Georgia Firearm Forums - Georgia Packing banner

1 - 18 of 18 Posts

·
Registered
Joined
·
5,798 Posts
Discussion Starter · #1 ·
Man With Drug-Resistant TB Locked Up

Apr 2, 9:35 PM (ET)

By CHRIS KAHN

PHOENIX (AP) - Behind the county hospital's tall cinderblock walls, a 27-year-old tuberculosis patient sits in a jail cell equipped with a ventilation system that keeps germs from escaping. Robert Daniels has been locked up indefinitely, perhaps for the rest of his life, since last July. But he has not been charged with a crime. Instead, he suffers from an extensively drug-resistant strain of tuberculosis, or XDR-TB. It is considered virtually untreatable.

County health authorities obtained a court order to lock him up as a danger to the public because he failed to take precautions to avoid infecting others. Specifically, he said he did not heed doctors' instructions to wear a mask in public.

"I'm being treated worse than an inmate," Daniels said in a telephone interview with The Associated Press last month. "I'm all alone. Four walls. Even the door to my room has been locked. I haven't seen my reflection in months."

Though Daniels' confinement is extremely rare, health experts say it is a situation that U.S. public health officials may have to confront more and more because of the spread of drug-resistant TB and the emergence of diseases such as SARS and avian flu in this increasingly interconnected world.

"Even though the rate of TB in the U.S. is at the lowest ever this last year, we live in a globalized world where, if anything emerges anywhere, it could come to our country right away," said Mark Harrington, executive director of the Treatment Action Group, an American advocacy group.

The World Health Organization warned last year of the emergence of extensively drug-resistant TB. The new strain, which has been found throughout the world, including pockets of the former Soviet Union and Asia, is resistant not only to the first line of TB drugs but to some second-line antibiotics as well.

HIV patients with weakened immune systems are especially susceptible. In South Africa, WHO reported that 52 of 53 HIV patients died within an average of 25 days after it was discovered they also had XDR-TB.

How to deal with people infected with the new strain is a matter of debate.

Dr. Ross Upshur, director of the Joint Centre for Bioethics at the University of Toronto, said authorities should detain people with drug-resistant tuberculosis if they are uncooperative.

"We're on the verge of taking what was a curable disease, one of the best known diseases in human endeavors, and making it incurable," Upshur said.

But a paper Upshur co-wrote on the issue in a medical journal earlier this year has been strongly criticized.

"Involuntary detention should really be your last resort," Harrington said. "There's a danger that we'll end up blaming the victim."

In the United States, which had a total of 13,767 reported cases of tuberculosis in 2006, public health authorities only rarely have put TB patients under lock and key.

Texas has placed 17 tuberculosis patients into an involuntary quarantine facility this year in San Antonio. Public health authorities in California said they have no TB patients in custody this year, though four were detained there last year.

Upshur's paper noted that New York City forced TB patients into detention following an outbreak in the 1990s, and saw a significant dip in cases.

In the Phoenix area, only one other person has been detained in the past year, said Dr. Robert England, Maricopa County's tuberculosis control officer.

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.

The ventilation system draws out the air and filters it to capture the bacteria-laden droplets he expels when he coughs. The filters are periodically burned.

Daniels said he is taking medication and feeling a lot better. His lawyer would not discuss his prognosis. Daniels plans to ask for his release at a court hearing late this month.

Daniels lived in Russia for 15 years and returned to the United States last year after he was diagnosed. He said he thought he would get better treatment here, and hoped eventually to bring his wife and children from Russia. He said he briefly worked in an office in Arizona for a chemical company before he was put away.

He said that he lost 50 pounds and was constantly coughing and that authorities locked him up after they discovered he had walked into a convenience store without a mask.

"Where I come from, the doctors don't wear masks," he said. "Plus, I was 26 years old, you know. Nobody told me how TB works and stuff."

County health officials and Daniels' lawyer, Robert Blecher, would not discuss details of the case. But in general, England said the county would not force someone into quarantine unless the patient could not or would not follow doctor's orders.

"It's very uncommon that someone would both not want to take treatment and will willingly put others at risk," England said. "It's only those very uncommon incidents where we have to use legal authority through the courts to isolate somebody."

University of Pennsylvania medical ethicist Art Caplan said Maricopa County health officials were confronted with the same ethical dilemma that communities wrestled with generations ago when dealing with leprosy and smallpox.

"Drug-resistant TB, or drug-resistant staph infections, or pandemic flu will raise these questions again," Caplan said. "We may find ourselves dipping into our history to answer them."

Daniels said he realizes now that he endangered the public. But "I thought I'd come to a country where I'd finally be treated like a person, and bam, here I am."
Source
 

·
Moderator
Joined
·
68,929 Posts
If I were the President, I would claim there is an outbreak of this stuff at Gitmo. Problem solved! :D
 

·
Registered
Joined
·
4,322 Posts
In a few months, the prison will look like...



Brains...Brains...
 

·
Registered
Joined
·
780 Posts
Can't we lock up Congress, the House and the President/Vice President for being common sense-resistant politicians?
 

