Atlanta Lawyer Has Less Severe Form Of TB; CDC Test Results In Question

Tuesday, July 3rd 2007, 6:08 pm

By: News On 6

DENVER (AP) _ New tests show the globe-trotting American lawyer who caused an international health scare by traveling with a dangerous form of tuberculosis has a less severe form of the disease, doctors said Tuesday.

The dramatic announcement from physicians treating Andrew Speaker raised immediate questions about the accuracy of the diagnosis by U.S. government health officials who had ordered Speaker quarantined in May.

But the Centers for Disease Control and Prevention stood by its earlier test and its action to isolate Speaker. And both Speaker's doctor in Denver and an official with the CDC who appeared at a news conference here said the public health response should be the same to both forms of drug-resistant TB.

``The public health actions that CDC took in this case, and are continuing to take, are sound and appropriate,'' said the CDC's Dr. Mitchell Cohen.

For the patient himself, the news that he apparently has a more treatable form of TB means he may avoid surgery and has a much better chance for a cure.

``These new test results are good news for Mr. Speaker. His prognosis has improved,'' said Dr. Charles Daley, who is treating Speaker at National Jewish Medical and Research Center. ``We now have more effective medications available to fight his disease and may be able to treat him successfully without surgery.''

It was also good news for any airline passengers who might have caught TB from Speaker while on one of his trans-Atlantic flights in May. The new diagnosis means their TB also stands a better chance of being treated, Daley said. Cohen said the CDC won't know until late July or August whether anyone may have contracted the disease from the 31-year-old Atlanta lawyer.

In a statement, Speaker said he was relieved by the new diagnosis.

``The truth is that my condition is just the same as it was back in early May, long before there was a huge health scare, and back when I was allowed to carry on my daily life and was told, 'I was not a threat to anyone,''' Speaker said.

He also gave a harsh critique of the government's handling of the case: ``In the future I hope they realize the terribly chilling effect they can have when they come after someone and their family on a personal level. They can in a few days destroy an entire family's reputation, ability to make a living, and good name.''

For the past month, Speaker has been isolated at the Denver hospital, which specializes in treating TB and other respiratory diseases. His bride, Sarah, has paid regular visits.

Speaker was diagnosed in May with extensively drug resistant TB, based on an analysis of a sample taken in March by the U.S. Centers for Disease Control and Prevention. The XDR-TB, as it is called, is rare, extremely difficult to treat and is a growing public health threat.

But later tests in Denver indicate Speaker's TB is a slightly more treatable form of the disease, multidrug-resistant TB. And CDC's own retesting of its original sample from Speaker now matches the results in Denver. Multidrug-resistant TB can be treated with some antibiotics that the more severe form resists.

Daley said he didn't know why the initial tests by CDC showed that Speaker had XDR. ``I don't think we'll ever know why this happened,'' he said.

The CDC's Cohen explained that reading these test results is not a black-and-white case.

It's possible for a couple of types of TB to be in one sample, and in one patient, he said. That is one of several possible explanations why CDC might have found XDR, while subsequent test results show MDR, Cohen said.

The CDC's diagnosis of XDR-TB was a key factor cited by CDC chief Dr. Julie Gerberding in issuing a quarantine order against Speaker. He had flown to Greece to be married in May despite warnings from health officials that he shouldn't travel.

At the time, he was diagnosed with MDR-TB and officials were awaiting results on whether his TB could be the rarer XDR form. Cohen said Tuesday that the same advice is appropriate for both forms of the disease.

His case became an international public health story and even raised questions about U.S. border security. Congress held a hearing on the CDC's handling of the case and Speaker's father-in-law, a TB researcher who works for the CDC, also came under scrutiny.

Speaker ignored federal health officials' warnings to get medical help in Europe and not to get on an airplane. Instead, he and his wife flew to Canada and crossed the border into the United States even though his name was on a no-fly list given to border guards.

He was briefly placed under federal quarantine and later sent to the hospital in Denver.

The incident prompted a hunt for passengers on the cross-Atlantic flights taken by Speaker so they could be tested for the disease.