Posted on October 18, 2007

Man Crisscrossed Border with TB

Sara A. Carter and Audrey Hudson, Washington Times, October 18, 2007

A Mexican national infected with a highly contagious form of tuberculosis crossed the U.S. border 76 times and took multiple domestic flights in the past year, according to Customs and Border Protection interviews and documents obtained by The Washington Times.

The Customs and Border Protection (CBP) agency was warned by health officials on April 16 that the frequent traveler was infected, but it took Homeland Security officials more than six weeks to issue a May 31 alert to warn its own border inspectors, according to Homeland Security sources who spoke on the condition of anonymity for fear of retribution. Homeland Security took a further week to tell its own Transportation Security Agency.

Multi-drug-resistant tuberculosis (MDR-TB) is a highly contagious illness and also resistant to the two most commonly used drugs to treat TB. It is the same dangerous strain of tuberculosis that concerned health officials when Andrew Speaker, a 31-year-old Atlanta lawyer, slipped into the U.S. from Europe via a flight to Canada. The story set off alarms that the system had failed to identify the contagious passenger, which led to congressional hearings in June.

A physician with the Centers for Disease Control and Prevention (CDC) said that his agency usually only notifies airlines of possibly infected passengers if the flight is eight hours or longer. But other doctors say the disease can be transmitted within minutes—especially in people with lowered immunity—and recommend that anyone coming in contact with this form of TB seek medical attention.

World Health Organization guidelines, which were rewritten in 2006 and adopted by the CDC, state that “physicians should inform all MDR-TB patients that they must not travel by air—under any circumstances or on a flight of any duration until they are proven” not to have the disease.

“You can argue that even one single cough would transmit TB, which is, in fact, what is probably happening,” said Dr. Mario Raviglione, director of the WHO’s Stop TB department, in a conference call with reporters in June. “It was seen that at least eight hours were required for someone to infect someone else. It does not mean that you cannot get infected in the first one minute, but it means statistically speaking that it’s much less likely to get infected until your hours of contact increase.”

Christopher White, Transportation Security Administration spokesman, said TSA was notified on the morning of June 7 by Homeland Security officials “that a person infected with MDR-TB may be attempting to use the U.S. transportation system.”

“TSA leadership quickly convened, and the individual was added to our no-board list” in a matter of four hours, Mr. White said.

In that time, the infected man, identified as Amado Isidro Armendariz Amaya, made at least one more trip across the U.S. border, on May 21, where he applied for an I-94 visa to extend his stay in the U.S.

Roger Maier, spokesman with El Paso CBP says the delay for issuing a “be on the lookout” (BOLO) alert to stop the man at the border was caused by the traveler’s use of an alias.


Other documents reveal that the Mexican government had known for more than five years of the condition of Mr. Armendariz, a businessman from Juarez, a city in the Mexican state of Chihuahua across the Rio Grande from El Paso, Texas. The officials who spoke on that condition of anonymity said, “Information sharing is still at an all-time low, if not nonexistent, in issues such as these.”


Homeland Security employees were told in June that they would be fired if the situation with Mr. Armendariz went public. At the same time, DHS officials were preparing to testify before Congress regarding the Speaker case, which had been front-page news across the nation.

The congressional investigation found that the CDC lacks a reliable means of preventing someone infected with a biological agent from entering or leaving the U.S. Congressional committees have taken up a bill to amend the Foreign Assistance Act of 1961 to provide more assistance in preventing, treating and controlling tuberculosis.


Both airlines were asked whether and when they were informed by Homeland Security or CDC officials that the infected foreign national had been a passenger on recent flights or of the possible contamination risks to fellow passengers.

US Airways and Delta Air Lines both declined to answer, citing passenger privacy issues.