Washington’s Tacoma-Pierce County Health Department has obtained multiple court orders requires one Tacoma resident to get treatment for her active tuberculosis, officials told NBC News on Friday.
The woman has so far refused to isolate or take the necessary medications, said Nigel Turner, the division director of the Department of Transmissible Disease Control.
“The court order is in effect to order isolation and quarantine,” Turner said. “We are working with her to assess compliance.”
The News Tribune, a local news outlet, reported on Friday that over the course of the past year, the health department has repeatedly sought and obtained court orders forcing the woman to be isolated and treated for tuberculosis. According to the Tribune, legal petitions from the department said the patient had disobeyed previous orders and had begun medication at some point but discontinued it. The health department confirmed the Tribune’s reporting to NBC News.
A judge issued the final order on Jan. 20, authorizing the department to test, treat and detain the woman starting next week.
The Department announced Monday that it was monitoring the matter and said at the time it was working with the woman’s family to persuade her to accept treatment.
The department declined to provide information on why the woman refused treatment.
below Washington state lawpublic health officials have the legal authority to seek a court order when a person’s refusal to take medication poses a threat to the public.
Tuberculosis can rise to that level because it can be deadly if left untreated, and infectious people are at risk of further spreading the disease. The bacteria that causes tuberculosis can spread through the air when a person with an active disease coughs, sneezes, or speaks.
The treatment process can take three to nine months, according to the Centers for Disease Control and Prevention. People who stop taking medications before treatment is complete may also develop antibiotic resistance.
When it comes to taking legal action, Turner said, “We do that with great reluctance because we clearly balance people’s civil liberties with the protection of the public’s health.”
Over the past 20 years, the department said, it has had to enlist the help of law enforcement to detain three people who refused tuberculosis treatment until they were no longer contagious. Turner said the department typically exhausts other measures before seeking a court order, such as enlisting family members, medical providers or infectious disease experts to reason with a patient.
Therapy for tuberculosis generally consists of antibiotics taken daily or weekly over a period of months. People with contagious tuberculosis should be isolated during that time, until they are no longer able to pass the disease on to others. The vast majority of cases can be healed with medicinessaid the World Health Organization.
Turner said the length of treatment or the possibility of side effects from the antibiotics may deter some people from accepting medication. People who don’t have reliable access to food or housing may also be reluctant to follow isolation guidelines, he said, so the health department can provide them with those resources.
With regard to the current patient, he said, the department is “really looking at every opportunity to comply and work with us to resolve this as quickly as possible.”
The stand reported that a January legal filing from the health department said the woman had previously gone to the emergency room after a car accident but had not disclosed her tuberculosis diagnosis to staff. Chest X-rays taken during the visit showed progression of the disease, the petition said, according to the Tribune. The Tacoma health department confirmed the report to NBC News.
Symptoms of active TB include a bad cough that lasts three weeks or more, chest pain, or coughing up blood or mucus, according to the CDC.
Nationally, the number of tuberculosis cases has declined steadily since 1992, According to the CDC. The United States included about 7,900 active cases in 2021. Tuberculosis vaccines are not widely administered in the US because the disease is not common and the injections are not very effective in adults.
Penetrate County sees about 20 cases of active tuberculosis a year, the health department said said.
But some people live with latent TB infections, meaning the bacteria is inactive and the host is not contagious and has no symptoms. The CDC estimates that this has an impact up to 13 million people in the US About 5% to 10% of those latent cases, if left untreated, will progress to active disease at some point in people’s lives.