Guy with TB travels anyway

I'm sure many of you know about this story. The atlanta lawyer who knew he had drug resistant form of TB, was advised not to travel, and took 7 flights in the US and Europe, including 2 intercontinental flights.



It says nothing about him actually wearing a mask on the flight. I doubt he did, because they probably wouldn't have let him board or enter France, Italy, or Greece.


Here it gets interesting. After he found out he was infected with a very dangerous strain and placed on a no fly list he flew on an intercontinental flight anyway to Canada (thats 6 countries now that he's been in). Again, I doubt he wore a mask.



The other interesting thing is that theres speculation his father in law (who works as a microbiologist for the CDC) was the one who reported him to federal authorities. I don't know about you to to me this guy actions were way beyond careless. Especially since he's an educated, informed person who understood the risks of his condition.

http://www.cnn.com/2007/HEALTH/conditions/05/31/tb.flight/index.html

I have mixed feelings on this one. First I agree that he NEVER should have gotten on the first flight to Europe once the doctors advised him against flying. I know he had this long planned wedding but so goes life. His wedding plans do not give him the right to endanger others.

Now that being said, after he was already in Europe and they tracked him down in Rome and told him they had identified exactly which strain of TB he had and told him not to return to the US and to notify Italian health authorities I would have probably done exactly the same thing and did whatever I had to do to get back to the US. As a US citizen on US soil he has rights under our constitution. As a US citizen on foreign soil with that type of medical condition he would have been completely at the will of the Italian government and medical personnel. And believe what you may about our government, I personally don't think our government would have done anything to try and help him or return him to the US.

Being trapped in a foreign country with no rights is not something I would wish on anyone.

I would be willing to bet that in the end they will discover that he contracted the TB from his father in law.

"...Being trapped in a foreign country with no rights is not
something I would wish on anyone..."

I don't believe anyone drug him screaming and kicking to that foreign country. He should not have flown there in the first place. You go there on your own, you are putting yourself under their laws, like them or not. When in Rome...

I agree which is why I said in the beginning that he never should have gotten on the flight to Europe. However I still would have done whatever I had to do to get back.

Kindasorta makes him a double bad guy...

Why didn't health officials have the authority to quarantine someone with a particularly nasty contagious infectious disease? I don't understand how he was allowed to fly out in the first place?

Actually it's not that we stick together I think it's just a case of we tend to think alike because of the training we go through. I think it's very similar to how most people who have been in the military (my father included) have a tendency to view things from a similar perspective that is somewhat different at times from those who have never served in the military.

Your idea about the embassy and the military base is a great one. My main goal was really more about getting back into US custody and on US soil so the embassy would have worked out great.

Still this guy is a complete moron for ever getting on the first plane to start with. There's no excuse for his actions.

I can understand that rationale, him being frightened and all. But it doesn't say anything about him evading being trapped in a foreign country and forced into a dark prison. I'm not sure what they would have done but he could have at least gone to a US embassy or consulate and proceeded from there. And what about wearing a mask? Just because he was afraid doesn't give him the right to possibly infect hundreds of people (in 4 countries) with a potentially lethal (and virtually lifelong) virus. Again, the whole kicker here is that the guy traveled to so many places (likely without a mask) AFTER he was aware of his illness. I mean, you couldn't ask for a better place to transmit TB than on an 10 hour intercontinental flight. Surely he knew this. I tell you what. If I were a passenger on one of those flights, especially on the last leg to canada, I'd be beyond upset.

I agree with the embassy idea completely. I also think that US helath authorities should have been able to quarantine him from the start and never allow him to leave in the first place (an authority which I'm sure they will have very soon). However being told that you have a disease that is 70% fatal is enough to bring out the survival instinct in anyone.

I find it curious that the US health officials who notified him in Rome did not suggest or offer the opportunity for him to go to the US embassy, they told him to turn himself into the Italian health authorities.

Sometimes the best educated are also the most ignorant!!!

I second that. I have spent over half my life attaining multiple degrees and higher and higher levels of formal education. My father in law never finished high school and has worked his whole life as a large equipment mechanic.

I wish I had half his knowledge and a third of his experience!

It gets even better. When he entered the US from Canada:



http://my.earthlink.net/article/top?guid=20070531/465e4840_3ca6_15526200705311960975527

Wow.

