Report: Man has less severe form of TB
Officials at National Jewish Medical and Research Center said multiple tests done there indicate Andrew Speaker's TB will respond to some of the antibiotics that a lab at the Centers for Disease Control and Prevention said would be ineffective. They have changed the drugs being used to treat him and have tabled plans for surgery to remove diseased lung tissue.
Mitchell Cohen, director of the CDC's Coordinating Center for Infectious Diseases, says it is not clear why the CDC test indicated the more drug-resistant form, but the public health response would not have differed.
"Without question, people with these infections should not be flying on commercial airlines," he said. MDR-TB is "a serious illness that can be transmitted to others," he said, and travel restrictions under World Health Organization guidelines are the same for MDR-TB as for XDR-TB.
Speaker, 31, became the focus of world attention after it became known that he flew to Europe in May for his wedding, knowing he had MDR-TB, a rare form of the disease that is resistant to at least the two of the most potent anti-TB drugs. While he was away, results of lab tests at the CDC indicated he had the even rarer form, XDR-TB, which is resistant not only to the first-line drugs, but also to most of the other available drug options.
Despite admonitions by CDC officials who told him to remain where he was — in Rome on his honeymoon — Speaker and his wife traveled to the Czech Republic, flew to Montreal, and drove back into the US in a rental car. The CDC and health ministries in several other countries have begun testing Speaker's fellow airline passengers to see if they became infected during either of the trans-Atlantic flights.
In a statement read at a press briefing, Speaker expressed relief that "I do not have, nor have I ever had XDR-TB." He repeated his contention that he was not prohibited from traveling to Europe, suggesting the international furor created was an overreaction. "The truth is my condition is the same as in early May when I was told I could carry on my life and that I was not a threat to anyone," he said.
Speaker was moved last month from Atlanta to the Denver hospital, which is considered the top TB treatment center in the U.S. Charles Daley, head of infectious diseases at National Jewish, said three tests conducted on three sputum samples produced the same results, indicating a broader range of treatment choices for Speaker, and also suggesting that if any fellow airplane travelers became infected, there are more options for preventive therapy.
However, Cohen noted, MDR-TB is still very difficult to treat and Speaker may need to take drugs for two years or more before he can be cured. Of the 14,000 cases of TB in the USA each year, Cohen said, only about 125 are MDR-TB.
Cohen said when properly treated, regular, drug-susceptible TB, is curable about 95%-97% of the time. With MDR-TB, it's about 70%, though Speaker's chances are much higher, Daley said, because he is otherwise healthy and getting the best treatment available. XDR-TB is very rare, but so far only 30%-40% of cases have been cured.
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