TB Patient’s Infection Less Serious Than First Thought

Physicians and laboratory scientists at the National Jewish Medical and Research Center in Denver on Tuesday announced that attorney Andrew Speaker is infected with a less-severe form of tuberculosis than was believed in May, when CDC unsuccessfully attempted to prevent him from returning to the U.S. from Europe, the New York Times reports (Altman, New York Times, 7/4).

Repeated tests at NJMRC, where Speaker is being kept in isolation, show that his infection is "multidrug resistant" rather than "extensively drug resistant," as was announced after Speaker flew to Europe for his wedding and honeymoon.

Mitchell Cohen of CDC said that the less-severe diagnosis would not have changed the agency's urgent response to Speaker's travels. "The public health action taken in his case was sound and appropriate," Cohen said.

Richard Chaisson, an expert in drug-resistant TB at the Johns Hopkins Bloomberg School of Public Health, said, "This is not a black eye for the CDC. It is embarrassing and difficult to explain, but that is because it is complicated. It is not a sign of incompetence or bad practice" (Brown, Washington Post, 7/4).

Trust for America's Health Director Jeff Levi said that the downgraded diagnosis might affect CDC's credibility, saying, "The next time CDC sounds the alarm and we need the public to respond, the concern is that they will be questioned" (Young/Schneider, Atlanta Journal-Constitution, 7/4).

Infectious disease experts not involved in the Speaker case on Wednesday in interviews said they "generally supported actions" taken by CDC, the Times reports.

Frank Plummer, chief science advisor for the Public Health Agency of Canada, said that CDC needed to act quickly after its test indicated that Speaker was infected with XDR-TB. "It's a call you make at the time, doing what you have to do with what you have on hand," Plummer said. Plummer added that his agency would have handled the situation in a similar manner.

Kent Sepkowitz, director of infection control at Memorial Sloan-Kettering Cancer Center, said that CDC could have faced even more criticism if the situation had turned out differently. "Everyone is a genius in retrospect," Sepkowitz said (Altman, New York Times, 7/5).