- The Washington Times - Friday, June 1, 2007

From combined dispatches

ATLANTA — SARS on a plane. Mumps on a plane. And now a rare and deadly form of tuberculosis, on at least two planes.

Commercial air travel’s potential for spreading infection continues to cause hand-wringing among public-health officials, as news of a jet-setting man with a rare and deadly form of TB demonstrates.

“We always think of planes as a vehicle for spreading disease,” said Dr. Doug Hardy, an infectious disease specialist at the University of Texas’ Southwestern Medical Center in Dallas.

In the latest case, a Georgia man with drug-resistant TB ignored doctors’ advice and took two trans-Atlantic flights, leading to the first U.S. government-ordered quarantine since 1963.

The man was identified yesterday as a 31-year-old Atlanta personal-injury lawyer whose father-in-law is a Centers for Disease Control and Prevention (CDC) microbiologist specializing in the spread of TB and other bacteria.

Bob Cooksey would not comment on whether he reported his son-in-law, Andrew Speaker, to federal health authorities. He said only that he gave Mr. Speaker “fatherly advice” when he learned the young man had contracted the disease.

“I’m hoping and praying that he’s getting the proper treatment, that my daughter is holding up mentally and physically,” Mr. Cooksey told the Associated Press. “Had I known that my daughter was in any risk, I would not allow her to travel.”

In a statement issued through the CDC, Mr. Cooksey said that neither he nor his CDC laboratory was the source of his son-in-law’s TB.

Mr. Cooksey has worked at the CDC for 32 years and is in the Division of Tuberculosis Elimination, where he works with TB and other organisms. He has co-authored papers on diabetes, TB and other infectious diseases.

“As part of my job, I am regularly tested for TB. I do not have TB, nor have I ever had TB,” he said. “My son-in-law’s TB did not originate from myself or the CDC’s labs, which operate under the highest levels of biosecurity.”

Mr. Speaker said in a newspaper interview that he knew he had TB when he flew from Atlanta to Europe in mid-May for his wedding and honeymoon, but that he did not find out until he was already in Rome that it was an extensively drug-resistant strain.

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 United States, he said. Mr. Speaker said he tried to sneak home by way of Canada instead of flying directly into the United States.

Yesterday, Mr. Speaker was flown from Grady Memorial Hospital in Atlanta to National Jewish Medical and Research Center in Denver, accompanied by his wife and federal marshals.

He looked healthy and tan when he arrived, and “he said he still felt fine,” the Denver hospital’s spokesman William Allstetter said. The chief of the hospital’s infectious-disease division said he is optimistic Mr. Speaker can be cured, because he is thought to be in the early stages of the disease.

Doctors planned to begin treating him immediately with two antibiotics, one oral and one intravenous. He also will undergo a test to evaluate how infectious he is and a CT scan and lung X-ray, Mr. Allstetter said.

Doctors also hope to determine where Mr. Speaker contracted the disease, which has been found around the world and exists in pockets in Russia and Asia.

Mr. Speaker will be kept in a special unit with a ventilation system to prevent the escape of germs. “He may not leave that room much for several weeks,” Mr. Allstetter said.

The case points out weaknesses in the system: Mr. Speaker was able to re-enter the United States, even though he said he had been warned by federal officials that his passport was being flagged and he was being placed on a no-fly list.

CDC officials said they contacted the Department of Homeland Security to put him on a no-fly list, but it doesn’t appear he was added by the time he flew from Prague to Montreal. Mr. Speaker was able to drive into the United States after a border inspector disregarded a computer warning to stop him and don protective gear, officials said yesterday.

“There’s always going to be situations where there is a lack of understanding and appreciation of responsibility to the community in a situation like this,” said Dr. John Ho, an infectious diseases specialist at New York-Presbyterian Hospital/Weill Cornell Medical Center.

There have been several prominent disease-on-a-plane cases in recent years.

Perhaps best known is severe acute respiratory syndrome, or SARS, which erupted in Asia in 2003. Over three months, CDC workers delayed on the tarmac 12,000 airplanes carrying 3 million passengers arriving from SARS-affected countries, isolating people with SARS symptoms.

Some travelers who flew on the same planes with Mr. Speaker angrily accused him of selfishly putting hundreds of other people’s lives in danger.

“It’s still very scary,” 21-year-old Laney Wiggins, one of more than two dozen University of South Carolina at Aiken students who are getting skin tests for TB. “That is an outrageous number of people that he was very reckless with their health. It’s not fair. It’s selfish.”

Mr. Speaker’s father, Ted, told WSB-TV: “The way he’s been shown and spoken about on TV, it’s like a terrorist traveling around the world escaping authorities. It’s blown out of proportion immensely.”

Health law specialists said Mr. Speaker could be sued if others contract the disease.

“There are a number of cases that say a person who negligently transmits an infectious disease could be held liable,” said Lawrence Gostin, a public health law specialist at Georgetown University. “So long as he knew it was infectious, and knew about the appropriate behavior but failed to comply, he could be held liable.”

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