American Who Set Off TB Scare Doing Well in Hospital

The tuberculosis scare continues unabated across the Atlantic. But the man who set off the panic is doing well in a hospital in Denver that specializes in the disease. The man himself has been identified as Andrew Speaker, a 31-year-old attorney from Atlanta. He is not coughing, has no fever and does not appear to be very likely to infect others, doctors said.

Still, staff at the National Jewish Medical and Research Center will wear surgical masks when treating him. The patient, Andrew Speaker, arrived there following an early-morning flight on an air ambulance. It is still not clear how he got the disease, but he has traveled extensively around the world over the last six years.

In a phone interview with the Atlanta Constitution-Journal from an Atlanta hospital earlier this week, he explained that he knew he had TB when he flew from Atlanta to Europe in mid-May for his wedding and honeymoon, but that he didn't find out until he was already there that it was an extensively drug-resistant strain considered especially dangerous.

Doctors initially did not order him not to fly and only suggested he put off his long-planned wedding. 'We headed off to Greece thinking everything's fine,' he told the newspaper. Despite warnings from federal health officials not to board another long flight, he flew home for treatment fearing he wouldn't survive if he didn't reach the U.S.

Health officials said they were looking for about 80 passengers and 27 crew members from two flights. Speaker flew from Atlanta to Paris on May 12, arriving on May 13, on Air France flight 385. He returned to North America on May 24, on Czech Air flight 104, from Prague to Montreal. He then drove back to the U.S.

Officials are trying to contact only those who sat within five rows of him on the two longest flights for testing. Other passengers are not considered at high risk of infection because tests indicated the amount of TB bacteria in the man was low, said Dr. Martin Cetron, director of the CDC's division of global migration and quarantine. Authorities in Europe said Speaker also took several more flights while he was in Europe.

Health officials in France, Italy and the Czech Republic are trying to track the man's movements and obtain passenger lists for the extra flights to warn people who may have had contact with him. Meantime more than two dozen college students were being tested for tuberculosis after they flew with Speaker. A University of South Carolina-Aiken spokeswoman said two students from the school were apparently sitting near him, possibly in the same row.

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Twenty-six students and two faculty members flew from Atlanta to Paris on May 12 as part of a study-abroad program with the school's business department. Speaker’s infection was discovered when he injured a rib, and an X-ray discovered an abnormality in the lung, it is said. Denver hospital authorities said they were confident treatment could help Speaker, in part because he is young, healthy and fit. He could be in the hospital weeks to months as doctors determine how to treat his infection.

Based on information from the Centers for Disease Control and Prevention, which had been coordinating care for Speaker the hospital planned to start one oral and one intravenous antibiotic Thursday. He would be put in a room with negative air pressure, meaning the air in his room would not be circulated to the rest of the hospital. He could be in that room much of the time for as long as his treatment lasts, except for things such as some scans that require large equipment.

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The treatment could ultimately include surgery to remove lung tissue that contains high concentrations of the bacteria. Dr. Charles Daley, head of the infectious disease division at National Jewish Hospital, said the hospital has treated two other patients with what appears to be the same strain of tuberculosis since 2000, although that strain had not been identified and named at the time. He said the patients had improved enough to be released.

'With drug-resistant tuberculosis, it's quite a challenge to treat this,' Daley told CNN Thursday. 'The cure rate that's been reported in other places is very low. It's about 30 percent for XDR-TB.' 'This is a different patient, though. We're told that this is very early in the course, and most of the time when we get patients that it's very extensive and very far advanced. So I think we're more optimistic,' he said. 'We're aiming for cure. We know it's an uphill battle, but we hope to get there.'

Speaker may get expert help from his family in fighting the disease. His new father-in-law works in a CDC laboratory aimed at preventing tuberculosis and has co-authored papers on the disease. Bob Cooksey said that he gave his son-in-law fatherly advice when he learned he had contracted the disease. Cooksey said that had he known his daughter was at any risk, he would not have allowed her to travel. He said he did not act in any official capacity with the CDC on the case.

According to health law experts, Speaker could end up being sued if others on his flights contract the disease. Lawrence Gostin, a public health law expert at Georgetown University said, 'a number of cases' hold that someone who 'negligently transmits an infectious disease could be held liable.' Gostin said that would apply to someone who knew the disease was infectious and 'knew about the appropriate behavior but failed to comply.'

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