Tuberculosis is a serious, potentially deadly infectious disease that has been a global public health crisis for years. Recently, a woman in Washington state has been in the news for her refusal to comply with court orders to have her active, contagious case of tuberculosis treated and to stay in isolation. In this blog post, we will discuss the woman’s case and the global public health threat of tuberculosis.

Tuberculosis is caused by Mycobacterium tuberculosis, a bacterial infection that mostly affects the lungs and can be spread through the air when an infected person coughs, sneezes, spits, or launches bacterial cells around them. Treatment for tuberculosis is not easy—in uncomplicated cases, it takes a four-month or six-month course of four types of antibiotics to effectively rid the infection. But M. tuberculosis is becoming increasingly drug-resistant, even extensively drug-resistant (XDR-TB), both of which are considered a global public health crisis and health security threat.

The woman in Washington state has been willfully violating multiple court orders to have her active, contagious case of tuberculosis treated and to stay in isolation for over a year now. Documents filed in the Pierce County Superior Court and reviewed by The News Tribune found that the woman’s first court order for involuntary isolation dates back more than a year ago, to January 19, 2022. Despite multiple court orders, the woman has continued to refuse treatment and isolation.

The health department has now reached a breaking point. Last month the health department filed a supplemental court document after the woman got into a car accident and tested positive for COVID-19, both of which suggest that she is not isolating as per the court’s order. Additionally, when she went to the emergency department the day after the crash complaining of chest pain and failed to tell her treating physicians about her active tuberculosis case, they initially suspected she had cancer. But in fact, the X-rays revealed that her tuberculosis case was worsening.

The court renewed its order on January 20, 2023, adding that failure to comply this time “may result in a finding of contempt whereby the court orders further measures, up to and including electronic home monitoring and detention in Pierce County Jail or other lawful orders the court may issue, in accord with the applicable code.” Nigel Turner, division director of Communicable Disease Control, said in a press announcement last week, “We assess that balance between restricting somebody’s liberty and protecting the health of the community. We also want to make sure that we have time for the person to comply and try lots of different options that are short of requiring somebody to be detained. Incarceration detention is the very, very last option that we want to take and we don’t do that lightly. But occasionally that becomes necessary if there is a risk to the public.”

The latest data from the Centers for Disease Control and Prevention reported that there were 7,882 tuberculosis cases in the US in 2021 and 600 tuberculosis-related deaths in 2020. It is clear that tuberculosis is a serious public health threat and that it is essential for individuals to take the necessary steps to protect themselves and others.

We hope this blog post has given you an insight into the seriousness of tuberculosis and the importance of adhering to court orders to protect the health of the community. Stay safe, and take care.