By David Brown
Washington Post Staff Writer
Friday, June 1, 2007

The man who took commercial flights to and from Europe last month while infected with untreated extensively drug-resistant tuberculosis was identified yesterday as an Atlanta lawyer whose father-in-law is a tuberculosis researcher at the Centers for Disease Control and Prevention.

Those are the latest revelations in a story that has grown more bizarre by the day as details of the man's ability to elude health authorities -- especially the CDC -- on two continents slowly trickled out.

The man, who flew to Europe on May 12 for his wedding and honeymoon and returned 12 days later, is Andrew Speaker, 31, a lawyer in a firm specializing in personal injury cases. Hours after his name was first reported by a news service, Robert C. Cooksey, whose daughter married Speaker, released a statement identifying himself as a CDC employee and saying he "wasn't involved in any decisions my son-in-law made regarding his travel."

He added that he did not "ever act as a CDC official or in an official CDC capacity with respect to any of the events of the past weeks."

Cooksey, who has worked for the Division of Tuberculosis Elimination at the Atlanta-based agency for 32 years, is a co-author of numerous papers on the TB bacterium, including strains resistant to common TB drugs. His statement said he is "regularly tested for TB" and has never had the infection.

"My son-in-law's TB did not originate from myself or the CDC's labs, which operate under the highest levels of biosecurity," he wrote.

Cooksey attended Speaker's wedding to his daughter, Sarah, said a CDC source who spoke on the condition of anonymity. According to a published announcement, the ceremony was to occur on the Greek island of Santorini. The announcement described the bride as a third-year student at Emory University's law school.

CDC officials earlier this week said the genetic fingerprint of the bacterium infecting Speaker did not match any in its library of TB samples. They added, however, that this is not surprising; strains of "XDR-TB isolates" are rare, and the library of them is small.

How Speaker contracted the infection remains a mystery. He appears not to have had the usual risk factors, such as previous incompletely treated TB, imprisonment, homelessness or poor health.

Tom Skinner, a CDC spokesman, said yesterday afternoon that "the source of the patient's infection is unknown." He added that current information does not suggest that Speaker contracted TB "as a result of his relationship with" Cooksey.

The tuberculosis was discovered after a chest X-ray in January showed an abnormality, according to a doctor at National Jewish Medical and Research Center in Denver, where Speaker was flown yesterday.

A CDC quarantine officer in Atlanta ultimately tracked down the newlyweds in Rome on May 22, the day tests revealed that Speaker's bacterium was extensively drug-resistant, which means it is resistant to two classes of first-line drugs and two classes of second-line drugs. At that time, the agency knew he was the son-in-law of one of its researchers, but when CDC officials first learned that is unclear.

The head of the health department in suburban Atlanta's Fulton County, Steven Katkowsky, said he did not learn until this week that Speaker was related to a CDC scientist.

Katkowsky also confirmed that a lawyer for the health department advised that Speaker could not be involuntarily detained until he defied a "medical directive." A letter explicitly telling him not to fly to Europe was mailed to Speaker on May 11, three days before the date health officials believed he planned to depart.

"You can't stop him from traveling until he has traveled -- isn't that a conundrum?" Katkowsky said.

ABC News reported last night that Speaker claims to have a tape recording of a meeting with health officials and that it confirms his view that it was all right to travel in his condition. The network plans to air its interview with Speaker, recorded yesterday, on "Good Morning America" today.

Speaker left Atlanta and flew to Paris on May 12, the day after the letter was mailed.

He apparently changed his travel plans for returning to the United States after being contacted in Rome on May 22 by a CDC official who told him to stay put while arrangements were made for safe travel or possible treatment in Italy. Two days later, on May 24, he flew to Prague and on to Montreal.

The next day, Martin Cetron, CDC's director of quarantine and global migration, reached Speaker in Upstate New York and asked him to report to a New York City hospital. He stayed there until he was flown in a CDC aircraft to Atlanta on Monday. He had been hospitalized in isolation until yesterday, when he was flown by air ambulance to Denver.

Speaker went there because National Jewish is one of the few hospitals that sometimes use surgery to treat tuberculosis -- an option being considered in his case. He will be there for weeks and possibly months, officials said.

Also yesterday, a spokesman for the Department of Homeland Security, Russ Knocke, said that Speaker and his wife were both positively identified by a port officer in Champlain, N.Y., where they entered the United States from Canada. Both had been entered on a list of people who should be detained and flagged for public health authorities.

Why they were not detained is under investigation, he said. The agent who identified the Speakers has been removed from border duty.