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Tuberculosis-Infectious Woman Refuses To Get Treatment And Isolate, Putting Public At Risk

A women in Tacoma, Washington, who has tuberculosis (TB), has been refusing treatment and was ... [+] spotted taking public transit and going to a casino. (Photo: Getty)

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When you have a contagious disease like tuberculosis (TB), refusing treatment and refusing to isolate are not personal choices. Such choices affect not only you but also everyone around you, at least those with nostrils or mouths. That's why there is now a warrant for the arrest of a woman in Tacoma, Washington, as reported by KOMO News. She has TB yet for over a year now has refused to be treated or to be isolated. That's two not-to-be's that be bad for preventing the spread of TB. Although Pierce County judge Philip Sorenson signed off on that arrest warrant last month, that TB move doesn't appear to be having much effect as the woman was recently spotted taking public transit and going to a casino.

This has been an "If at first you don't succeed, try, try again fifteen times" situation. So far, there have been 16 court orders for this woman to submit to the Tacoma-Pierce County Health Department (TPCHD) for involuntary detention, testing, and treatment. This has meant that a whole lot of taxpayer money has gone into getting one person to take steps to protect not only her own health but also the health of those around her. This would mean taking a medication called isoniazid (INH) in combination with three other drugs: rifampin, pyrazinamide and ethambutol. While treatment would last three to nine months, she would have to stay isolated no longer than 45 days or until testing has shown that she is no longer contagious.

TB can result when you breathe in Mycobacterium tuberculosis bacteria that's exhaled by someone who is infected. So if you are infected, you can spread Mycobacterium tuberculosis into the air by coughing, speaking, or singing the Doors song, "Break on Through to the Other Side" or any song for that matter. When you air such infectious grievances, they can hang in the air for others to breath into their lungs. This is why those with active TB are often kept in negative pressure rooms. In this case, negative pressure doesn't mean being in a room with someone who is telling you to do something because you suck. Instead, it's a room where the air pressure inside is lower than the air pressure outside the room. As a result, whenever the door is opened, this pressure difference effectively sucks air into the room so that any dangerous airborne pathogens don't leave the room.

This chest X-ray shows pulmonary tuberculosis, interstitial infiltration in the left upper lung due ... [+] to Mycobacterium Tuberculosis infection (Photo: Getty)

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Getting TB is not to be a fun thing. The infection can ravage your lungs as well as other parts of your body such as your kidneys, spine, and brain. Typical symptoms include a chronic cough, coughing up sputum or blood, and chest pain. You may become weak and fatigued, suffer fever, chills, and night sweats, and lose your appetite and weight. You may have any combination of these symptoms. Of course, these symptoms aren't always specific to TB. For example, just because you lose your appetite after watching that vomiting scene in the 2011 movie Bridesmaids doesn't necessarily mean that you have TB.

You can be infected with Mycobacterium tuberculosis without having symptoms. This is called latent TB. When you have latent TB, you aren't infectious. However, you should still get treatment because latent TB could always become active TB.

Now, TB treatment is not like eating a hot dog. Once you start, you had better finish the entire course. Ending treatment early could end up selecting for and promoting Mycobacterium tuberculosis that's resistant to antibiotics. Taking the full course of treatment makes it more likely that you will wipe out all the Mycobacterium tuberculosis in your body and not just the weaker ones.

Speaking of hot dogs, not too many people relish getting TB. It can be a killer, and not in a positive sense of the word. The World Health Organization (WHO) indicates that "A total of 1.6 million people died from TB in 2021," and that "Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after COVID-19." While TB in its early stages is very treatable, those who go untreated may have a 50% probability of dying.

So it would totally make sense to get treated if you are infected with Mycobacterium tuberculosis. And it would totally make sense for others to want you to get treated if you are infected with Mycobacterium tuberculosis. After all, no one should say, "It would be great for there to be more TB."

As they say, it's all fun and games until someone gets TB. You can cry freedom all you want, but that doesn't mean that you have the freedom to put others in danger.

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World Tuberculosis (TB) Day, to be observed on Friday March 24, brings back painful recollection of how I almost lost my life to this dangerous but highly curable disease. My journey stared in 2011 with a fever, unusual fatigue, night sweats, weight loss and a swollen stomach, but no sign of the cough usually associated with TB.

I was put on antibiotics but there was no improvement and soon after, came the first surgery to remove puss from my stomach.

Unfortunately, there was still no change, since my condition had not been properly diagnosed. Only after a second operation was a sample tested and the doctor diagnosed tuberculosis.

The diagnosis was confusing to me because, until then, I thought TB was a disease of the lungs. I found out, however, that I had contracted Zoonotic TB, likely through consuming unpasteurized milk or under-cooked meat.

Ensuing treatment included one month of daily injections and seven months of anti-tuberculosis drugs.

Taking the pills was a challenge since they are big and difficult to swallow. One nurse's advice to swallow them with porridge, though well-meaning, had the opposite effect since I would immediately throw up whatever I had eaten to take the pills. I was, however, determined to get cured so I did whatever I had to in order to take the medication.

During this time I suffered severe weight loss as well as memory loss and confusion. Doctors said, as a result of the rapid weight loss, my brain was protecting itself by going into "standstill" mode. I was losing my capacity to function as an adult.

My experience, and recovery, has taught me valuable lessons about TB. I learnt this disease does not only affect the lungs but it can affect most parts of the body. Touching someone who has the disease does not spread it, because the bacteria is transmitted only through the air.

People with active tuberculosis in their lungs contaminate the air when they cough, sneeze, laugh, spit or speak. The bacteria stays in the air for hours and when someone else breathes that air, they may become infected.

However people who have latent tuberculosis, or extra-pulmonary TB, do not spread bacteria into the air and cannot transmit the infection.

This type of TB is spread through the blood to other organs and typically affects the kidney, lymph nodes, brain cells, membranes around the heart, joints, and reproductive organs. The symptoms of extra pulmonary TB are vague. They include: Fatigue, poor appetite, fever, night sweats and weight loss.

Tuberculosis that affects the brain (tuberculosis meningitis) is life threatening and its symptoms include: Fever, persistent headache, neck stiffness, nausea and drowsiness, that can lead to a coma.

As a TB survivor, I now work as a champion creating awareness in my community about the disease and I take great care to make a distinction between the form of the disease that affects the lung/pulmonary and that which affects other parts of the body or extra pulmonary.

The feedback I get from the community is that most people are unaware of extra pulmonary TB, the same way I was prior to contracting the disease. Most are also unaware that TB can be transmitted from animals to human.

This ignorance around the disease means that symptoms are too often treated as something else, and patients are lost, in the end, to a disease that is preventable, treatable and curable with free medication.

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The solution lies in more public education. I am calling on the health sector, private sector, civil societies and policy makers to lead the way by making more information and education materials available.

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