Bureaucratic Failings Are Cited in TB Case
Agencies Were Slow to Communicate

By Spencer S. Hsu
Washington Post Staff Writer
Tuesday, June 5, 2007

The Atlanta lawyer with extensively drug-resistant tuberculosis who crisscrossed the Atlantic on commercial jets last month was not added to a U.S. no-fly list until at least two hours after he reentered the country by car from Canada, according to congressional investigators.

That was only one of a series of breakdowns at the international, federal and state levels that allowed Andrew Speaker, 31, to fly to Europe on a 12-day trip for his wedding and honeymoon, setting off a transatlantic health alarm.

Although Speaker's name was placed on a different watch list meant to catch people who cross the border by any route, a customs inspector used his discretion to ignore an alert triggered by the lawyer's passport. The Department of Homeland Security (DHS) is revoking that discretion at border crossings and an inquiry is underway, officials said yesterday.

Investigators are pursuing several tracks in the case, which exposed major gaps in controls on worldwide travel by people with dangerous infectious diseases. Bureaucratic turf fights, legal concerns over applying counterterrorism tools to public health cases, and technological problems appear to have delayed or blocked the sharing of critical information among health and security agencies, congressional and administration officials said. House and Senate hearings on the episode are scheduled for tomorrow.

Speaker, who is being treated at the National Jewish Medical and Research Center in Denver, remained in an isolation room yesterday pending confirmation that his sputum is free of TB bacteria and that he is "relatively non-contagious," hospital officials said. With the patient now under a detention order issued by Denver health officials, the Centers for Disease Control and Prevention withdrew a federal quarantine order, the first it had issued since 1963.

CDC officials also said they are investigating the role played by Speaker's father-in-law, Robert C. Cooksey, an agency microbiologist who helped test and diagnose Speaker's bacteriological sample, but who may not have known it was from Speaker.

Separately, the Associated Press reported that after the CDC learned on May 18 that Speaker had left for Europe, it took a week and a half for CDC officials to notify their counterparts in Europe that Speaker was traveling to Greece and Italy. The World Health Organization and Italian health authorities say they were not notified until May 24, and the Greek Health Ministry was not informed until May 25, officials said.

Homeland Security officials briefed House and Senate committees yesterday on new details about how the CDC and border, transportation security and counterterrorism agencies failed to catch up with Speaker, even though they knew his name and passport number and health officials had reached him in Italy. Congressional investigators produced detailed chronologies of the events based on the briefing.

Speaker left for Europe May 12 after he said health authorities in Fulton County, Ga., advised -- but did not order -- him not to fly, two days after the county discussed the situation with the Georgia Division of Public Health, which contacted the CDC.

It was on May 22, after the CDC determined Speaker carried an extensively drug-resistant strain, known as XDB-TB, that authorities notified Homeland Security through a regional office of Customs and Border Protection (CBP) in Atlanta, not its Washington headquarters.

Neither the CDC nor the CBP alerted the Transportation Security Administration or DHS to place Speaker's name on a no-fly list until May 24. DHS officials now question why the alert was shared between field offices only and why the CDC did not notify DHS's National Operations Center, alerting agencies from the TSA to the Coast Guard to state partners.

On May 24, according to the chronology, the CDC hesitated for hours to share Speaker's name with security agencies for privacy reasons. Congressional sources said lawyers at the FBI-maintained Terrorist Screening Center also balked at using terrorist watch lists to target an individual for public health reasons for the first time, before TSA leaders acted.

"The no-fly list has historically been a counterterror tool, and there was an assessment made that we have an authority to use it for medical purposes," said one Homeland Security official. "It happened quite quickly, but it did involve a legal review of the authorities."

An FBI statement referred questions to Homeland Security, saying only, "The FBI deals with terrorism related matters in regards to the watch list."

Speaker landed in Montreal at approximately 3:27 p.m. on May 24, rented a car with U.S. license plates and was admitted across the U.S. border at 6:18 p.m. His name was added to the TSA no-fly list at 8:31 p.m., and Canadian authorities were notified about 8 p.m., congressional investigators said.

Speaker was held at the border for no more than two minutes, although his passport triggered an alert to refer him for secondary screening, to hold him and to contact public health officials. For reasons that remain unclear, the border inspector, now under investigation, ignored information added to a master database two days earlier by an Atlanta officer.

Hours later, after midnight, a routine, automated sweep of the CBP database notified headquarters of the alert, a U.S. homeland security official said.

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