I haven't tried digging that hard, but one important question that I have yet to see answered is whether this guy's TB was actually at an infectious stage? You can be infected with TB but it's dormant and no risk to anyone, you can have an active case of TB but you're not infectious, and you can have active TB which is infectious because it's in your lungs. I have yet to see a medical professional say that he was infectious to the people around him.

Maybe I'm reading too much into the lack of details of this story in the press, but a lot of people may be villifying him assuming that he was infectious but maybe he wasn't. I know that the authorities are trying to find the other passengers to test them, but it's not clear if that is simply a precaution "just in case", or if they legitimately think he might have spread it.

For example, he was flown to a hospital in Denver today that has respiratory specialists. The paper says that, among other things, that he's going there for CT and MRI scans to determine "how infectious he is". Sounds like it's possible that he was not infectious or maybe only slightly infectious while he was cavorting through Europe.

In addition, his CDC microbiologist father-in-law made the comment to the press, "Had I known that my daughter was in any risk, I would not allow her to travel." To my mind, then, it sounds like this guy wasn't infectious when he left for Europe because the father-in-law let his daughter go. Either that, or else the son-in-law didn't tell him the true extent of his condition (not a good way to start a relationship with your father-in-law...)

Anyway, just wondering if the press hasn't totally overblown this story into another modern-day equivalent of Typhoid Mary.

By the way, for anyone interested, Mr. Daniels in Arizona is still in quarantine. He did get another hearing recently, but I guess his argument wasn't convincing because he's still in the prisoner ward. I think he did get some of this things back, though, like his telephone.

Great points and thanks for the update on Mr. Daniels. I remember us talking about him before. I'm glad to hear he got some of his things back at least.

national public radio on tuesday spoke to the head of the cdc.

go here to hear the interview:

http://www.npr.org/templates/story/story.php?storyId=10518734

cdc did try to contact him when they found out the strain - but he was already gone and traveling - most irresponsible, but he knew he was facing 18 months of "cutting edge" medicine - in quarantine - and a high mortality rate.

cdc tried to get him home - and would have flown him home @ their expense - but it was memorial day weekend. we later find out that he was back in the us on may 24, before the big weekend - the director may have been given bad info.

an interesting interview.

there have been almost 50 of similar tb cases. as we haven't heard much about them - maybe this guy has some really bad stuff. why else the hubbub?

what about the civil liberties vs "national security" aspect of this? i think they were exercising great caution before they locked him up.

I agree with you completely. He thinks himself as perfect for being a lawyer. I just want to punch the guy on the face for putting many people at risk with severe version of TB. His TB is immune with 4 antibiotics. It is very severe case of TB that the CDC must surgically remove the left infected lung.

"...Sometimes the best educated are also the most ignorant!!!..."

And sometimes the more arrogant!!!

"...must surgically remove the left infected lung..."

I suspect that some of his traveling companions would be happy to do it with a rusty razorblade...

"...only slightly infectious ..."

Small comfort if you happen to be the one sitting next to him...

From what I can gather, the hubbub is for two reasons: 1) XDR-TB is a great public health threat, and 2) This guy was an idiot for hopping on planes and travelling from place to place.

It seems that his case wasn't considered particularly infectious, as reported by Dr Martin Cetron, director of the CDC's Division of Global Migration and Quarantine, so there's very little chance than anyone else on this honeymoon trip was infected. That's the good news for all those unwitting fellow passengers.

What worried authorities was this guy's blatantly selfish behavior that kept putting more people and more countries in potential jeopordy. Probably you don't hear about most other XDR-TB cases--well, except for Mr Daniels in Arizona--is because these people stay put, get treated, and don't put other people at risk. After doing a bit more reading, it seems that when Andrew Speaker was contacted in Rome that his TB was actually XDR-TB by the CDC, he was told that he could not fly and that he would be banned from flying. That's when he and his wife went on the lam, flying from country to country in a desperate bid to get home before the health authorities could find him. They weren't just "touring Europe" on their honeymoon. They were in escape and evasion mode. I guess that's why he ended up flying to Canada and then trying to sneak across the border by car back into the US to avoid entering through a US airport.

How incredibly selfish of him. I don't know, people say he's a great guy in these news stories, but this makes me question his ethics and character, particularly being a personal injury attorney who should know better.

