Andrew Speaker's TB Saga Detailed in Diane Sawyer Interview

Some answers regarding the puzzling events surrounding Andrew Speaker's transatlantic flights are now coming to light. It is these flights that exposed fellow passengers to Level 2 extensively drug-resistant tuberculosis. Diane Sawyer of ABC's Good Morning America obtained exclusive interviews with Andrew Speaker and his new wife Sarah Cooksey Speaker . An Internet video title "Exclusive: TB Patient Answers Questions" is available on-line at ABC News.

A summary of events in Andrew Speaker's situation follows, with details reported by Diane Sawyer. Andrew Speaker and Sarah Cooksey, who have an eight-year old daughter named Ariel, became engaged in December 2006. In January 2007, Speaker had chest X-rays taken because of an injured rib, Mrs. Speaker said. It was then, a month after their engagement, that Speaker and Ms. Cooksey learned that he has tuberculosis, which was revealed in the X-rays.

The Center for Disease Control and Prevention (CDC) tracks all cases of tuberculosis (TB) in the country and they were duly informed of Speaker's TB. The Fulton County, Georgia, health authorities were also informed. It is the CDC who makes the definitive determination as to the type of strain of TB an individual has.

Speaker stated to Diane Sawyer that he was told that because he was showing no symptoms, such as cough and fever, and his smear tests were negative, he was not infectious He told Sawyer that he was given no cautions about his relations with Sarah Cooksey. She was also not given any cautions regarding her relations with Speaker. Neither were given any cautions regarding their daughter. Speaker continued to work in his law practice and in his charitable activities, and he continued his jogging routine. There were no medical restrictions put on him of any kind, whether in relation to private or public contacts and activities.

According to Speaker, he duly notified his doctor and the Kaiser Permanente Hospital, where he was being treated, that he was engaged to be married. He also informed them that since they had determined that he was not contagious his marriage to Sarah Cooksey would take place in Greece. The CDC and Fulton County knew Speaker would fly to Greece. The Fulton County medical authorities and the CDC were kept fully apprised of all details. They knew well in advance of the event that Speaker would travel to Greece for his wedding ceremony.

At some time before May, a time left unspecified, the CDC determined that Speaker's TB to be Level 1 drug-resistant tuberculosis. This was a determination that we now know was clearly wrong. It is not yet known why or how the CDC came to change that determination and reclassify Speaker's tuberculosis as Level 2 extensively drug-resistant tuberculosis. But it is known when the reclassification occurred. It occurred while Speaker and the new Mrs. Speaker were in Rome on their honeymoon.

Was a new test made on the strain of Speaker's tuberculosis? Was a test re-run? Were test results reexamined? Was there something troublesome that his last medical visit revealed? Does the test to determine Level 2 extensively drug-resistant tuberculosis take five months to run, as Dr. Tim Johnson, the ABC News Medical Editor, seem to suggest? These questions have no answers as yet. One of the ironic twists of the story is that Sarah Cooksey Speaker's father Dr. Cooksey is a microbiologist specializing in Level 2 drug-resistant tuberculosis and has work at the CDC as a tuberculosis expert for more than thirty years.

All we know regarding Dr. Cooksey is that CDC Director Dr. Julie Gerberding said to ABC and NCB that in regard to Speaker's TB Cooksey "acted as a father-in-law" and nothing more. We also know that Dr. Cooksey issued a statement reported by ABC declaring that Speaker did not contract his TB from himself nor from the CDC. On the contrary, Sarah Cooksey Speaker told Diane Sawyer that she suspects Speaker may have contracted it during a trip to Vietnam for the purpose of doing charitable work there. And we know that Cooksey accompanied Speaker to at least some of Speaker's medical appointments, as did Speaker's own father, Ted Speaker, who is also an attorney.

Diane Sawyer reports that the last time Speaker met with his doctors at Kaiser Permanente Hospital prior to departing for Greece was on May 10, 2007. His father was present and tape recorded the discussion. It is reported, but not confirmed, that Dr. Cooksey was also present. Speaker stated to Sawyer that the doctor "preferred" that Speaker not travel to Greece. Mr. Ted Speaker requested clarification by asking if the preference was because Speaker was a risk to others. The reply, which Speaker says was tape-recorded, was that Speaker was not a risk to anybody. He was not believed to be contagious. Dr. Eric Benning of the Fulton County Health and Wellness Department confirmed this statement by agreeing at a general press conference that at the time they did not believe Speaker to be contagious.

