Grady Memorial Hospital in Atlanta to the National Jewish Medical and Research Center in Denver, Colorado, for further treatment.[13]

It was reported that Speaker's father-in-law, Robert C. Cooksey, works for the Centers for Disease Control and Prevention and is a microbiologist who has conducted research on tuberculosis, according to his CDC biography posted on the agency's Web site.[14]

Aftermath

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Wearing a medical mask, Speaker was interviewed by Diane Sawyer on the June 1 edition of the American talk show Good Morning America on ABC and apologized to all passengers, explaining that he had not intended to endanger them.[15]

On July 4, 2007, the National Jewish Medical and Research Center announced, and the CDC confirmed, that Speaker's earlier diagnosis was incorrect and that he instead had multidrug-resistant tuberculosis (MDR-TB), a more treatable form of tuberculosis.[16] On July 26, 2007, Speaker was discharged after undergoing surgery to remove infected lung tissue and receiving antibiotic treatment. A statement by his physicians said that he was no longer contagious, showed no detectable evidence of infection, and that he would continue antibiotic therapy for approximately two years.[17]

In 2007, seven Canadians and two Czechs sued Speaker in Montreal Superior Court; eight of the plaintiffs were on the same flight as Andrew Speaker and one was related to one of the passengers.[18]

In 2009, Speaker sued the CDC for invasion of privacy, claiming that the release of his personal and medical information caused significant harm to his reputation and marriage.[19][20] The lawsuit was dismissed later in 2009 by a U.S. District Court judge,[21] revived in 2010 by the 11th U.S. Circuit Court of Appeals, and finally dismissed again in 2012 by a U.S. District Court judge.[22]

Isolation and law

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Speaker was in New York when the CDC served him with an isolation order but CDC director Julie Gerberding stated that the government was legally constrained prior to that order. The federal statute under section 361 of the Public Health Service Act grants the federal government the ability to isolate or quarantine individuals but only those coming into the country from a foreign nation or territory.[23][24]

Georgia TB law may have required Speaker to be confined for two weeks and only allowed travel for medical appointments.[25] A court confinement order can isolate a patient only after the infected patient ignores medical advice. This method can be overridden by a declaration of public health emergency by the governor of Georgia.

See also

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References

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  1. ^ Border security scrutinized after TB patient slips in Archived 2008-03-08 at the Wayback Machine, CNN.com
  2. ^ a b c Emily Brown and Jeff Bliss, "Border Agents Failed to Stop Man With Tuberculosis" (Update4).
  3. ^ "Fact Sheet on Isolation and Quarantine". Centers for Disease Control and Prevention. Retrieved June 3, 2007.
  4. ^ "Odd twist in TB alert: Patient is TB researcher's son-in-law". CIDRAP. May 31, 2007. Archived from the original on June 3, 2007. Retrieved June 2, 2007.
  5. ^ a b c "A Timeline of Andrew Speaker's Infection, June, 2007". NPR. Retrieved April 16, 2016.
  6. ^ Andrew Speaker Says He's Being Unfairly Attacked by Eve Conant, Newsweek, 2 Jun 2007. Accessed 2009-04-30. Archived 2009-05-21.
  7. ^ "TB patient insists he was never banned from travel". CNN. June 7, 2007
  8. ^ "CDC Stands by Decision to Sound Public Alarm". ABC News. July 4, 2007
  9. ^ Park, Alice. "The TB Scare: A Broken System?" Time. May 31, 2007.
  10. ^ a b Mike McPhee, TB patient apologizes Denver Post. June 1, 2007. Accessed 2009-04-30. Archived 2009-05-21.
  11. ^ "Border agent fired after allowing TB patient into country". Fox News. Archived from the original on July 19, 2012. Retrieved June 11, 2007.
  12. ^ "Flight Itinerary of U.S. Traveler with Extensively Drug–Resistant Tuberculosis (XDR TB) (May 30, 2007)". Cdc.gov. Archived from the original on October 12, 2008. Retrieved November 8, 2008.
  13. ^ "Foxnews.com: TB Patient moved to Denver hospital, May 31, 2007". Foxnews.com. May 31, 2007. Archived from the original on October 2, 2008. Retrieved November 8, 2008.
  14. ^ "CNN web site: TB patient's name released; father-in-law works at CDC". Cnn.com. Archived from the original on March 8, 2008. Retrieved November 8, 2008.
  15. ^ "ABCNews.com: TB Patient: "I Really Believed I Wasn't Putting People at Risk" June 1, 2007". Abcnews.go.com. Archived from the original on September 29, 2008. Retrieved November 8, 2008.
  16. ^ "Doctors: TB traveler's diagnosis more treatable than thought". CNN. July 4, 2007. Archived from the original on July 12, 2007. Retrieved July 4, 2007.
  17. ^ "TB-infected lawyer released from hospital". CNN.com. July 26, 2007. Retrieved July 26, 2024.
  18. ^ "Plane passengers sue TB patient - CNN.com". www.cnn.com. July 12, 2007. Retrieved July 26, 2024.
  19. ^ Mashnitski, Aleksandr (April 30, 2009). "Andrew Speaker Sues CDC Over Handling of '07 TB Scare". FindLaw. Retrieved July 26, 2024.
  20. ^ "Lawyer in 2007 TB scare sues CDC". CNN.com. April 30, 2009. Retrieved July 26, 2024.
  21. ^ Poole, Shelia M. (November 23, 2009). "Judge dismisses Andrew Speaker suit against CDC". ajc. Retrieved July 26, 2024.
  22. ^ Rankin, Bill (March 15, 2012). "Suit over TB case dismissed against CDC". ajc. Retrieved July 26, 2024.
  23. ^ "The Legal Questions Behind the TB Case". Law.com. Retrieved June 8, 2007.
  24. ^ CDC (April 17, 2024). "Legal Authorities for Isolation and Quarantine". Port Health. Retrieved September 27, 2024.
  25. ^ "TB patient travel may have been illegal". Physorg.com. Archived from the original on August 26, 2007. Retrieved July 18, 2007.
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