TB patient's third phlegm test negative

Doctors approve brief trips from hospital isolation

Bill Scanlon, Rocky Mountain News

Published June 6, 2007 at midnight

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Tuberculosis patient Andrew Speaker got another bit of good news Tuesday when National Jewish Medical and Research Center doctors announced a third consecutive phlegm test found his cough not very contagious.

That means he'll be able to leave his isolation room as early as a week from now for brief periods with an escort and wearing a mask. However, he will not be allowed to leave the hospital grounds in east Denver.

The three negative results came from smear tests, in which phlegm was put under a microscope for evidence of TB bacteria.

There's a relatively low possibility that Speaker could spread the disease by sneezing or coughing, but there's still a chance, said Dr. Charles Daley, his attending physician at National Jewish.

"No one who was in contact with him or any other patient with tuberculosis is out of the woods," Daley said at a news conference.

Now doctors will tweak their regimen of unusual drugs, giving him 12 pills a day, hoping to get the right combination to knock out his drug-resistant TB, which can't be killed by the first line of drugs, or even the second line.

"It's a total guess what the drugs will do" - make him better, do nothing or make his TB even more resistant to drugs, Daley said.

The goal is to get two negative cultures from Speaker, Daley said. That involves taking his phlegm, putting it in various media that spur growth, and seeing whether the drugs have turned the TB inactive.

There's no real sense in testing the cultures for six to eight weeks because it will take that long for an X-ray or another test to show whether the drugs have done their job.

Meantime, doctors will decide as early as this week whether Speaker is a good candidate for surgery.

Typically, TB specialists like to wait until a patient has a negative culture before doing surgery to remove the most concentrated mass in the lung.

But with Speaker, they might not have the luxury to wait, because they're not sure what the drugs are doing, Daley said.

Speaker's TB mass is the size of a tennis ball and in only one node of the lung, rather small compared to other cases, Daley said. The mass can be removed, making it easier for the drugs to rid the rest of the body of TB.

Speaker made worldwide news when it was revealed that he flew to Europe and back last month for his wedding and honeymoon while infected with XDR TB. Speaker has said no health official told him outright not to travel, but merely suggested against it.

The World Health Organization is trying to round up the passengers on those airplane trips. It takes eight weeks for an exposure to TB to show up on a skin test, Daley said. So all those passengers will have to be tested again in July.

Developments

• Senate hearing: A "furious" Sen. Tom Harkin is planning to ask tough questions today about how Speaker was able to travel abroad. Julie Gerberding, director of the Atlanta-based Centers for Disease Control and Prevention, and Fulton County, Ga., health director Steven Katkowsky are to testify before the Senate Appropriations subcommittee that oversees funding for the CDC.

• House hearing: Gerberding's chief aide on global migration and quarantine issues, Martin Cetron, is scheduled to testify before the House Committee on Homeland Security.

scanlon@RockyMountainNews.com or 303-442-8729 The Associated Press contributed to this report.

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