TB Patient Has Less Dangerous Strain: CDC

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By E.J. Mundell
HealthDay Reporter
Tuesday, July 3, 2007; 12:00 AM

TUESDAY, July 3 (HealthDay News) -- The tuberculosis-infected Atlanta lawyer at the center of an international public health scare in May does not have the most highly drug-resistant strain of the disease, as had been thought, U.S. health officials announced Tuesday.

In an afternoon press conference, the officials said that sputum tests now consistently show that 31-year-old newlywed Andrew Speaker carries a slightly less dangerous strain of bacteria -- multi-drug resistant tuberculosis (MDR-TB) -- rather than the more lethal strain known as extensively drug-resistant TB (XDR-TB).

Reports that Speaker had the more lethal strain when he flew to and from Europe for his honeymoon two months ago had triggered public and global warnings to all passengers seated around him on his flights.

On Tuesday, health officials said that one test conducted on a bronchoscopy sample in May at the U.S. Centers for Disease Control and Prevention showed Speaker to be infected with XDR-TB, but every test conducted since then at either the CDC or Denver's National Jewish Medical and Research Center, where he is being treated, shows only the MDR-TB strains.

"This is a positive development for the patient, suggesting that some of the second-line TB medications may effectively treat this disease," Dr. Mitchell Cohen, director of the CDC's Coordinating Center for Infectious Diseases, told reporters.

Cohen stressed, however, that "MDR-TB remains difficult to treat and will require approximately two years of medication and relatively toxic drug regimens to achieve the desired outcome."

Doctors will now treat Speaker with drugs, rather than surgically removing lung tissue, in an attempt to control his TB.

Despite the change in diagnosis, Cohen supported the CDC's actions in May to track down Speaker as he traveled to Europe and back for his honeymoon, calling them "sound and appropriate."

"Without question, people with these infections should not be flying on commercial airlines, and if they do, an effort should be made to notify and evaluate passengers who were seated near them," Cohen said.

Discrepancies between TB diagnostic test results "happen all the time," added Dr. Charles Daley, head of the infectious disease division at National Jewish. According to the experts, results can vary between tests based on the specimen, the day it was collected, specific bacterial colonies and other factors.

"This is not a new thing for us to deal with, in terms of two laboratories having different answers," Daley said. "In this particular setting, I don't know why the first result showed XDR at the CDC and the second result and our results did not."

He noted that, as is standard procedure, the specimen from which the XDR-positive test arose was discarded, so it may be impossible to know how the discordant result occurred.


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