July 3, 2007 / 7:21 PM / 12 years ago

TB patient does not have most dangerous form

WASHINGTON (Reuters) - The U.S. tuberculosis patient who set off international alarms after fleeing across borders does not have the most dangerous form of TB but instead a strain that is easier to treat, his doctors said on Tuesday.

Andrew Speaker, a 31-year-old attorney, stands next to his bride Sarah Cooksey during their wedding ceremony on the Greek island of Santorini May 18, 2007. The U.S. tuberculosis patient who was legally isolated after fleeing across international borders does not have the most dangerous form of TB but instead a strain that is easier to treat, his doctors said on Tuesday. REUTERS/Stringer

They said Andrew Speaker, a 31-year-old lawyer, has multi-drug-resistant tuberculosis, known as MDR TB — and not a form of the disease known as extensively drug-resistant, or

XDR.

“It allows us to change the way we treat him. We have put surgery on hold for the time being,” Dr. Charles Daley of National Jewish Medical and Research Center in Denver said at a news conference. “We can use drugs not originally available.”

Nonetheless, Daley said Speaker has a serious condition and it is important to track down anyone he may have infected.

“It is fatal,” he said. “MDR TB is very difficult to treat. The cure rate is nowhere near what we would expect with just standard TB therapy.”

Dr. Mitchell Cohen of the U.S. Centers for Disease Control and Prevention said it is not clear why one CDC test indicated Speaker had XDR TB.

He said the sample tested by the CDC was taken using an instrument called a bronchoscope, while the Denver team used a method that forces the patient to cough up sputum from deep in the lungs.

Both Cohen and Daley said it is possible Speaker has or had some XDR bacteria in his lungs but the dominant strain is an MDR strain that can be treated with a class of drugs called fluoroquinolones and perhaps other drugs, too.

Either way, they agreed that isolating Speaker and trying to prevent him from traveling had been appropriate.

“It is better to err on the side of caution,” Cohen said. “It really is mandatory to take the appropriate public health action as soon as you can ... Without question people with these infections should not be flying on commercial airlines.”

RARE ISOLATION ORDER

The CDC intervened to stop Speaker after May 18 when the agency learned he had flown to Greece for his wedding. He was the first person isolated under federal order in 44 years and now is held under a standard Denver Public Health isolation order used for all TB patients at the hospital.

Speaker has said several times that health officials told him he was no threat to anyone else.

The CDC and health authorities in Europe tracked down more than 100 passengers and crew on two flights who sat near Speaker and urged them to get tested for TB. They expect to find at least a dozen people who were already infected before they flew on the same flight with Speaker because TB is so common.

Speaker’s voyage also prompted investigations by Congress into how the CDC and border authorities handled the matter.

Cohen said it likely will take months to clear up Speaker’s infection. “MDR TB remains difficult to treat and will require approximately two years of medication,” he said.

Speaker issued a statement saying the incident had affected his family’s “reputation, ability to make a living and good name.”

“From the international panic that was created after my misdiagnosis and the way my case was handle, I can only hope that this news helps to calm the fears of people who were on the flights with me,” Speaker said in the statement.

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