Medical Fugitive

updated 06/18/2007 AT 01:00 AM EDT

originally published 06/18/2007 AT 01:00 AM EDT

Flying home after a fairy-tale Greek wedding and Italian honeymoon, Andrew Speaker looked like any other healthy young newlywed. Fellow passengers could never have guessed that the marathon runner was a medical fugitive bearing a contagious disease believed to be so dangerous that he was rushed into federal quarantine as soon as he got back to the U.S.A. A few days later, he was confined to a room in Denver's National Jewish hospital, a leading respiratory facility, as a medical prisoner. "Welcome to my world," Speaker says, as a negative air pressure machine designed to contain bacteria clicks and bangs with annoying regularity. From his hospital bed he watches his old yearbook photo flash hourly on CNN. Several pieces of discarded hate mail poke out of the trash basket under the desk. "Andrew Speaker is the devil," one letter reads, advising him to load a gun and "put it in his self-centered mouth and pull the trigger."

Speaker, 31, an Atlanta lawyer diagnosed with tuberculosis in January, brought on the storm after traveling to Europe against medical advice, provoking an international scare and branding him a selfish American who may have exposed hundreds of fellow air travelers to a potentially incurable strain of the disease. The Centers for Disease Control and Prevention (CDC) officials contacted almost all of the 274 passengers aboard Speaker's flight to Europe, including the 26 who sat in the rows surrounding him, and so far not one has tested positive for TB. Still, the Speaker case raises questions about how easily deadly diseases can now cross borders. "It's a wake-up call," says Ian Orme, Ph.D., who studies TB at Colorado State University. "This whole episode illustrates how little we know about these particular organisms. That he's healthy and walking around seems to suggest that the people on the plane with him are probably okay."

Speaker argues that it wasn't until after he arrived in Europe that CDC officials determined that his particular strain of TB was a rare type known as XDR (extensively drug resistant), different from the TB carried by millions of people around the world. (For more on TB, see boxes.) A family member contacted Speaker in Italy and told him to call the CDC in Atlanta. The message: "Italian officials are going to come in the morning and take you to a hospital, and by the way, this thing that you have could kill you," recalls Speaker's new wife, Sarah, 25, adding, "We were crying and terrified." And panicked. When the CDC failed to offer a way home, they cut their honeymoon short and fled to Prague to avoid forced hospitalization in Italy, and then boarded a plane to Canada, rented a car and headed toward New York. At the border, a U.S. immigration agent ignored a warning that flashed when he swiped Speaker's passport, describing him as a medical threat, and waved the couple through. (Immigration authorities are investigating the matter.) He turned himself in May 25 in New York. "In retrospect," says Sarah, "it wasn't a good decision" to flee.

The question of how dangerous a threat Speaker remains to the public is a matter of debate, however. On June 5 hospital officials said three tests failed to detect the presence of the TB bacteria in Speaker's sputum—although a previous test in Georgia found traces—meaning Speaker might not be as infectious as initially believed. So far, Sarah and her 8-year-old daughter Ariel, from a previous relationship, have tested negative; they will be tested again in two months.

Speaker, who, like his father, Ted, is a personal injury lawyer in Atlanta, got a chest X-ray in January after hurting his ribs wrestling. Doctors found a tennis-ball-size lesion of tuberculosis on one lung. No one knows exactly how he got it, though Speaker speculates that he may have picked it up in Vietnam, where he did volunteer work for the Rotary International. Doctors say he might also have gotten it in Peru or Europe, where he has gone backpacking. He took the diagnosis in stride. "I told my family right afterward, and I told my friends shortly thereafter," he says. "I let everyone know I wouldn't be drinking for about six to nine months because of TB medication."

But he did not let the diagnosis interfere with plans to be married in five months. Speaker met his future bride, Sarah Cooksey, now a law student, at a bar in 2005. "I think meeting Sarah [and Ariel] was a life-changing event for him, and he was just committed to spending as much quality time with them as possible," says Ryan Prescott, a lawyer and Speaker's law school classmate. In a bizarre coincidence, Sarah's father, Robert, is a microbiologist specializing in TB at the Centers for Disease Control. He insists that there is no connection between his work and Speaker's contracting the disease, and says he only offered the couple "fatherly advice" about treatment. The CDC, though, is investigating what role, if any, Cooksey had in the health scare set off by his son-in-law.

Speaker proposed to Sarah last December, a few weeks before he was diagnosed. They decided to wed on a romantic Greek island. On May 10, two days before the couple planned to fly to Europe, Speaker and his father met with Fulton County health authorities. "Our patient was advised not to travel," says April Majors, spokeswoman for the Fulton County Dept. of Health and Wellness. The Speakers say that the health authorities drew the line short of actually forbidding him to go. Speaker's father taped the session, and the family says it plans to release the tape to prove that Speaker was not ordered to stay home.

And so the couple flew to Greece, checking into the luxurious five-star Majestic Hotel. They wed on May 18 before 11 family members at a restaurant on the picturesque island of Santorini, with whitewashed cottages and the Aegean Sea in the background. (Controversy erupted here too, when the town mayor said afterward that the couple did not file the proper paperwork. Speaker said he believed the correct forms were filled out.) Following the ceremony, the couple flew to Mykonos and then Athens and, on May 21, to Rome, where a few days later, Speaker spoke with the CDC official.

Andrew and Sarah did not avoid physical contact on their honeymoon. (At the Denver hospital, Sarah wore a protective face mask.) Both wanted to talk about their anger at the CDC. So did Speaker's mother, Cheryl: "I blame the CDC for creating this international panic." Replies CDC rep Glen Nowak: "There was obviously a lot of media attention, but I wouldn't equate that with a panic. The CDC did act aggressively and very visibly to protect the public's health." The Speakers also expressed an understanding of the people who flew to Europe on the same plane as Speaker and now hold him in contempt. "This is a new feeling for us, this fear and terror about TB," says Sarah. "And the fact that other people feel that way, we can't forgive ourselves for that." Still, they insist he did nothing wrong. "If someone had said to us, 'You're going to put people at risk,' we would have canceled [the trip] in a heartbeat," maintains Sarah.

At the moment Speaker, who faces possible surgery and two years of medication, appears more worried about his reputation than his health. "I worked my whole life to get where I was when I left for Europe," he says. "I had a beautiful wife, a beautiful daughter and my practice was going great. I just hope to get my life back where it was."

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