Frequent U.S. Visits By TB Patient Noted
DHS Official Acknowledges Errors

By Spencer S. Hsu
Washington Post Staff Writer
Thursday, December 13, 2007

The Department of Homeland Security's chief medical officer yesterday acknowledged errors in the federal government's failure to stop a Mexican businessman infected with multiple-drug-resistant tuberculosis from entering the United States 21 times over seven weeks in April and May.

At his Senate confirmation hearing, Jeffrey W. Runge, DHS's acting assistant secretary for health affairs, said he and the agency's deputy secretary at the time, Michael P. Jackson, wanted to revoke the border-crossing card of Amado Isidro Armendariz Amaya after learning on April 30 about his situation and World Health Organization guidelines against international travel by such a patient.

But Martin Cetron, director of the U.S. Centers for Disease Control and Prevention's global migration and quarantine division, objected that doing so would drive patients in Mexican border areas with similar conditions underground and create a bigger health risk, Runge said.

Armendariz, a Ciudad Juarez resident with a business in the United States, turned in his border card on or about May 31 only after he was confronted by his physician at a Juarez clinic run by Texas's health department. The physician was concerned about Armendariz's continued unauthorized travel to neighboring El Paso, amid publicity over the efforts to quarantine Andrew Speaker, an American lawyer with the same disease whose honeymoon in Italy led to a global manhunt.

"I think your original judgment was right and that they should have pulled his visa," said Sen. Joseph I. Lieberman (I-Conn.), chairman of the Senate Committee on Homeland Security and Governmental Affairs.

"It is just plain unacceptable that our border security operation was unable to connect the dots on an individual who posed a public health threat and was thus allowed into the country," Lieberman added later. He called on DHS to release its case records.

Runge acknowledged that it took until June 1 for DHS's Transportation Security Administration to be notified and until the following week for federal officials to place Armendariz's name on a no-fly list despite WHO guidelines against public air travel by such patients. DHS has drafted new procedures, he said.

After the story was first reported by the Washington Times, DHS officials initially said that the U.S. Customs and Border Protection bureau did not catch Armendariz on his frequent travels because he provided a false name. But Senate aides said that U.S. authorities failed despite knowing Armendariz's birth date and all his names but his first.

An alert to stop Armendariz was entered into a U.S. border-control computer system on April 16, but the day and month of his birth were transposed when given to the CBP. The date was corrected on April 20, but his two last names were then transposed, Senate aides said. It is not clear why the CBP did not catch Armendariz anyway, since the use of paternal surnames before maternal surnames is a common practice in Spanish and automated name-checking systems can detect such variations.

CBP spokesman Michael Friel said the agency received "incomplete information." Public health officials often rely on "a covenant of trust" and on voluntary compliance in tuberculosis cases, and there was no initial evidence that Armendariz was not cooperating, Tom Skinner of the CDC said.