Man's Journey Sparks Fear, Outrage

It wasn't much of a honeymoon, but Andrew Speaker has mostly himself to blame for that. The 31-year-old personal-injury lawyer from Atlanta wants the world to know he's really sorry for eluding health and security officials and potentially exposing planeloads of people to a deadly disease when he flew to Europe to get married last month—despite being told he was infected with an active, drug-resistant form of tuberculosis. No longer America's top medical fugitive, Speaker, who is now being treated in a Denver hospital, is the first person to be quarantined by the federal government since 1963. He says the stories about him are wrong. "There's a perception that I haphazardly put people at risk. It's not true," he told NEWSWEEK in a long telephone interview from his isolation room. "I'm just truly sorry if I've caused anyone to be scared or worried. I pray to God that everyone will be fine."

Speaker's extraordinary saga—he continued to fly even after the Centers for Disease Control tracked him down in Italy with news that his TB was far worse than originally thought—made him enemy No. 1 in the tabloids and on the Internet. He and his new bride, 25-year-old Sarah Cooksey, say they have received a flood of vicious messages from strangers. "People are now sending me hate mail, like 'I hope you die,' or 'I hope your treatment is painful and as long as possible. You're a terrorist who needs to be eradicated'," he says. "I'm a good person. I've tried to live a good life."

Aside from being an international pariah, Speaker is a very lucky man. If he hadn't visited a doctor for a minor injury, he might not have discovered the disease so early. A chest X-ray revealed a bruised rib, and something else: a "hazy area" on a lung. After tests, he was diagnosed with tuberculosis in April, and the docs sent his samples out for more cultures. TB grows slowly in the lab, and it wasn't until May 10 that he was told he had a particularly bad, multidrug-resistant strain of the disease. By that time, Speaker was already planning to meet his fiancée in Paris. From there, they would continue on to the Greek islands for their wedding, followed by a honeymoon trip around Europe.

Health officials in Georgia couldn't imagine a worse idea. Saliva tests showed he was at low risk for spreading the disease—which is commonly transmitted when carriers cough, sneeze and speak—but the risk increases when people are exposed to an infected person for long periods of time in a closed space, like on an airplane. At a meeting with Speaker, they said, they urgently recommended that he not travel. But Speaker insists that health officials conceded they were just "covering themselves" when they asked him not to fly. Speaker's father, a methodical lawyer, was at the meeting and taped it, though the family has not made the contents public. Speaker's soon-to-be father-in-law, Robert Cooksey, was also in the room. In a strange twist to the tale, Cooksey is a respected scientist at the CDC who specializes in tuberculosis. (In a statement, he said he took no part in advising Speaker about his travel plans, and played no official role in deciding how to handle his case. He also ruled out that he was the source of the infection.)

At the meeting, Speaker says, "no one ever mentioned the words 'quarantine' or 'isolation' ... I wasn't told there was little risk, I was told there was no risk." Speaker says he was convinced he could safely begin his treatment after his European honeymoon. "They've worked everyone into a frenzy that I was some big threat. Do you think that my dad and her dad, sitting in that room—if I had been told I was a risk, do you think they'd let me be around their wives and sisters and children?" This is where Speaker may have been missing the point. Officials say they weren't concerned about his infecting people in open spaces like a shopping mall, or even a restaurant. It was the close quarters of an aircraft cabin for an extended period of time that worried them—and Speaker apparently did not get that.

The Georgia health officials might have gone to a judge to keep him from getting on the plane to Paris, a measure they are authorized to take if they believe someone may pose a health risk. They took the first required step on May 11, when they sent him a bluntly worded letter that once again "strongly" recommended he not go. (At the same time, in the letter, the officials warned that they "cannot be responsible for exposure of this multi-resistant strain to the public.") But Speaker never got the letter. Though he told officials he was planning to leave on May 14, he changed his plans and flew to Europe two days earlier without letting them know.

Unknown to Speaker, who was off to Greece and points beyond, a new round of test cultures was finally in, and it turned out Speaker had the rarest and most potent strain of the disease. "Extensively drug-resistant tuberculosis"—XDR-TB, doctors call it—first showed up in the United States in 1993. Fifty to 70 percent of those who contract it die, compared with less than 5 percent for common TB.

Now the CDC was on the case. Officials got hold of Speaker by phone in Rome on May 23 and told him he needed to check into an Italian hospital until he could get home in a manner that wouldn't put others in danger. That meant no commercial flights. Speaker had planned to get treatment at the National Jewish Medical and Research Center in Denver, which specializes in treating XDR-TB. Now he feared he would die in an Italian hospital. CDC officials insisted last week that they told Speaker they were working on a way to get him home, but that it could take a while. He claims the CDC told him his only option was to hire an expensive private air ambulance. "I said, 'You want me to turn myself in to an Italian hospital until I can raise $140,000?' You knew I was coming here and now you abandon me." Speaker says he and his wife "were frantic. We were scared out of our minds. The options we were faced with seemed ludicrous."

Fearful that Italian officials could arrive at any time, they fled. In fact, the CDC did not send someone to Speaker's hotel until the next day. Scared or not, at that point Speaker knew the U.S. government didn't want him to get on a commercial flight. He decided to do it anyway, even if it meant evading authorities. The couple booked online tickets to Montreal, believing their names might have been placed on the U.S. no-fly list.

Despite the warnings, Speaker made a decision that effectively put his well-being ahead of other passengers'. He insisted he wasn't any more contagious than when he arrived in Europe. But he seemed not to hear what officials were telling him. Something had changed with the new diagnosis: while the risk of passing on the disease was still small, if he did happen to transmit the more virulent XDR-TB to others, it was likely to kill them.

Speaker's Canada gamble worked. In fact, his and Sarah's passports were flagged and their names were added to the no-fly list into the United States; but Canada had not been alerted about the runaway TB patient and his bride. Incredibly, when the couple drove a rented car into the United States, a U.S. Customs agent let them through after a few routine questions. Speaker finally turned himself over to health officials and was eventually flown to Denver.

Last week officials from every government agency involved launched into an epic blame game, and critics wondered how the system would handle a crisis more dangerous than a single sick lawyer. The Customs agent who waved Speaker through was quickly reassigned. Meanwhile, the Centers for Disease Control seemed to finger "local health officials" for not acting to keep Speaker in the United States. "If we had been aware that travel was imminent, we may have been able to act," CDC head Julie Gerberding told reporters. But the CDC's own performance in the case turned out to be less than perfect—and the agency was tight-lipped about its role, refusing to answer many questions about the timeline of events.

Speaker's doctors say his illness was caught early, which improves his chance of survival. It's still a mystery where he got it. He is well traveled, and it's believed he might have picked it up in Asia, where the disease is more common. Speaker says he feels fine and doesn't have a cough or other outward symptoms. But he still has intensive treatments ahead of him, possibly including surgery to remove damaged lung tissue and contain the disease. He can't leave the hospital, and staff watch to make sure he swallows all his pills. Doctors say Speaker could be confined to the hospital for six months or more. Given the scorn that awaits him on the outside, he may want to stay longer than that.

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