As far as his fear of not getting the best treatment in Europe goes, this guy has Kaiser Permanente HMO insurance. I say this as a Kaiser member myself, but when it comes to a very expensive, complicated treatment regime like for XDR-TB, seriously, he might've been better off in Italy! OK, half in jest, but half not. Besides, in all likelihood, he would've been transported back to the US for treatment. If he were a penniless illegal alien from Africa who snuck into Italy, that's one thing, but I think an American attorney and the son-in-law of a career CDC scientist has little to fear going to the health authorities in Italy.

Arrogance does seem to have a role in his decision making. He put his wants above the health needs of many/any others. You can make an argument that his travels up until he was notified of the severe TB strain was okay because he wasn't in a contagious stage. . .I wouldn't make that argument. Once the XDR TB strain was identified however, he was obligated to comply with CDC and do whatever he could to minimize the spread of the strain -- he didn't.

That said, whoever told him to turn himself in to the Italian health establishment was an idiot. They should have had the paperwork to take him into custody in Rome and transport his ass back to the U.S. ensuring further spread of the disease was minimized. The interview indicated that option was there; it shouldn't have been an option, it should have been Plan A.

Hopefully, his low risk of being contagious will give us a pass, but as a practice run I'd have to say that patient zero acted very typically and the CDC didn't do enough to contain the problem.

As far as I can figure, he is noncontagious. The joy of being a medical librarian's kid- the summary I've got from my mother, she of the medical intell, is that this a hard strain to catch, and almost as hard to give away if you nonsymptomatic.

That being said, I think he should have turned himself over to the nearest embassy or consulate, or at least to the Italians (look, people can be as jingoistic as they want, but Italy has a decent medical system- what he needs is isolation in a low pressure room and all but the poorest hospitals in the US have those so Rome should have a couple) as soon as he was told which strain he has. My understanding is that he was told he had a possitive for TB but was noncontagious, then they IDed the strain after he left the country but I could be wrong on that one.

What bothers me is his route. I haven't had a chance to look at airline times, but there should have been something that didn't involve him flying into Montreal, that's just screwy.

On the media side, it's interesting. The nationals are all reporting that the boarder agent who passed him has been "reassigned", but he crossed not too far west of where I am and our local news was reporting that the agent is on "administrative leave" or "administrative suspension" pending evaluation. I find that kind of funny, in a sad kind of way.

The other funny thing... At work, we have two TVs that are tuned to the news all the time, one FoxNews, one CNN, just becuase. They were both talking to the what looked like same young lady who had been on the flight to Paris at the same time, and both were running it with the "live" banner. This was about 1pm Eastern. We have the sound down, but I'm pretty sure it was the same girl "live" on both stations, solo on one and with a class mate on the other, but the same hair, build and hideous shirt. "Live". HA!!!

Morally obligated, yes. Legally obligated, not in the least.

In the US, unless a judge has ordered you to receive medical attention, there is no way to force someone to consent to medical treatment. You can't force someone who is bi-polar to take lithium, can't force someone who needs glasses to wear them, can't force someone who is a high heart attack risk to get his blood pressure and cholesterol down. And you can't, as the law stands now (and there are a number of Constitutional issues at play) force someone to go into a quarantine unless a judge decides they are a clear and present danger to the population as a whole.

Don't be surprised if that changes soon. It will be the law of the land for a few years while it percolates upstream in the federal court system.

They weren't in the U.S. Seems to me the CDC could have requested the Italians take him into custody and send him back to the U.S. on that aircraft CDC had as an option. I'm sure the Italians would have been more than happy to cooperate with his deportation.

Instead he was allowed to fly from Rome to Prague to Montreal. Then the Border agent thought the flag on his passport was discretionary. WTF? Whatever.

As I said, something looks screwy with his return trip and I hope they have that border agent is out of a job. People dropped the ball.

As for telling the Italians, I haven't seen anything to indicate that they hadn't, but I can think of good reasons not to. Not the least of which is they didn't know where he was. Going down the list, if it is an official government to government request, things sometimes spiral out of control and lots of people get quarantined; if he voluntarily turns himself in, maybe no one other than his blushing bride joins him.

As for a deportation, that means that the various foreign ministries get involved. Paperwork galore, people who don't need to be quarantined are, it gets political. After you find him, in a country with free internal movement and open borders with it's neighbors. Not as easy as it sounds, even if you can get a track on credit cards.

