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Quarantined TB Patient On ABC: 'I Hope They Forgive Me'

Speaker's Doctor Say Tests Show He's Not Highly Contagious

POSTED: 4:53 am MDT June 1, 2007
UPDATED: 7:30 pm MDT June 1, 2007

The Atlanta lawyer quarantined with a dangerous strain of tuberculosis apologized to fellow airline passengers in an interview that aired Friday, and insisted he was told before he set out for his wedding in Europe that he was no danger to anyone.

"I've lived in this state of constant fear and anxiety and exhaustion for a week now, and to think that someone else is now feeling that, I wouldn't want anyone to feel that way. It's awful," Andrew Speaker, speaking through a face mask, told ABC's "Good Morning America" from his hospital room in Denver.

Meanwhile, questions arose as to whether the wedding even took place. The mayor of the island of Santorini in Greece, Angelos Rousso, told The Associated Press: "There was no wedding. They came for a marriage but they did not have the required papers." He said the couple stayed in a hotel for three days and then left.

Doctors At National Jewish Optimistic With Test Results

Speaker's doctors said he could be in the Denver hospital for up to two months, and if antibiotics fail to knock out the extremely drug-resistant infection, he may have to undergo surgery to remove infected lung tissue, which currently is about the size of a tennis ball, or one-sixth of his lung.

Dr. Gwen Huitt, Speaker's attending physician at National Jewish, said that Speaker is doing very well. She said that hospital officials moved an exercise bike into his ventilation-controlled room so that he can exercise everyday and prepare for the long road to recovery.

Huitt said that he has started taking medications and thus far, is tolerating them quite well -- showing no side effects or other problems.

She said over the next week, they will continually add to his medications so they don't have to assault his body with toxic drugs. She said he has already started taking two antibiotics, and the total could reach five over the next week as doctors add medications. He could end up taking more than 12 pills a day. Some of the drugs are normally used against other diseases, including leprosy.

He has no cough, no fever, and the chest X-ray and CT scan showed "no surprises regarding the extent of his disease in his lungs," Huitt said. Speaker had a good night's sleep and is eating well.

Based on a a sputum analysis -- which analyzes how communicable a disease is -- and a smear test, all signs appear positive that he is not highly contagious and his tuberculosis is unlikely to be transmitted to others.

"It is our opinion that he is of low communicablity," Huitt said. "Everybody should breathe a size of relief at this time ... This is all extremely good news for anyone who might be concerned about acquiring this riding on a plane."

"I can assure everyone in the public that they can come into our facility. There is absolutely no risk," Huitt said.

"We want to thank all the people who have expressed to us that they are keeping us in their prayers. Their good wishes mean so much to us during this difficult time," Speaker said Friday, through hospital officials.

Speaker's doctor said his care, which could include surgery, could cost at least a $250,000. National Jewish was founded over 100 years ago in the days when Colorado's sunshine and clean air attracted TB patients from across the country. It ranks among the best in the nation for research and treatment of the disease.

Surgery to remove pieces of the lung was a more common practice before the advent of sophisticated drugs in the 1960s. But surgery is coming back as a treatment because of the development of strains resistant to those drugs.

Speaker is the first infected person quarantined by the U.S. government since 1963. In the TV interview, Speaker, wearing street clothes, repeatedly apologized to the dozens of airline passengers and crew members now anxiously awaiting the results of their TB tests.

There are guards at the hospital but "there's been no indication that he's a security risk," Huitt said.

Speaker Explains Why He Flew

In an interview with GMA, Speaker said he doesn't expect people to forgive him for flying back-and-forth across the ocean for his wedding when he knew he had the disease.

"I don't expect for people to ever forgive me. I just hope that they understand that I truly never meant to put them in harm," he said, his voice cracking.

Speaker, 31, said he, his doctors and the federal Centers for Disease Control and Prevention all knew he had TB that was resistant to front-line drugs before he flew to Europe for his wedding and honeymoon last month. But he said he was advised at the time by Fulton County, Ga., health authorities that he was not contagious or a danger to anyone.

Officials told him they would prefer he didn't fly, but no one ordered him not to, he said. Speaker said his father, also a lawyer, taped that meeting.

"My father said, 'OK, now are you saying, prefer not to go on the trip because he's a risk to anybody, or are you simply saying that to cover yourself?' And they said, 'We have to tell you that to cover ourself, but he's not a risk,"' Speaker said.

