Diseased-traveler threat not eliminated, federal report warns

By Craig Schneider

Some 18 months after authorities repeatedly failed to stop the international travel of an Atlanta man with drug-resistant tuberculosis, problems still exist that could allow an infected person to slip through security, according to a federal report released today.

Atlanta attorney Andrew Speaker spurred an international health scare as he evaded no-fly lists and border control checkpoints aimed at stopping him.

The incident in May 2007 raised questions about why officials hadn’t stopped Speaker from traveling to Greece for his wedding, and why they did not stop him from fleeing Italy back to the United States.

The 59-page report by the federal Government Accountability Office faults the U.S. Department of Homeland Security and the Atlanta-based Centers for Disease Control and Prevention, as well as its parent agency, the U.S. Department of Health and Human Services. The Atlanta Journal-Constitution received an advance copy of the report. It cited inadequate lines of communication among federal agencies that enforce public health laws, as well as flawed practices and delays in action.

U.S. Sen. Joseph Lieberman (I-Conn.), whose congressional committee requested the report, said better communication between federal agencies is needed to prevent outbreaks of disease and potential terrorist attacks and improve response to natural disasters.

“Our border security and aviation controls must be stronger if we are to prevent repeats of these types of border breaches,” Lieberman said.

While the report credits the federal agencies with improving their policies and procedures since the Speaker incident, it criticized them for not passing on enough information to state and local health officials regarding these new tools. Such education is especially important since state and local officials are usually the first to become aware of TB cases, the report said.

“Unless state and local health officials are informed and educated about the new tools and procedures, delays in accessing federal assistance, like those encountered … could persist,” the report said.

In addition, the agencies should explore implementing more thorough background checks and better public health alerts at the U.S. border, the report said.

The lack of that, the report said, “may result in missed opportunities to locate persons subject to public health alerts.”

At one point, a border inspector ignored an electronic alert and allowed Speaker to enter the country from Canada.

The agencies reviewed the findings, and their responses were included in the report. Many improvements were noted. For instance, the names of people identified as public health threats are placed on a new “Do Not Board” list sent to airlines. Border officials also have revised their public-alerts system to prevent officers from overriding them.

“There’s no doubt there are many lessons to be learned from that incident,” said CDC spokesman Tom Skinner. “We’re more prepared today.”

Speaker was eventually quarantined and received medical treatment at a Denver specialty hospital. Tests at the Denver center showed he did not have the Extensively Drug Resistant (XDR) form of TB, but a more treatable form of drug-resistant TB.

Tests of more than 250 airline passengers showed that none had caught TB from Speaker.