The case of a man traveling overseas with a potentially lethal form of tuberculosis has raised several policy questions for how an avian influenza pandemic or international biological attack would be contained in the first hours and days.

While protocols have been established between the departments of Health and Human Services and Homeland Security for limiting the travel of people with contagious diseases, lawmakers and health officials said the protocols were clearly flouted in this case.

And the scenario — which can be seen as a microcosm for a pandemic — raised new questions about the complexity of international travel and standards.

“Nature’s providing us the perfect drill for a pandemic,” said Nicole Lurie, co-director of the RAND Center for Domestic and International Health Security. She said it has raised many unresolved issues about when individual rights can be curtailed, and when government officials should inform and coordinate with international partners.

Andrew Speaker, a 31-year-old attorney from Atlanta, allegedly traveled to Paris on May 12 to attend his wedding in Greece, despite being told he had a form of TB that is resistant to drug treatments.

While in Europe, officials at the Centers for Disease Control and Prevention determined that he had a strain that was extremely drug resistant. CDC officials said they worked with Speaker to try to find ways to bring him back to the United States.

But Speaker resisted orders to not return back to the United States on his own, government officials said, and took a flight on May 24 to Montreal, and then rented a car to return to America.

A Customs and Border Protection official, who knowingly ignored a specific warning not to allow Speaker to enter the country, has been reassigned to a desk job. The Customs official allegedly decided the man looked healthy and allowed him to enter, despite a clear message to the contrary, according to a Department of Homeland Security source who requested anonymity.

DHS officials said Speaker had been added to government watch lists for less than 24 hours when he arrived in Canada. CDC Director Julie L. Gerberding said Canadian officials were not informed because it was unclear where in the world Speaker was.

“We’ve learned a number of things within the travel section that need to be addressed,” Gerberding said.

The case raises separate questions about how Speaker was able to leave the country despite his diagnosis, what the U.S. government could do to help him return safely from Europe and how he was able to board a passenger aircraft and enter North America.

Gerberding said Friday that CDC officials did not know Speaker’s identity until he was in Europe, although they were familiar with the case.

The patient, on ABC News’ “Good Morning America,” said he had been told he should not travel, but also was told by local health officials that they were saying it to cover themselves from liability, and that he was not at risk of spreading the disease.

Dr. Martin Cetron, director of CDC’s division of Global Migration and Quarantine, said the agency would review the ability of local and state health officials to recommend patients with infectious diseases to no-fly lists as part of a series of after-action reports.

DHS and HHS agreed in 2005 to share information and cooperate in informing the public during disease-related threats.

The Transportation Security Administration also is empowered, by the Aviation Transportation Security Act of 2001 (PL 107-71), to broadly protect the transportation system from disease-related and other kinds of threats.

Both of these resources were put to use late last week after the CDC realized they had lost track of Speaker in Italy.

The CDC contacted DHS May 24 to see what resources could be used to prevent Speaker from independently boarding a commercial flight bound for the United States.

DHS Chief Medical Officer Jeffrey W. Runge said the concern was sent to his office.

“We immediately got TSA on the phone and they complied with CDC’s wishes to put him into a no-fly status,” Runge said.

TSA spokeswoman Ellen Howe said it was the first time a person with a potentially infectious disease was placed on a no-fly list.

However, the agencies later discovered their efforts came too late and were misdirected. At the time the initial phone call to TSA was placed, Speaker was already in the air bound for Montreal from Prague.

Because the flight was handled by a foreign air carrier and bound for a non-U.S. destination, the Canadian government was under no obligation to vet the passenger manifest against the U.S. no-fly list.

Speaker was then able to rent a car at Pierre Trudeau International Airport in Montreal and cross the border at Plattsburgh, N.Y., the evening of May 24.

TSA removed Speaker’s name from the no-fly list on May 25 after he re-established contact with CDC and the agencies learned he already re-entered the U.S. territory. Speaker was subsequently directed to Bellevue Hospital in Manhattan.

He is now being treated at the National Jewish Medical and Research Center in Denver, under federal quarantine authority. He told ABC News he took the flight because he believed he would die if he did not get the specialized treatment the hospital provides.

Gerberding said the CDC had been working to find methods of returning him to the United States, aided by Robert C. Cooksey, a CDC microbiologist whose specializes in TB and is Speaker’s father-in-law.

CBP Assistant Commissioner Jay Ahern said the system worked, because Speaker’s name was flagged.

“Just because we had a breakdown by an individual doesn’t mean that we need to completely throw the system out,” he said.

But Lurie said the case raises international questions about when someone is viewed as posing a risk of infecting others.

“There’s a lot of international coordination that has to get done, and questions about what the triggers are for doing so,” she said. “It seems like there needs to be a really clear standard if someone is a risk or not, and if someone is a risk, there ought to be a clear trigger for quarantine or isolation.”

However, the situation would be different for a pandemic, because it would spread more quickly and widely, augmenting the quarantine requirements.

She also said the case has highlighted the complexities of getting flight manifests and tracking down those who might have been exposed, something which pandemic plans have assumed would be easy.

Gerberding said World Health Organization standards for the treatment of patients with infectious diseases does not go into effect until June 15, and the CDC must work to better understand how to implement them.

“I’m not sure we are in the position where we can guarantee an infectious person cannot leave the United States,” she said.

She said there also are questions about who is responsible for patients visiting foreign lands.

Lawmakers are expected to review the Speaker case in the coming weeks. The House Homeland Security Committee will hold its first hearings on the subject Wednesday.

One congressional aide said there will not likely be calls for new laws, but for clearer protocols.

“We need a review of state and local public health authorities,” said the staffer, who spoke on condition of anonymity. “CDC used the authority it had, it just came too late.”

Matthew M. Johnson and Eileen Sullivan contributed to this story.