Gerberding's recommendations follow an ongoing investigation of US citizen Andrew Speaker who traveled from Italy back into the United States by the way of the Czech Republic and Canada despite being instructed to cancel all his flight plans following a diagnosis of extensively drug-resistant tuberculosis (XDR TB). Speaker also testified at the hearing by phone. The US Department of Health and Human Services (HHS) and the CDC had requested that the US Customs and Border Protection (CBP) detain the patient upon his re-entry into the US, but according to the Department of Homeland Security (DHS), a Border Patrol agent ignored the flag and allowed Speaker to reenter the US. He remains in quarantine under the authority of the Denver County health officials.
Dr. Julie Gerberding, Director of the Centers for Disease Control and Prevention (CDC) and Administrator of the Agency for Toxic Substances and Disease Registry (ATSDR), testified before the US Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies Wednesday in the wake of a tuberculosis scare that US interstate and foreign quarantine regulations needs to be codified to reflect up-to-date disease containment methods such as isolation and quarantine. Gerberding said that "more explicit due process protections for written orders and an administrative review hearing" were necessary, as well as expanding the availability and reporting of ill passengers on aircraft. Gerberding also emphasized the need to tighten health security at ports of entry by increasing information sharing, detection equipment, and medically-trained staff.
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