U.S. health and government officials are pledging to tighten procedures in the wake of an incident in which a man infected with a drug-resistant form of tuberculosis was able to travel out of the United States and return, evading health protection measures at the border. VOA's Dan Robinson reports from Capitol Hill, where the man, Andrew Speaker, challenged testimony by officials.

Speaker is in medical quarantine in a U.S. hospital, but the controversy sparked by his travels has re-focused the attention of Congress and government on gaps in the nation's border security system. Although he had been told he had TB, he was able to leave the United States, fly to Italy for his wedding ceremony before health authorities were able to notify him about the full seriousness of his disease.

After further tests confirmed he had what is called a multi-drug-resistant form of TB, U.S. officials contacted him in Rome asking him to report to local health officials there, but did not directly contact Italian authorities. Instead, Speaker and his wife flew on commercial flights to the Czech Republic, then to Montreal, and crossed back into the U.S. after a land border patrol officer waved him through, despite having seen a computer alert to detain and isolate him, and contact health authorities.

CDC Director Julie Gerberding, (l), testifies before Senate subcommittee hearing on threat posed by a patient with drug-resistant TB on Capitol Hill,  6 Jun 2007

Julie Gerberding, director of the Center for Disease Control and Prevention (CDC) in Atlanta, said a thorough review is under way.

However, she and others maintain that Speaker was "uncooperative" and that they were unaware he was planning to travel.

"We made decisions based on the theory that the patient would cooperate," she said. "That was in retrospect a wrong matrix [basis] for making decisions in this case, and if we had to do it all over again knowing what we know now, we would have acted much earlier."

But testifying by telephone from Denver, where he is in medical quarantine, an angry Andrew Speaker took issue with that assertion, saying both local and CDC officials told him he was "not contagious" or a threat, and knew he was planning to travel:

"Everyone knew what I was going, I didn't go running off or hide from people," he said. "It is a complete fallacy and it is a lie."

Speaker said U.S. officials told him they did not have the resources to fly him back to the United States. Lawmakers have criticized CDC officials for not dispatching an aircraft to transport him back to the U.S.

Steven Katkowsky, a local health officer in Atlanta, Georgia, said Speaker was told in a meeting that he was not "highly contagious" and before authorities were able to determine further steps, accelerated his travel plans.

"What we found out was Mr. Speaker moved up his travel date, was not available, could not be reached, and the whole question of whether or not we could have compliance at that point, and was it safe for him to travel, could not even be addressed, because at that time he was out of the country," he said.

Senator Tom Harkin, chairing the Senate committee, expressed concern that current procedures may be insufficient to prevent a repetition of such incidents.

"We want procedures and processes in place, plans done ahead, so that instances like this can be handled expeditiously in the best interests of both the patient, the individual, but also the public at large and that is where this thing just fell apart," he said.

Later, Ralph Basham, commissioner for Customs and Border Protection, told the House Homeland Security Committee most of the fault is with the border officer who allowed Speaker to re-enter the United States from Canada.

"CBP had an opportunity to detain Mr. Speaker at the border, and we missed," he said. "That missed opportunity is inexcusable, and it appears at this stage to be largely a result of a CDP officer failing to follow his procedures and instructions."

"Last week, we dodged a bullet," said Congressman Bennie Thompson, who chairs the panel. "We should have connected more dots."

Jeffrey Runge, chief medical officer for the Department of Homeland Security says that despite best efforts, U.S. borders remain vulnerable to infectious diseases.

"Short of draconian and economically damaging health screening techniques being routinely implemented at each port of entry for the millions of people crossing the border, there will always be opportunities for people who are ill to cross our borders undetected," he said.

But Congresswoman Jane Harman says there was potential for disaster in the incident.

"Had it been smallpox, or had it been something else, we could have right this minute a major national emergency both in health terms and economic terms," she said.

A statement from the Denver medical center where Speaker has been quarantined, said laboratory tests so far have been negative, a sign that the chances he could have spread the disease are very low.