Man Jailed For Having TB

[docB]

http://www.foxnews.com/story/0,2933,263380,00.html

So if you have a communicable disease and refuse to follow directions about how to avoid transmitting it should you be jailed?

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[TexasBoy]

Hm... tricky question. Laws that punish irresponsible/known HIV spreading are known and widely excepted, but TB...

... One could liken it to spreading HIV knowingly and say, yes, its criminal. However, if you look at the other extreme would one jail someone for spreading Varicella Zoster or Herpes Labalis? Neither of those two infections are curable (like TB), but its not jail-worthy to lock them up. One could leave it in the hands of civil courts and lets civil lawsuits work it out though in the face of a typical TB patient, monetary penalties probably won't mean much (no money anyway).

Seeing that TB for the vast majority of people isn't "terminal", I think its premature to annouce it purely illegal to "not where a mask", but the alternative is, unfortunately, less than ideal.

 

[docB]

Hm... tricky question... less than ideal.

All excellent points. Let me play devil's advocate and say that HIV, with current, maximal therapy, could be viewed as being similarly morbid as resistant TB. So if we are to jail only those who spread "deadly" diseases we'll have to define that for the letter of the law. Civil penalties would be functionally useless as the HIV and TB populations tend not to have many assets to attack (this is a generalization but we are talking about a social health issue here). You could make a better argument about using civil penalties to fight the spread of the other diseases you mentioned like genital herpes or gonorrhea.

 

[dpmd]

This isn't a guy with regular TB, where if someone gets infected they have to take meds for about a year (not that it wouldn't suck to get) and that is the end of it. This guy has extremely resistant TB that may not be able to be cured, and may not be able to be controlled either. At my school we spend a lot of time at the county hospital and have a lot of TB patients. If we diagnose them in the hospital, they stay there until their sputum is negative (and they are therefore less likely to spread the disease). We had a guy that was resistant to some drugs, unable to take others because of his liver disease, and we were running out of ways to treat him. My attending told us a story of a patient who spent a year in the hospital with XDR-TB waiting for his sputum to become negative, or until they could find a way to transport him back to his home country (he was here illegally). No one would ride with him to transport him home, because of the high risk of transmission. They finally worked it out so he could go home, but I would guess that he is not infection free (and may be transmitting it if he isn't careful). If someone doesn't take their meds they will mandate observed therapy, and if someone is refusing to take such a simple measure to avoid transmitting this terrible disease I don't see the problem with forcing him to. Perhaps this time spent will show him the seriousness of the situation and he will be more compliant with treatment and transmission reduction measures.

No, this shouldn't be the standard for all communicable diseases. The severity of the disease, treatment availability, and compliance with preventive measures should be taken into account.

 

[deleted87716]

Consider it "quarantine."

 

[apoptosisisfun]

Daniels has been living alone in a four-bed cell in Ward 41, a section of the hospital reserved for sick criminals. He said sheriff's deputies will not let him take a shower -- he cleans himself with wet wipes -- and have taken away his television, radio, personal phone and computer. His only visitors are masked medical staff members who come in to give him his medication.

This is the only part that troubles me. If the guy is worthy of indefinite quarantine, they should at least be caring to his situation - not a lock-him-up-and-throw-away-the-key ordeal.

On the other hand, it is a Fox article, and there probably is a reason why his belongings were taken away.

 

[dpmd]

Well, he's in jail. I think they take away everything when you go to jail. He probably can't take a shower because they don't want to expose the general population (they probably don't have showers in the infirmary-usual thinking is probably that if you are well enough to shower you are well enough to back to your cell), or more staff than necessary.

here is another story

So he is in the hospital jail ward. Makes more sense now. They wouldn't have a shower in the room, and they won't let him expose the rest of the ward. Another issue, why was he allowed into the country after he was diagnosed? It could have saved us a lot of money (in treatment, and in costs associated with his confinement) if he had to stay home.

 

[apoptosisisfun]

Well, he's in jail. I think they take away everything when you go to jail. He probably can't take a shower because they don't want to expose the general population (they probably don't have showers in the infirmary-usual thinking is probably that if you are well enough to shower you are well enough to back to your cell), or more staff than necessary.

He's only in jail in the literal sense. From my understanding of the article he is under the state's policing powers of quarantine (read: not charged with a crime), thus he should at least be provided some amenities.

 

[sdn1977]

Well, he's in jail. I think they take away everything when you go to jail. He probably can't take a shower because they don't want to expose the general population (they probably don't have showers in the infirmary-usual thinking is probably that if you are well enough to shower you are well enough to back to your cell), or more staff than necessary.

here is another story

So he is in the hospital jail ward. Makes more sense now. They wouldn't have a shower in the room, and they won't let him expose the rest of the ward. Another issue, why was he allowed into the country after he was diagnosed? It could have saved us a lot of money (in treatment, and in costs associated with his confinement) if he had to stay home.

I have a hard time believing they have quarantined this guy in a positive pressure airflow isolation room which doesn't have full bathroom facilities in all of Tucson. It seems unnecessarily punitative to me.

Certainly, SOMEWHERE in AZ there is a positive pressure room with bathroom facilities that allow a shower.

Likewise - why no television? What could possibly be cross contaminating about that? Goodness - they are so inexpensive - if they felt it was contaminated after his stay they could toss it. It makes me wonder what they are doing with his linens, clothes, etc.....

 

[dpmd]

He is in the county hospital. If it is anything like our county hospital, there are no negative pressure rooms with a shower (TB isolation requires negative pressure). There could be some in the state, but I don't think a private facility would be used in a case like this. At our county hospital, there are maybe three or four TV's for the entire hospital, and I guarantee you they aren't going to get sent for the jail ward patients to use. I don't think they would allow a patient's family to send their own entertainment stuff on the regular wards because they wouldn't want to assume the liability for it (if it broke, or got stolen, or if it affected other hospital equipment), and I expect the jail ward is set up so that absolutely no outside stuff is allowed (even though he is detained for quarantine and not exactly in jail, I don't think they tend to be very flexible on these things) *Edit just found this quote:
Jack McIntyre, a sheriff’s spokesman, said sympathetic nurses gave Daniels a computer, a phone and other items for a time, but those were confiscated for security reasons. “While he’s there, we treat him as an incarcerated individual,” McIntyre said. “It’s a jail ward.”

There are so few people a year that have to be dealt with in this manner that they haven't really gotten a great system in place. I think they should make his stay more comfortable if possible (evidently this is the only facility that can accomodate a medical lockdown of this sort). If his sputum is indeed negative at this time (likely because of treatment) like one article stated, then perhaps he can be transitioned to an outpatient direct observed therapy situation (perhaps under house arrest for a time until he demonstrates willingness to comply with wearing the mask), to ensure he doesn't subsequently become sputum positive due to failure to comply with treatment.

 

[docB]

On the other hand, it is a Fox article, and there probably is a reason why his belongings were taken away.

So what if it's a Fox article? It's an AP wire story.
http://www.tucsoncitizen.com/daily/local/43554.php
http://www.cbsnews.com/stories/2007/04/02/ap/health/main2639956.shtml
http://www.cnn.com/2007/HEALTH/conditions/04/03/tuberculosis.confinement.ap/

 

[apoptosisisfun]

So what if it's a Fox article? It's an AP wire story.
http://www.tucsoncitizen.com/daily/local/43554.php
http://www.cbsnews.com/stories/2007/04/02/ap/health/main2639956.shtml
http://www.cnn.com/2007/HEALTH/conditions/04/03/tuberculosis.confinement.ap/

Thanks for pointing that out, I missed the nice big header that said "Associated Press". I riscend my jab at Fox