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TB patient testifies he wasn't on the run

Denies officials warned him he was contagious

WASHINGTON -- Speaking from his hospital room in Denver yesterday, the lawyer who has extensively drug-resistant tuberculosis told a US Senate panel that no health official ever told him he would be a threat to anyone if he flew across the Atlantic and back.

"I didn't go off running from people," Andrew Speaker , 31, of Atlanta told the hearing over a speaker phone after one US health official said Speaker had gone "underground" in order to fly home. "It's a complete fallacy. It's a lie."

But Dr. Julie Gerberding , director of the Centers for Disease Control and Prevention, and a senior Fulton County health official both testified before a Senate subcommittee that health authorities warned Speaker against traveling to Europe for his wedding and honeymoon and then a second time before he flew to Canada.

The dramatic testimony yesterday revealed a couple's desire to carry on with their overseas wedding plans amid fears of being grounded for a couple of years because of the disease. Health officials, meanwhile, detailed their struggle to protect the public from a patient who refused to follow their advice.

On May 10, after learning Speaker had multiple drug- resistant TB just four days before he and his then- fiancee were scheduled to fly to Europe, health officials visited the couple and their parents in Speaker's home. Speaker said no one wore masks to protect themselves against contracting the drug-resistant TB bug.

Steven Katkowsky, Fulton County district health officer, said in an interview yesterday that health officials told Speaker "that the plan to travel would be against medical advice and that you are putting other people at risk" by flying on a long-distance flight. Katkowsky was not at the meeting, but he said notes taken by participants confirmed his account.

Speaker, though, told the panel that he remembered the message differently. He said health officials told him he was "not contagious, that I was not a threat to anyone." He also said they did not issue an order against flying.

Katkowsky told the panel that Speaker was correct on the last point. He indicated that county health officials were considering doing so but had been told by local prosecutors they would have to prove Speaker had harmed others.

"We found ourselves in a Catch-22" situation, Katkowsky said. "The law allows action after there's a violation, but not before."

While Speaker and health officials have given different versions of events separately to the media, the Senate hearing was the first time both sides could respond to each other's comments. A Senate and a House panel each held hearings yesterday on the matter, and in both forums lawmakers criticized aspects of the performance of the CDC and US Customs and Border Protection.

"I am dismayed and concerned that so many things went wrong in this case of drug-resistant tuberculosis," said Senator Tom Harkin, an Iowa Democrat. ". . . Clearly, there are gaps in planning on how to control the travel of persons with dangerous infectious diseases. It's as though the issue had not been raised before."

In the House hearing, Homeland Security Committee chairman Bennie Thompson, a Mississippi Democrat, found fault with homeland security procedures that allowed Speaker to enter the country in a rented car at the Champlain, N.Y., border crossing on May 24.

"We should have connected more dots," said Thompson. "Better or at least more complete policies and procedures may have made a difference in preventing Andrew Speaker from coming across the border."

Deborah J. Spero , deputy commissioner of US Customs and Border Protection, told the Senate panel that everything had gone right up to the moment that Speaker approached the border post. The guard, an 18-year veteran, "had an opportunity to detain Mr. Speaker at the border and missed," she said, calling his actions "inexcusable."

On the guard's computer, Spero said, appeared a message that said: "Place mask on subject. Place in isolation, well ventilated room, if possible. Subject has multiple resistant TB. Public health risk." She said it also gave the name of a public health doctor with two telephone numbers.

Gerberding said the biggest failing of the CDC was putting too much trust in a patient to follow the advice of public health officers.

She said that in two instances, in the May 10 meeting in Speaker's house and in a phone conversation with Speaker in Rome just after midnight on May 23, officials were too lenient with him.

"We gave the patient the benefit of the doubt, and in retrospect we made a mistake," she said.

Speaker said that in the conversation from Rome, CDC officials told him that he should turn himself in at an Italian hospital. He said that the CDC also said they could not send a plane to take him home and that he might have to pay up to $140,000 for a private flight to return to Atlanta.

"I could be stuck indefinitely in an Italian hospital," Speaker told the Senate subcommittee. "I just wanted to get home. I'm sorry for all the distress I caused people."

He traveled to Prague, where he and his wife flew to Montreal. Gerberding described his actions as going underground because he feared that a no-fly order had been issued.

The CDC has two small airplanes, but Gerberding said neither could provide "safe transportation for a patient who needs isolation."

John Donnelly can be reached at donnelly@globe.com

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