You're right, easier said than done even if it's legal. Apparently even the Italian Health Ministry couldn't do much without his consent.

I'm just a bit surprised that they didn't offer him the free ride home as a first option rather than trying the turn yourself in to Italy first.

What is your source for this information? Everything I have seen says he is being treated with antibiotics in the Denver hospital. Nothing has indicated his case was so severe that he needed to have a lung removed.

Here's the way I see it. This guy is intelligent enough to know that any TB is contagious, even if he is in the early stages. Prior to finding out it was the worst form of TB, he had already decided deliberately to expose other passengers to the disease, however slight, on his trip to Europe and abroad, without letting any of them know. That, in Tort law, is negligence. When he found out he had the resistant strain, he deliberately concealed that knowledge and successfully attempted to fraud our domestic security, along with again exposing additional passengers to his infection; more negligence. That he is a personal injury claims attorney who knowingly jeopardized the public in general and all those passengers in particular and attempted to conceal the fact makes him extremely culpable.

In addition to paying all costs associated with the investigation, testing, any subsequent treatment of those exposed, sanitization of all facilities he encountered, transportation to Denver, and associated court costs, he should also be permanently disbarred, and tried for criminal negligence, since there is no known cure for his disease (treat it like an HIV positive person exposing others through intimate contact). He should remain in complete isolation, save for properly attired medical staff, which would preclude any further contact with his new wife or family, until he is free of the disease, while continuing to incur liability for treatment costs.

I love how his family portrays him as this really nice, magnanimous person. He is a monster that is so self centered and callous to the needs of others, I would almost characterize his actions as psychopathic.

Well put...

As I said other places, I don't think there is any criminal charges that can be brought and have them stick. Largely becuase at this stage in the game, his wife is about the only person he's likely to have given it to. (If I were her, I'd be asking who else he's been, if y'all will pardon the expression, swapping spit with.)

Civil law on the other hand, as a lawyer, he should know better. He might even wish he was dead before that's all finished, particularly if someone test positive who was on one of those aircraft.

Bingo. He's a selfish guy. Considering he was aware of his condition and completely disregarded the advise of the health officials - I wonder if he could be held criminally liable should anyone contract the disease dn die. Negligent Homicide?

I agree with you Ironraven, I can't think of any criminal statute he has broken at all in this. As far as I can see within the criminal statutes he has not committed any crime.

I also agree with you on part of the civil law side. Unless one of the other passengers actually gets sick and can prove causation and actual damages there is not much they can sue him for, however I think the airlines and government agencies can make a case for reimbursement of their expenses since they have suffered actual damages.

"Mental suffering" is the term of the art, isn't it?

I know it's a low probability of transmision, but I'd be doing a lot of pacing or busy work waiting for the test results if I'd been on those planes.

No one knew before he left if he was contagious or not, but they DID know he had some form of TB in January.

I am wondering if, since he's an attorney, he figured that no one could really do much to him, so he felt free to do as he pleased, right or wrong?

Speaker and his wife are saying that the CDC didn't offer to fly them home from Italy, and it would have cost them $100,000 to pay it themselves. Speaker is an attorney. His father-in-law is "a prominent researcher at the Centers for Disease Control and Prevention" [ABC news] (a microbiologist). And they couldn't dig up a hundred grand? I wonder what the wedding cost?

"He is the first person infected with TB to be put in isolation by order of the U.S. government since 1963." [Sources: ABC News, washingtonpost.com] I am assuming that they've just very recently done this, as he seems to be too stupid and too uncaring to isolate himself.

But the news articles say he's "sorry" if he infected anyone. I've never heard that "sorry" ever kept anyone from getting infected with anything, or prevented anyone's death.

Sue

Yeah, probably not any criminal code with any real teeth in it that can be used on this guy, and civil would also be limited to apparent claims due to handling/investigation/testing costs for now. That could still be up to several hundred thousand dollars, and if anyone claims injury or illness from this event, even if it is only stress related, the costs will escalate.

Criminal negligence would be a stretch, only because intent would be a bit difficult to establish.

I still say his actions are reckless enough to warrant permanent disbarment, and extended isolation from everyone except a few medical staff, and he should continue to foot 100% of the bill for all this extra quarantine procedure. I would also entertain the notion of terminating his father in law's services at CDC, since he obviously knew in advance and failed to notify.