"I never would have put my family at risk, and my daughter at risk. I repeatedly asked my doctors, 'Is my family at risk? Is anybody at risk of this?'" Speaker said.

Speaker was in Europe when he learned tests showed he had, not just TB, but an especially dangerous, extensively drug-resistant strain known as XDR-TB.

"He was told in no uncertain terms not to take a flight back," said Dr. Martin Cetron, director of the CDC's division of global migration and quarantine. Cetron said Wednesday that in conversations between health officials and Speaker before the flight, "they clearly told him not to travel," but "there were no legal orders in place preventing his travel, and no laws were broken."

Speaker, his new wife and her 8-year-old daughter were already in Europe when the CDC contacted him and told him to turn himself in immediately at a clinic there and not take another commercial flight.

He said he felt as if the CDC had suddenly "abandoned him." At that point, he said, he believed if he didn't get to the specialized clinic in Denver, he would die. If doctors in Europe tried to treat him and it went wrong, he said, "it's very real that I could have died there."

Speaker said he and his wife were "scared out of our minds" at the prospect of being indefinitely placed in an Italian hospital and dying there.

"In hindsight, maybe it wasn't the best decision, but I did ask if it was voluntary. And in my mind, I thought that if I went there, if I waited until they showed up, that meant I was going to die," Speaker said, his voice shaking.

"I know people will judge it," he said. "Truly, in our minds, we were told we were not a threat to the people around us and we wanted to get home.

Speaking through a mask, Speaker said he feels awful because he's been so fearful and anxious, and now others are feeling that way because of him. And while he said he doesn't expect forgiveness, he hopes they understand he didn't mean them any harm.

"I just hope they can forgive me."

Some legal scholars said it's possible that instead of forgiveness, airline passengers who flew on the same planes as Speaker will sue him, especially if any of them caught the disease.

Others said he could sue the federal government for quarantining him on the basis of federal regulations they see as unconstitutional. President George W. Bush had to sign an executive order for the quarantine, the first time it had been used since the 1960s.

Flight Raises Security Concerns

Speaker and his wife were on the no-fly list so they flew from Europe to Canada and drove across the U.S. border on May 24 at Champlain, N.Y.

A guard at the U.S.-Canada border who let him pass has been relieved of his duty. Officials have said that Speaker's passport had been flagged and that he was supposed to be stopped.

The unidentified inspector later said the infected man seemed perfectly healthy and that he thought the warning was merely "discretionary," officials briefed on the case told The Associated Press. They spoke on condition of anonymity because the matter is still under investigation.

The inspector ran Speaker's passport through a computer, and a warning -- including instructions to hold the traveler, don a protective mask in dealing with him, and telephone health authorities -- popped up, officials said. About a minute later, Speaker was instead cleared to continue on his journey, according to officials familiar with the records.

Colleen Kelley, president of the union that represents customs and border agents, declined to comment on the specifics of the case, but said "public health issues were not receiving adequate attention and training" within the agency.

CDC Defends Actions

Speaker's new father-in-law, Robert C. Cooksey, is a CDC microbiologist whose specialty is TB and other bacteria. But he said neither he nor his CDC lab was the source of Speaker's TB.

On Friday, CDC director Dr. Julie Gerberding said that Cooksey was "extremely helpful" in tracking down the couple during their honeymoon in Europe by providing cell-phone and other numbers.

She also said Cooksey may have been involved in preparing one of the lab tests that determined what type of TB Speaker had contracted. But she declined to provide more details on Cooksey's involvement in the case, and would not comment on the propriety of his actions, which included flying to Europe himself to be there at his daughter's wedding.

"We're not privy to any conversations that he might have had with his family, so we're not going to comment on that," Gerberding said. But she also said: "The father-in-law's role was limited to what was expected of a father-in-law."

Gerberding defended the CDC's move to quarantine Speaker, and said the agency had been exploring options -- including hiring an air ambulance or a ship -- so that Speaker could return to the U.S. without having to board a commercial airliner.

"That's another thing we'll be focusing on in the future: Can we create a protocol so that if such a thing happens again, we don't have to invent a solution?" she said. She said it is one of several things the CDC hopes to look into over the next few weeks.

"The CDC and many others have learned a lot from this process," she said.

Doctors hope to determine where Speaker contracted the disease, which has been found around the world and exists in pockets in Russia and Asia. The tuberculosis was discovered by accident when Speaker had a chest X-ray in January for a rib injury, doctors said.


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