As Speaker and Mrs. Speaker made clear to Diane Sawyer, everyone agreed that Speaker's one chance at survival was to be treated at the national Jewish Hospital in Denver. He and his doctors agreed that after his marriage he would immediately go to National Jewish Hospital to commence treatment. Speaker had been told and firmly believed that without the specialized and highly sophisticated treatment available at National Jewish, he would die.

Following this last meeting on May 10, the Fulton County Health Department wrote a letter dated May 11, 2007 with a clear statement of caution against Speaker's traveling. As is reported by NBC Nightly News, the letter said in part: "It is imperative that you are aware that you are traveling against medical advice."

It was delivered so that Speaker would receive it on May 12, 2007. Diane Sawyer reports that Speaker had already departed by air for Greece when the statement was delivered.

After the CDC's reversal on the previous determination of Level 1 drug-resistant TB, Speaker was contacted in Rome, as Dr. Cooksey was informed as to Mr. and Mrs. Speaker's itinerary and whereabouts. It is not known whether Speaker was specifically told about the new determination of Level 2 extensively drug-resistant TB. Explanations from the CDC for the reversal are as yet forthcoming.

Speaker explained to Sawyer that during the phone conversation between Speaker and the CDC, he was told told to go the next day and turn himself into Roman authorities. He was to submit to being quarantined in isolation in Rome for an indeterminate length of time. Both Mr. and Mrs. Speaker stated to Sawyer that no alternative to flying on a public airline was offered as a means to return Mr. Speaker and his family to the United States. On the other hand, Dr. Martin Cetron the CDC said in a general press conference that it had specified that Speaker stay in Rome until some option for transport could be arranged. This is an offer that Speaker flatly denies having received from the CDC. Although he also says he felt frightened at the idea of waiting "for them to show up," as was reported by NBC.

Speaker said to Diane Sawyer in her exclusive for ABC that he directly asked, "Is this voluntary?" The reply is never stated but no charges are brought against him. It must be supposed that turning himself in to be held in isolation for an unspecified time was, indeed, voluntary. Speaker also tells Sawyer that in the same conversation he asked the CDC official, "What's changed?...I was told I wasn't a threat to anyone...What's changed?" It is already known that Mr. and Mrs. Speaker then left Rome and went to Prague, Czechoslovakia from where they flew into Canada. They had been informed that Speaker had now been put on a US no-fly list. It is to be noted that the CDC did not put Speaker on a no-fly list before he left Atlanta to fly to Greece.

It is also known that Speaker arrived in Canada and crossed at the American border. A warning had been issued to detain Speaker, don protective gear, and hold him in isolation. The border guard did not do this, but rather let him cross. As Diane Sawyer reports, he said he let Speaker through to the US because Speaker "didn't look sick." NBC's Robert Bazell further reports that the border guard has subsequently been given other duties pending an investigation.

Andrew Speaker and Sarah Speaker independently stated to Diane Sawyer that the compelling rationale and intention for getting back to the US was that Speaker believed, truly and wholeheartedly, that if he did not get to the National Jewish Hospital he would die--his chance at life would be over. Answers are as yet forthcoming as to why the Speakers passed Colorado and went straight on to Atlanta where they were eventually contacted after he called the CDC. The CDC quarentined Speaker at Grady Memorial Hospital in Atlanta, Georgia. He was later flown to National Jewish Hospital in Denver, Colorado where his in quarantined in isolation at the present time.

Diane Swayer, "Exclusive: TB Patient Answers Questions." ABC Good Morning America. URL: http://abcnews.go.com/GMA/Health/story?id=3238139&CMP=OTC-RSSFeeds0312

Robert Bazell, NBC Nightly News. URL: (http://video.msn.com/v/us/msnbc.htm?f=00&g=c0d26ca8-e0e9-453a-8629-d8ea45078d36&p=hotvideo_m_edpicks&t=c24&rf=http://www.msnbc.msn.com/id/18978573/&fg=)

NBC Nightly News, MSNBC MSN. URL: (http://www.msnbc.msn.com/id/18978573)