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Tests on TB traveler indicate lesser strain
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 yesterday.
The dramatic announcement from the doctors treating Andrew Speaker raised immediate questions about the accuracy of the diagnosis by U.S. government health officials who had ordered Mr. Speaker quarantined in May.
But officials at the Centers for Disease Control and Prevention stood by their earlier test and the action to isolate Mr. Speaker. And both Mr. Speaker’s doctor in Denver and an official with the CDC who appeared at a press 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,” Dr. Mitchell Cohen said.
For the patient, 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 Mr. 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.”
The 31-year-old patient 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,’ ” Mr. 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 affect 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, Mr. Speaker has been isolated at the Denver hospital, which specializes in treating TB and other respiratory diseases. His wife, Sarah, has paid regular visits.
Mr. Speaker was diagnosed in May with extensively drug resistant TB, based on an analysis of a sample taken in March by the CDC. The XDR-TB, as it is called, is considered extremely difficult to treat and is a growing public health threat.
But later tests have shown Mr. Speaker’s TB to be the more treatable form of the disease, multidrug-resistant TB. And the CDC’s own re-testing of its original sample now matches that result. Multidrug-resistant TB can be treated with some antibiotics that the more severe form resists.
Dr. Daley said he didn’t know why the initial tests by CDC showed that Mr. Speaker had the other form. “I don’t think we’ll ever know why this happened,” he said.
The CDC’s Dr. Cohen explained that the test is not a black-and-white one. It’s possible for a couple of types of TB to be in one sample, and in one patient, he said.
By John R. Bolton
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