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TB lapses pose no health threat

WASHINGTON --Security lapses that allowed two men infected with tuberculosis to enter and leave the United States do not pose a serious health threat to people in this country, a top government health official said Friday.

In April, U.S. officials were unable to catch a tuberculosis-infected Mexican man because his doctor did not know his real name. And in May, an Atlanta attorney was able to fly from Atlanta to Europe for his wedding and honeymoon despite warnings from public health officials not to travel.

"Although we want to be vigilant about finding these people so that they can get treated and they won't pose any risk to the public, in fact, the risk is very small," said Jeffrey Runge, the chief medical officer at the Homeland Security Department. Runge said someone must be exposed to the disease for more than eight hours to be at risk of infection, and even then, the risk is relatively small.

Runge said tuberculosis cases in the United States are on the decline. In 2006, there were 13,779 cases, according to the federal Centers for Disease Control and Prevention, a 2 percent drop from 2005.

The case involving the Atlanta man, Andrew Speaker, revealed inadequate lines of communication among the U.S. government agencies responsible for enforcing public health laws. Ultimately a Customs and Border Protection inspector ignored federal orders and let Speaker enter the U.S. through Canada. The 18-year veteran inspector who ignored the warning has since retired.

During this time, Mexican national Amado Armendariz Amaya was being treated for his disease in Mexico under a fake name, according to officials familiar with the incident. Armendariz Amaya agreed with his doctor that he would not travel, but he entered the U.S. 21 times between April 16 and May 31 undetected because he was using his real name and legal travel documents.

The publicity surrounding the Speaker case prompted Armendariz Amaya to turn himself over to his doctor in Mexico on May 31. Lawmakers have called for an investigation into the incidents.

"The Speaker case was obviously a huge wake-up call for making sure that officers can't override the system," Runge said. And the protocols the departments of Health and Human Services and Homeland Security have put in place since the Speaker incident are already working, he said.

The Armendariz Amaya case represents the constant struggle health officials face in providing treatment, Runge said.

The man was being treated under a fake name at a clinic in Ciudad Juarez that is affiliated with the CDC and the Texas Department of State Health Services. When his doctor alerted Texas and CDC officials to be on the lookout for him, border agents were not able to stop him because they did not have the right name.

In many clinics on both sides of the border treating patients is more important than ensuring their identities, health officials said.

"There's a greater interest in someone with tuberculosis being treated and cured than there is in whether or not they've produced an accurate identification," said Texas Department of State Health Services spokesman Doug McBride. If identification were required for treatment, "you could end up with someone with infectious TB in a community untreated, because the person didn't have a valid driver's license," he said.

According to the CDC, Armendariz Amaya did not take any flights longer than eight hours, which is the World Health Organization standard for the amount of time someone would have to be exposed to the disease in close quarters in order to risk becoming infected.

Armendariz Amaya's associates and some family members have tried to enter the United States since May 31, but Customs officials made them go through additional inspections and tested them for the disease. None of them were infected and they were cleared to enter the U.S., the official said.

And Mexican health officials have been monitoring Armendariz Amaya as well. "The patient is in good physical condition and we're also monitoring his closest relatives and they're all OK," Hector Puertas Rincon, director of state health services in Ciudad Juarez, said in a telephone interview.

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Associated Press writers Marina Montemayor in Ciudad Juarez, Mexico and Olga Rodriguez in Mexico City contributed to this story.

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