Thread: US probes how TB traveler crossed border

http://news.yahoo.com/s/ap/20070530/ap_ ... the_border

WASHINGTON - The government is investigating how a globe-trotting tuberculosis patient drove back into the country even after his name was put on a no-fly list provide to border guards. The failure exposed a major gap in a system that is supposed to keep the direst of diseases from crossing borders.

But the communications breakdown at a U.S.-Canada border crossing was only one of a series of missed opportunities to catch the Atlanta man and his wife who seemed determined to elude health officials.

And worried infection specialists say it shows how vulnerable the nation is, from outdated quarantine laws and the speed of international flight, to killer germs carried by travelers. What if, they ask, the now-quarantined man had carried not hard-to-spread tuberculosis but something very contagious like the next super-flu?

"It's regretful that we weren't able to stop that," said Dr. Martin Cetron of the Centers for Disease Control and Prevention, said of how the man fled when U.S. health officials tracked him down in Rome and told him not to get on an airplane.

Should the CDC have asked Italian health authorities to put the man in isolation there? That was under discussion when the CDC learned the man had fled, Cetron said.

"We need to rely on people to do the right thing," Cetron said, saying the CDC hesitates to invoke its quarantine powers. "Can we improve our systems? Absolutely. There will be many lessons learned from this."

The man has a rare but exceptionally dangerous form of TB, a type that international health authorities are desperate to curb because it is untreatable by most medications. The CDC was a step, or more, behind the man on his six-country odyssey. His name didn't get on the no-fly list until he apparently already was en route to Canada, Cetron said.

But the CDC did get word to U.S. Customs and Border Patrol before the man and his wife crossed into the country at Champlain, N.Y., a Department of Homeland Security spokesman told The Associated Press on Wednesday.

Customs "is reviewing the facts involved with the decision to admit the individuals into the country without isolation," said DHS spokesman Russ Knocke.

Both Homeland Security's inspector general and internal affairs officials are investigating, reflecting the seriousness of the case, Knocke said.

Congress is probing, too.

The House Homeland Security Committee has scheduled a June 6 hearing.

Sen. Charles Schumer (news, bio, voting record), D-N.Y., said the case "shows that something is wrong with the training and supervision of our border agents. We put all this time and effort into identifying those who shouldn't enter our country, but what good is it if it can be brushed aside by a border guard? I shudder to think that this individual could have been a terrorist."

Border security isn't the only issue. While the man now is cooperating with CDC investigators, he remains in federally ordered isolation, in a guarded room in an Atlanta hospital. His identity is being withheld to protect his privacy.

But the nation's quarantine laws are so outdated that if the TB traveler challenged that order, "he would probably win in court," warned Lawrence Gostin, a public health law expert at Georgetown University who has advised the CDC's ongoing effort to update those laws.

"There is a hole" in the nation's disease-security system, Gostin added. "The person's instinct to get back to the United States in this case is understandable. But that's exactly what the law's there for, to prevent a person from endangering other people. ... We need to update the entire process."

Adding to the complexity is the tracking down of roughly 80 passengers who were close enough to the man on two trans-Atlantic flights to potentially have been exposed to TB, plus 27 crew members. The CDC has pushed for years for faster access to electronic lists of air passengers to trace their whereabouts in disease emergencies, and hopes to have new regulations to ease that access in place later this year.

Where was he missed?

The saga begins in mid-May, when Fulton County, Ga., health department officials say they told the man he had a drug-resistant form of TB and should not travel. The man contacted his hometown newspaper to contradict that, saying he was never told to cancel his May 12 flight to Paris for his wedding and honeymoon.

The CDC caught up with him by cell phone in Rome a week and a half later, telling him that updated test results showed he had the worst form of TB, called "extensively drug-resistant" or XDR-TB. Cetron said a CDC official told him not to get on an airplane, that U.S. officials were working on how to get him home, but in the meantime he could seek medical care through the U.S. embassy or Italian hospitals.

The man told the Atlanta Journal-Constitution that he interpreted that conversation as being stuck in Italy, and decided to sneak home, flying from Prague to Montreal and then driving to New York, because he feared he would die without treatment in the U.S.

"I thought to myself: You're nuts. I wasn't going to do that. They told me I had been put on the no-fly list and my passport was flagged," the man said.

Still, the man didn't violate any laws and faces no charges, CDC said.