TB is a contagious disease. It doesn't matter whether he was extremely contagious at the time or not. There is always a risk of transmission, it just gets greater as time goes by if left untreated. The bottom line is he had no business travelling anywhere and he knew it.

He's actually probably very fortunate he's in isolation right now. I don't think he'd fare too well in the gen pub if certain individuals on that plane could get close enough to him.

We can all agree this person acted in irresponsible manner once he learned of the severity of his infection. What I have not heard much of is the CDC attempt to tract down the source of his infection. While speculation of his father-in-law’s seemingly suspicious connection with CDC-TB research abounds, there has been little speculation on other sources of the infection.

Based upon the apparent (at least for now) lack of transmission to others, even with persons that he has fairly close contact with, begs the question from whom did he contact this virulent strain of TB? Is there an individual or more then one out there who is unknowingly (or knowingly) spreading this strain of TB and whom else will soon be infected? Just as with other epidemiological studies of bacterial (or viral) infections, various strains have distinct genetic markers that allow tracking. Does the strain he is infected with point to any particular geographical source? The media and we may be so focused on his irresponsibility that the real danger lays in his source of infection and what is or is not being done to tract down that source.

Pete

The most likely theory on where he became infected was on a Rotary Foundation sponsored trip to Vietnam. I forget the exact timing. A year ago? XDR-TB is not uncommon in pockets of Asia. In addition, he also spent time touring a hospital there, in enclosed spaces, which would seem to be the likeliest opportunity for him to contract TB while in Vietnam. At least as of a few days ago, Mr. Speaker could not remember the name of the hospital so someone needs to look up their itinerary to track down the name of the hospital, so I don't know where that lead stands. Even if this was the source, though, it's likely that the actual person who infected him may be long gone from the hospital.

Sorry to dredge up an old thread, but it seems appropriate to keep this all together.

I was just reading yesterday that Andrew Speaker will be served with a $1.3 million lawsuit shortly by 9 of his fellow airplane passengers (actually, 8 passengers and the brother of one of them). Although none of the eight have tested positive, they're suing for all the worry and anxiety he caused them. Since Mr. Speaker is a personal injury attorney, I'm sure he has a good idea what's coming down the road.

I don't bring this up just to beat up on this guy. I just think it's useful to hear some follow-up after some sensational news story and the repercussions that people face when they make certain decisions, whether it's getting on a plane with TB, getting lost in the wilderness and triggering a massive SAR operation, etc. If nothing else, it's quite common that so-called "facts" turn out to be wrong later on. Case in point...

A month or two ago, the CDC announced that Speaker doesn't actually have the most dreaded form of TB--the extensively drug-resistant (XDR) kind--but a strain that is resistant to some drugs but still susceptible to others. It baffles me how the CDC could have gotten that wrong. But when the CDC tested some of the samples taken from him when he first arrived at National Jewish Medical Center, they discovered the discrepancy. I guess some could argue that the CDC subjected Speaker to some mental anguish by telling him he had the worst possible kind of TB.

Identifying bugs isn't real easy to do. As I recall, it takes about a month to even culture tuberculosis. Then you'd have to stain it, maybe use some molecular markers or other quick method of checking the surface of the bacteria.If I had to hazard a guess, I'd assume his local County Health Agency did some sort of screening of his TB initially, hence the presumptive diagnosis of a multi-drug resistant strain.

From there, the CDC probably got involved and did a full blown ID of the strain of TB. DNA analysis and such, which again, can't be done in an hour.

Couple of comments on this one chaps and my apologies if what I say seems a bit obnoxious.
1) I notice that the first reaction of the U.S.Goverment was to disown one of their citizen's by preventing him from reentering the U.S.
2) There seems to be an assumption that someone with a fatal untreatable disease, who is being treated as a pharah, is going to care what happens to to the people around him. Common decency aside that is. Which could be arguably lacking in the standard of conduct exhibited towards the gentleman concerned. Being hounded does not exactly engender a feeling of helpfulness and co-operation.
3) If he had been quarantined by the Italian's he would have been humanely treated.
4) One of the major reason's why detaining people is so difficult in these cases is because such powers have been abused in the past. Being able to confine someone incommunicado on medical grounds is the sort of powers much beloved of Dictators. So such powers have to be exercised with great caution and be subject to serious independant judicial oversight.
5) Were the matter not so serious, I for one would applaud a man who goes to his bride. Come hell or high water.

