Officials Detail Errors in TB Case

By David Brown and Spencer Hsu
Washington Post Staff Writers
Thursday, June 7, 2007

Officials of federal agencies that guard public health and the nation's borders yesterday told congressional committees that they made mistakes in their unsuccessful effort to stop an Atlanta lawyer from traveling on two continents with an extremely dangerous form of tuberculosis last month.

The hearings provided the fullest accounting to date of an episode that has embarrassed the agencies at a time when immigration is dominating the political debate and the threat of pandemic flu or bioterror attack remains a concern.

The Centers for Disease Control and Prevention was too trusting toward 31-year-old Andrew Speaker and too slow in notifying other agencies that he was abroad once it learned he had ignored medical advice and flown to Europe while still infectious, said Julie L. Gerberding, the CDC's director.

The agency also was late in telling the World Health Organization and the government of Italy, where Speaker and his bride were honeymooning.

"We failed to take action to limit his movements. . . . I think we can do that faster. I think we should have done it faster. In retrospect, that was a mistake," Gerberding told a subcommittee of the Senate Committee on Appropriations.

Speaker himself addressed the committee through a telephone hookup from his room at National Jewish Medical and Research Center in Denver, where he is undergoing treatment for "extensively drug-resistant" tuberculosis (XDR-TB).

He defended his actions by saying doctors told him he could not infect others and would need to wait at least three weeks before he could begin a two-year course of anti-TB therapy. Together, he said, those alleged assertions convinced him to go ahead with long-standing plans to get married on a Greek island and then travel to Rome and Florence.

"Nobody has said a single thing to me that I am a threat to anyone," he recalled of a conversation on May 10 with physicians from the health department of Fulton County, where he lives in an Atlanta suburb.

While this was going on, members of the House Homeland Security Committee were also hearing sometimes-conflicting narratives of the events and official mea culpas.

U.S. Customs and Border Protection (CBP) "had an opportunity to detain Mr. Speaker at the border, and we missed," and "that missed opportunity is inexcusable," said Commissioner W. Ralph Basham, accepting what he called the need for "100 percent success, 100 percent of the time."

But homeland security officials blamed what they called "a single point of failure," the front-line border inspector who ignored an alert to detain and isolate Speaker and to contact health authorities.

"Those actions appear to be indefensible," Basham said. Jayson P. Ahern, an assistant CBP commissioner, added: "We didn't execute well enough."

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