2007 XDR-TB Incident: A Breakdown at the Intersection of Homeland Security and Public Health [open pdf - 577KB]
"In May 2007, Mr. Andrew Speaker, an attorney from Atlanta, Georgia, caused a major health scare in the United States and abroad when he flew to and from Europe while knowingly infected with a drug resistant form of tuberculosis (TB). Though initially diagnosed with multidrug resistant tuberculosis (MDR-TB), Mr. Speaker was subsequently confirmed to be infected with extensively drug resistant tuberculosis (XDR-TB). When public health officials realized he left the U.S. to travel in Europe, they began working with other Federal and state authorities, as well as international bodies, to limit the spread of the disease. Disregarding a directive from the Centers for Disease Control and Prevention (CDC) to seek medical treatment in Italy, Mr. Speaker returned to the U.S. by altering his flight itinerary, flying to Canada, and then driving across the border. Although Mr. Speaker's name appeared on a list of individuals who should be denied entry into the country, Federal agents failed to detain him at the border crossing. Shortly thereafter, Mr. Speaker notified the CDC of his entry into the U.S., and the CDC placed him under involuntary isolation-first in New York City, then Atlanta, and finally Denver. In July 2007, he was released from a hospital in Colorado, whereupon he returned to his home state of Georgia for outpatient treatment. A number of homeland security and public health processes were utilized to manage this incident, many of which failed at different points."
United States House of Representatives, Committee on Homeland Security: http://homeland.house.gov/