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Quarantined TB patient: 'I hope they forgive me'

Posted Oct 23 2008 2:23pm
DENVER — While authorities try to determine how an Atlanta lawyer was able to avoid detection while traveling to Europe with a highly drug-resistant form of tuberculosis, the man apologized to his fellow plane passengers in an interview broadcast Friday.

"I've lived in this state of constant fear and anxiety and exhaustion for a week now, and to think that someone else is now feeling that, I wouldn't want anyone to feel that way. It's awful," Andrew Speaker told ABC's Good Morning America from his hospital room in Denver.

Wearing a face mask, Speaker repeatedly apologized to the dozens of airline passengers and crewmembers now anxiously awaiting their own test results because of the exposure to him.

"I don't expect for people to ever forgive me. I just hope that they understand that I truly never meant to put them in harm," he said, his voice cracking.

He insisted that he was told he wasn't contagious or a threat to anyone.

The 31-year-old personal injury lawyer is "doing extremely well, in very good spirits," said infectious disease specialist Gwen Huitt, treating him in Denver at National Jewish Medical Research Center.

Doctors hope to determine where he contracted the disease, which has been found around the world and exists in pockets in Russia and Asia. The tuberculosis was discovered by accident when Speaker had a chest X-ray in January for a rib injury, Huitt said.

Huitt said he may have carried the disease in a "latent, dormant" state for years.

She said Speaker is expected to remain in the hospital in isolation and taking multiple antibiotics for two to six months, at a cost of up to $350,000.

Speaker said he, his doctors and the federal Centers for Disease Control and Prevention all knew he had TB before he flew to Europe for his wedding and honeymoon last month. But he said he was advised that he wasn't contagious or a danger to anyone. Officials said they would rather he didn't fly but no one ordered him not to, he said.

He said his father, also a lawyer, taped that meeting.

"My father said, 'OK, now are you saying, prefer not to go on the trip because he's a risk to anybody, or are you simply saying that to cover yourself?' And they said, we have to tell you that to cover ourself, but he's not a risk."

Dr. Steven Katkowsky, director of the Fulton County Department of Health & Wellness, said Speaker was told in early May not to travel to Europe: "He was told traveling is against medical advice."

Dr. Martin Cetron, director of the CDC's division of global migration and quarantine, said once Speaker was already in Europe, "He was told in no uncertain terms not to take a flight back."

Speaker, his new wife and her 8-year-old daughter were already in Europe when the CDC contacted him and told him to turn himself in immediately at a clinic there and not take another commercial flight.

Speaker said he felt as if the CDC had suddenly "abandoned him." He said he believed if he didn't get to the specialized clinic in Denver, he would die.

"Before I left, I knew that it was made clear to me, that in order to fight this, I had one shot, and that was going to be in Denver," he said. If doctors in Europe tried to treat him and it went wrong, he said, "it's very real that I could have died there."

Speaker's ability to re-enter the United States through Canada to avoid detection despite having his passport flagged has raised the ire of some members of Congress.

Sen. Charles Schumer, D-N.Y., called for an investigation of staffing at border crossings. In a statement, Sen. Susan Collins, R-Maine, said the incident "highlights how vulnerable our security remains … and raises considerable doubts about the nation's preparedness for pandemic influenza and other biological incidents."

Even though U.S. officials had put Speaker on a warning list, he caught a flight to Montreal and then drove across the U.S. border on May 24 at Champlain, N.Y. A border inspector who checked him disregarded a computer warning to stop Speaker, officials said Thursday.

The unidentified inspector later said the infected man seemed perfectly healthy and that he thought the warning was merely "discretionary," officials briefed on the case told the Associated Press. They spoke on condition of anonymity because the matter is still under investigation.

The inspector ran Speaker's passport through a computer, and a warning — including instructions to hold the traveler, don a protective mask in dealing with him, and telephone health authorities — popped up, officials said. About a minute later, Speaker was instead cleared to continue on his journey, according to officials familiar with the records. The inspector has since been removed from border duty.

Colleen Kelley, president of the union that represents customs and border agents, declined to comment on the specifics of the case, but said "public health issues were not receiving adequate attention and training" within the agency.

The next day, Speaker became the first infected person to be quarantined by the U.S. government since 1963. He was flown by medical transport to Denver on Thursday.

In perhaps the most curious twist, Speaker's father-in-law, Robert C. Cooksey, is a microbiologist who does research on tuberculosis at the Centers for Disease Control and Prevention. Cooksey said, in a statement released by the CDC, that he is tested regularly for TB, has never had it, and could not have been the source of Speaker's infection.

Cooksey said he had no part in Speaker's decisions to travel to Greece to be married, which included a flight from Atlanta to Paris on May 12-13 on Air France. CDC officials became aware of Speaker's infection with the highly drug-resistant form of TB on May 22, and told him to remain in his Rome hotel, but instead, he flew to Prague, boarded a plane for Montreal and then drove back to the USA with his new bride.

Some travelers who flew on the same planes with Speaker angrily accused him of selfishly putting hundreds of people's lives in danger.

"It's still very scary," 21-year-old Laney Wiggins, one of more than two dozen University of South Carolina-Aiken students who are getting skin tests for TB. "That is an outrageous number of people that he was very reckless with their health. It's not fair. It's selfish."

CDC spokesman Tom Skinner said the agency has contacted 50 of the more than 400 passengers on the Air France flight, but called it a "labor intensive process."

Speaker's new wife, Sarah, fought back tears as she told ABC about the horrible things said about her husband: that he was a terrorist, that he should have been eradicated.

"Imagine sitting in a foreign country with your husband and your government saying they were going to leave you there," she said through tears.

She said she has tested negative for TB, despite being closer to him over the past month than anyone, and she is praying that no one they came in contact with would test positive for the disease.

Both Speaker and his father-in-law said they didn't believe he was a danger when he left for Europe.

"I never would have put my family at risk, and my daughter at risk. I repeatedly asked my doctors, 'Is my family at risk? Is anybody at risk of this?'" Speaker said. "They told me I wasn't contagious and I wasn't dangerous."

Speaker said he and his wife were "scared out of our minds" at the prospect of being indefinitely placed in an Italian hospital and dying there.

"I know people will judge it, it's natural human instinct to judge what other people do," Speaker said. "Truly, in our minds, we were told we were not a threat to the people around us and we wanted to get home."

"I just hope they can forgive me," he said.

Dr. Charles Daley, chief of the National Jewish Hospital's infectious-disease division, said he is optimistic Speaker can be cured because he is appears to be in the early stages of the disease.

He is "a young, healthy individual" who is "doing extremely well," Dr. Gwen Huitt said Thursday.

"By conventional methods that we traditionally use in the public health arena ... he would be considered low infectivity at this point in time," she said. "He is not coughing, he is healthy, he does not have a fever."
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