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Stopping TB at the Border: What Went Wrong


An American man infected with a drug-resistant strain of tuberculosis was able to fly to and from Europe, and then drive into the United States over the Canadian border.

The patient, Andrew Speaker, a 31-year-old lawyer from Atlanta, is now in isolation at a Denver treatment center. But in recent weeks, he traveled on airline flights despite being told by the U.S. Centers for Disease Control and Prevention not to fly commercially, and to check himself into a clinic.

European authorities were unable to detain Speaker; border guards near upstate New York didn't stop him from re-entering the United States. As NPR's Dina Temple-Raston tells John Ydstie, Homeland Security officials are looking into the security breach.

Speaker has said that the CDC doctors merely suggested to him that he not fly. But after being told to check himself into a clinic while he was in Italy, Speaker became determined to go to a specialized clinic in Denver instead.

The CDC is authorized to hold people only if they have resisted a quarantine order. At the time the agency contacted Speaker, he had not yet resisted the order.

Speaker was then put on the CDC's medical warning list. But officials in Europe and Canada say they did not receive the update in time to stop him from traveling.

When Speaker entered the United States at Champlain, N.Y., the U.S. border guard saw the medical alert when he checked Speaker's passport. But the guard has said he determined that Speaker did not pose a threat, since he did not look sick.

An internal inquiry is under way; the border guard who allowed Speaker into the country has been put on administrative leave.

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