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AP Enterprise: Government e-mails show CDC received little help from TB patient’s family

    ATLANTA — Health officials trying to stop a globetrotting honeymooner with a dangerous form of tuberculosis got little assistance from his lawyer father and his future father-in-law, a TB expert who not only balked at stopping the Greek wedding but went to the ceremony himself, according to e-mails obtained by The Associated Press.
    Some of the 181 pages of e-mails, obtained through a public records request, suggest that the 31-year-old Andrew Speaker’s father was clipped and combative in phone conversations with health officials.
    E-mails from Fulton County officials portray his father-in-law, CDC microbiologist Robert Cooksey, as initially unhelpful, at least before May 22, when tests showed that Speaker had a more dangerous form of TB than previously understood.
    ‘‘This is terrible news. I hope the father-in-law will be more forthcoming now,’’ reads a May 22 e-mail written by Beverly DeVoe-Payton, director of the Georgia Division of Public Health’s tuberculosis program, to other state health officials regarding the new test results.
    But CDC spokesman Tom Skinner said Tuesday that Cooksey had already begun to cooperate and provided the agency with Speaker’s phone number in Europe.
    Speaker, an Atlanta lawyer, sparked an international scare when health officials tried to find — and isolate — him because he was infected with an exceptionally dangerous form of TB that is highly resistant to drugs.
    He knew he had TB and that it was resistant to some drugs when he left Atlanta, but he did not find out until he was in Europe that it was the highly dangerous form.
    In his conversations with health officials, Speaker ‘‘placed a lot of emphasis on contagiousness. He asked questions in a way so he could hear what he needed to hear to justify his leaving,’’ Skinner said.
    When federal health officials eventually reached him by phone in Europe with the new test results, they warned him not to fly aboard commercial aircraft, and urged him to turn himself in to local health officials.
    Instead, Speaker and his bride flew to Montreal, rented a car and drove across the U.S. border, even though officials had flagged his passport. He is now in a Denver hospital.
    Dr. Andrew Vernon, a Centers for Disease Control and Prevention TB researcher who sees patients at the Fulton County Department of Health and Wellness, had earlier appealed to Cooksey to help stop the planned wedding in Greece, according to a May 30 e-mail from a Fulton County physician. Cooksey did not put a halt to the plans; instead, he went to the wedding.
    Calls to Cooksey’s office and home were not immediately returned Tuesday.
    CDC officials are reviewing Cooksey’s conduct as part of an internal review of the case. Dr. Julie Gerberding, head of the CDC, has said that Cooksey did help health officials contact Speaker and his new wife in Italy.
    Speaker’s father, Ted Speaker, did not immediately return a message seeking comment left at his law firm. He did not provide needed information either, according to e-mails from state and Fulton County health officials.
    In one e-mail, Dr. David Kim of the CDC summarized a May 22 phone conversation with Ted Speaker this way:
    ‘‘’I need your assistance to reach out to (Andrew) to get him back to U.S. quickly and safely,’’’ Kim said he told the elder Speaker.
    ‘‘’I can’t do that. I don’t know where he is ... I appreciate your call.’ End of call,’’ Kim wrote, summarizing Speaker’s response.
    Kim, the CDC’s lead investigator on the case, learned of Cooksey’s relationship to Andrew Speaker around May 19, Skinner said.
    Skinner did not disclose who told Kim, saying the detail is not being released because it’s a focus of a separate review of Cooksey’s conduct by the inspector general of the Department of Health and Human Services.
    Kim contacted Cooksey, and Cooksey called Andrew Speaker in Italy and provided Kim with Speaker’s telephone numbers. ‘‘He was instrumental in helping us reach the patient in Europe,’’ Skinner said of Cooksey.
    Andrew Speaker told a congressional hearing by phone last week that health officials had told him he wasn’t contagious on May 10, a few days before he left Atlanta for the wedding, a meeting he said his father had taped. He has also apologized for the scare, which put dozens of other airline passengers who sat near him through the need for TB testing.
    Health officials have said Speaker was ‘‘not highly contagious.’’ But they noted that because he had stopped taking medications, his condition could have changed quickly, possibly making him more contagious.
    Right after the May 10 meeting with Speaker, his fiancee, and their fathers, county health officials began researching legal measures to stop the trip to Europe, according to information released Tuesday.
    On May 13, Dr. Eric Benning of the Fulton County Health Department got a call from Speaker, who said he had already flown to Greece — a day earlier than planned.
    He promised to call back May 14 with contact information. But Speaker did not check in until May 20, when he sent Benning an e-mail that said: ‘‘We have tried to use the cell phone and things just don’t seem to work.’’
    Speaker also sent a photo from the wedding, held May 18 on the Greek island of Santorini.
    When Kim finally reached Speaker in Italy, Speaker said he was planning to return to the United States on June 5. County officials then began researching ways to meet him at the airport with a court order for emergency confinement.
    But the couple left Italy on May 24 to travel through Prague and then Montreal to sneak back into the United States.
    The couple rented a car, drove into New York and Speaker turned himself in. He was under a federal isolation order — the first since 1963 — and was transported to Atlanta on May 28.
    He was placed under guard at Atlanta’s Grady Memorial Hospital, and the sheriff’s guards assigned to him were ‘‘very worried,’’ according to a May 30 e-mail from a Grady official.
    ‘‘They are even asking for hazmat suits,’’ the official wrote.
    Speaker was feeling well enough Tuesday to do some legal work for Atlanta clients, said William Allstetter, a spokesman for National Jewish Medical and Research Center. Allstetter said doctors had not determined whether he would undergo surgery to remove the infection.
    U.S. health officials say it’s unlikely they will be able to trace the origin of Speaker’s tuberculosis in part because many types of the disease-causing bacteria have not been genetically analyzed, said Patrick Moonan, a CDC epidemiologist involved in the testing of Speaker’s TB.
    About 84 percent of the TB types circulating in the United States have been genetically identified. But that percentage is much lower in many other countries — including Peru, Vietnam and Cambodia, where Speaker said he previously visited, Moonan said.

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