"There's a whole body of public health law that's going to be closely scrutinized and redefined with this case," said Michael Osterholm, an infectious disease expert who advises the government. "It's going to be looking back at what do you do when you have a non-compliant carrier of some infectious agent that is border-hopping?"

Gosh, how could this have happened?

Let's have a probe.

Originally Posted by TheWatchdog

Gosh, how could this have happened?

Let's have a probe.

Here's a guy who was being looked for by just about everybody, yet he just waltzes back into the country unnoticed, just like millions of illegals and who knows what else. Yet the moron in the White House claims he's been securing the borders.

Now I know, this guy cheated. He bought an airline ticket from France to Atlanta, but fooled everybody by flying in to Canada instead. I'm sure that doing something like that would never occur to the terrorists.

Maybe what we need is a $100 billion per year Department of Homeland Security to control our borders. And Comprehensive Immigration Reform with a Guest Worker Program to take the pressure off of our borders so we can look for the bad guys. Yeah, that's what we need all right.

Originally Posted by TheWatchdog

Gosh, how could this have happened?

Let's have a probe.

I emailed my Senators -

President Bush stated the following,

[i] “And my answer to the skeptics is, give us a chance to fix the problems in a comprehensive way that enforces our border and treats people with decency and respect. Give us a chance to fix this problem. Don't try to kill this bill before it gets moving. Give us a chance to make it easier for the folks who wear the uniform along our borders to do our job.â€

Don't worry Boosh is in charge of national security. He won't let another 9/11 happen.

Good Lord! We are all standing here with our pants down and NO ONE can help us.

Are those the same government authorities who are going to check and make sure the lawbreakers do what they suppose to do when they get ammesty? What a joke!!

http://today.reuters.com/news/articlene ... IS-USA.xml

Homeland Security probes TB fugitive case

WASHINGTON (Reuters) - The U.S. Homeland Security Department said on Thursday it was investigating how a newlywed lawyer with a dangerous form of tuberculosis slipped through borders despite orders to detain him.

The patient, 31-year-old Andrew Speaker of Atlanta, arrived at a specialist hospital in Denver for treatment for his infection, known as extensively drug-resistant tuberculosis or

XDR TB.

"There is an investigation into what transpired at the port of entry," Homeland Security Department spokesman Russ Knocke said in a telephone interview.

He said all officers at all ports of entry into the United States had Speaker's name and were told to detain him and contact the local public health department.

"The system worked," Knocke said. "The information was actually sent out to all ports everywhere for all port officers to access on the 22nd of May."

But Speaker slid through on the 24th of May, driving from Montreal to New York. An officer may have mistakenly waved him through, Knocke said. Speaker could also have fooled someone. "Let's not forget that he was pretty deceitful," Knocke said.

Members of Congress said they would investigate how border agents and the U.S. Centers for Disease Control and Prevention handled the case.

"This incident only reinforces my concern about our nation's ability to cope with a major outbreak, whether naturally occurring, as in this case, or intentional," said Sen. Susan Collins, ranking Republican on the Senate Homeland Security and Governmental Affairs Committee.

FATHER-IN-LAW SURPRISE

Speaker's father-in-law, Robert Cooksey, revealed he has worked at the CDC for 32 years in the Division of Tuberculosis.

The twist in the story of a newlywed couple who hopscotched across Europe to Canada ahead of health authorities trying to stop them raised immediate questions about how Speaker became infected.

"I do not have TB, nor have I ever had TB," Cooksey said in a statement. "My son-in-law's TB did not originate from myself or the CDC's labs, which operate under the highest levels of biosecurity."

Speaker was the first patient to be isolated under a federal order in 44 years.

His flight forced the CDC, the World Health Organization and European authorities to track down about 100 people who may have been in close contact with him on trans-Atlantic flights.

Speaker was scheduled to undergo treatment that would include oral and intravenous antibiotics and perhaps surgery.

Dr. Gwen Huitt, an infectious diseases expert at National Jewish Medical and Research Center in Denver who is treating Speaker, said he was diagnosed with tuberculosis by accident, after being X-rayed for a rib injury.

"He has a fairly extensive travel history over the past six years," Huitt told a news conference. "We don't have any idea where he contracted it."

He may need surgery to remove infected tissue and can expect to be on a cocktail of antibiotics for two years, she said. She estimated the total cost at $250,000 to $350,000. Speaker's insurance company said it paid $12,000 to fly him from Atlanta to Denver.