Having said all that I have to say that if I had a fatal transmittable disease there is no way in hell that I would let anyone I love anywhere near me.

And that last statement of yours is quite to the point, isn't it? I would say that your delineation of what is right and decent and the proper thing to do in such a case would tend to preclude treating this fellow as a proper gentlemen, which no one could objectively accuse him of being now.

Courtesy I believe is a two way endeavor. Common decency would be warranted if such a person could demonstrate they are disposed towards their fellow traveller in like fashion. It was obvious from the start that this man neither had such a compassionate concern for anyone he encountered, let alone his own family, and so none was afforded him, as it should be.

Honor and respect are not things deserved or demanded, but earned. This person did nothing that would indicate he is worthy of receiving any such benefit, and persists in the same. Were the matter not so serious, then none of this would be an issue, and he would be home now enjoying the company of his new spouse, instead of facing imminent litigation.

Being a US Citizen doesn't mean much when you put the general public in danger for purely selfish reasons. Our jails are filling with citizens that we would gladly disown, and would be all to happy to send elsewhere if they are not happy with the way things are going for them here. I'd say the first reaction of the US Government was to tell this guy not to go anywhere in case things worsened so that maybe they could keep this thing under control and prevent or minimize the risk to himself and others, which he happily ignored. Not surprising how subsequent recommendations/actions would go.

I've seen Italian justice with foreigners before. I don't give them the same sort of credit you would. Then again, this guy does have a lot of cash, so they may have been kinder to him than they were to the kids in the hostels a few years back.

I agree that detention is an often abused process, which is all the more reason why travellers need to exercise better judgement lest they give cause for those in power to justify such abuses.

In reviewing the record, it appears that our TB infected traveller had no intention of caring what happened to anyone around him long before those who could sought to start controlling his actions. In fact, it was his wanton disregard that instigated such an attitude amongst the authorities and the public in general. One shouldn't expect any measure of sympathy after having already trampled on the welfare of others.

I found none of your comments obnoxious in the least, but quite stimulating for debate. Carry on mate.

In fairness to the Italians: Any foreign national is in Italy upon the sufferance of the Italian People. They get seriously annoyed when people enter their society, abuse the privilege and then scream "I'm a -------- Citizen, how dare you!" The Polizi play hardball with perps. Its a very effective way of keeping the crime rate down.

I feel the need to reply, basing my answers on the article.
1) They didn't turn their backs on him. They told him to get on a plane and get his butt back to the US. He didn't. In fact, one of the articles mentions that the CDC (IIRC), was sending a plane for him.
2)TB is not a "fatal untreatable disease." Heck, most stuff is treatable, and still fatal: HIV, many cancers, Cruzfeld-Jakobs Disease, etc. Besides, why should being sick automatically allow someone to become narcissistic and not care about anyone else?
3) Unless you've been quarantined by Italians, what are you basing this assertion on?
4) Totally agree.
5) Agree to an extent. Could also be called "stalking."

I don't blame them one little bit. When in Rome obey the Roman laws, or suffer Roman justice. If you spray paint someones car, and the local penalty is getting a whipping, drop your drawers and bend over. Or, as the old saying goes, if you can't do the time, don't do the crime...

So, Andrew Speaker was sent home today. After finding out that his extensively drug resistant TB was actually the somewhat less dire multidrug resistant kind, they eventually decided to still go ahead and remove the infected portion of his lung. They probably could've cured his MDR TB with antiobiotics, but it would take years of daily doses and might still fail after all that. So surgery sounds like a much swifter, more definitive treatment.

He was sent home by air ambulance. Doctors do not consider him contagious anymore and they would have let him fly a commerical flight home, but after what happened before, they thought it was better to send him home this way. He will still continue antibiotics for a couple years.

Oh, in other related news, remember Mr. Daniels from Arizona? The TB patient in the prisoner ward? He was transferred to the same hosptial where Andrew Speaker was, National Jewish Medical Center in Denver, a number of weeks back. The details were sketchy in the short news clip I read, but sounds like his condition is getting worse. I forget, but I believe he has XDR TB.

So, I guess that pretty much closes the book on Andrew Speaker's saga. Sure, he still faces lawsuits, but at least as far as his TB is concerned. From international manhunt to hospital discharge took maybe four months. Not bad. Maybe he should've taken a long honeymoon in Italy, eh?