·
Premium Member
Joined
·
8,460 Posts
I get the no shower and quarantine part, but why have they "taken away his television, radio, personal phone and computer"?

I did not know you could spread TB by listening to the radio.
 

·
Registered
Joined
·
391 Posts
Yeah, if you've got to quarantine him for public safety, go for it. But at least give him something to entertain himself while he twiddles his thumbs.
 

·
Registered
Joined
·
5,215 Posts
Gunstar1 said:
I get the no shower and quarantine part, but why have they "taken away his computer"?
What? You never heard of a computer virus?
 

·
Premium Member
Joined
·
8,460 Posts
USMC - Retired said:
Gunstar1 said:
I get the no shower and quarantine part, but why have they "taken away his computer"?
What? You never heard of a computer virus?
Sure, I just did not know that a computer could cough on me and cause me to catch the Iloveyou virus... or vice versa, cough on it can cause it to catch TB.
 

·
Registered
Joined
·
2,472 Posts
Once again, this sounds like everything is not disclosed/accurately reported.

The guy was arrested because he refused to wear a mask, but the wording the article sounds like he didn't know he was a supposed to. :?
I tend to think that would be impossible. The doc's would have had to have told him to do that & likely provided him masks to wear. I can't imagine one trip to the gas station would result in being arrested either. How did anyone even know? My guess is this guy was told repeatedly & violated those instructions enough so that the powers that be were watching him. He stepped over the line one time too many & they locked him up. I do agree though that he should have all the comforts of home. And if they can filter his air, why not his grey water? Though I hate to see another expense put on the state (I guess?) they should have to put him somewhere with that kind of facilities or else install them wherever they are locking him up. Also if they are not letting him shower then they certainly would have been concerned with leaving him (or anyone else with this condition) at home where they could shower freely - which makes me think that anyone with an advanced enough case of this would be confined. The numbers just aren't adding up here...
 

·
Registered
Joined
·
5,798 Posts
Discussion Starter · #10 ·
What is at issue is is the government allowed to indefinitely detain people without charging them in the name of public safety?

Obviously, the government has the right to protect the public from serious, highly-contagious, incurable diseases....but is this the right precedent to set?
 

·
Registered
Joined
·
2,472 Posts
Depends on the how highly contagious it is. Like I said above, something doesn't sound right. If this guy can't bath then I would think either
A) he has a strain that is "super virulent" compared to the average strain of this type of TB (but wouldn't that make it a different strain?...) and wouldn't he then have been locked up as soon as this was realized.
or
B) This strain is so bad that everyone with it should be contained. But that's not happening so....

What gives?
Sucks for this guy no matter what.
 

·
Registered
Joined
·
5,798 Posts
Discussion Starter · #12 ·
I would think if this were a truly highly-virulent strain then the CDC would have him quarantined in some facility. Not in the back of some police station....
 

·
Sledgehammer
Joined
·
4,777 Posts
Gunstar1 said:
I get the no shower and quarantine part, but why have they "taken away his television, radio, personal phone and computer"?

I did not know you could spread TB by listening to the radio.
I don't get the no shower part. Presumably, this is to keep the bacteria out of the sewage system. But, if the guy wore his mask (as he apparently was supposed to), he would have been allowed to continue living at home and washing all the germs down the sewer that he cared to. This seems very odd to me.
 

·
Registered
Joined
·
4,322 Posts
Maybe a late April 1 joke? the date on it is April 2, anyone confirm the article?
 

·
Registered
Joined
·
5,215 Posts
I hear they put him on a P & P diet.
 

·
Premium Member
Joined
·
8,460 Posts
jrm said:
Gunstar1 said:
I get the no shower and quarantine part, but why have they "taken away his television, radio, personal phone and computer"?

I did not know you could spread TB by listening to the radio.
I don't get the no shower part. Presumably, this is to keep the bacteria out of the sewage system. But, if the guy wore his mask (as he apparently was supposed to), he would have been allowed to continue living at home and washing all the germs down the sewer that he cared to. This seems very odd to me.
Well, depends on the facility. A shower all to himself (inside the quarentine zone) is one thing, but a larger communal shower area, even if alone would spread germs all over, meaning you would have to scrub the room after he showered before letting any other patients in.

Wet naps or towels can be tossed right into the bio-hazard container without the need of decontaminating the room after use.
 

·
Registered
Joined
·
4,322 Posts
this should take care of that problem.

 

·
Registered
Joined
·
2,472 Posts
Well, I don't know about the story about about 30 seconds on Google shows that the disease is real.

What is XDR-TB?

TB can usually be treated with a course of four standard, or first-line, anti-TB drugs. If these are misused or mismanaged, multidrugresistant TB (MDR-TB) can develop. MDR-TB takes longer to treat with second-line drugs, which are more expensive and have more side-effects. If these drugs are also misused or mismanaged, extensively drug-resistant TB (XDR-TB) can develop. Because XDR-TB is resistant to first- and second-line drugs, treatment options are seriously limited and so are the chances of cure.


The source I was reading the above on also noted the the XDR strain isn't any more or less infectious than normal TB. Just once you get it you stand a good chance of taking a dirt nap.
 
1 - 18 of 18 Posts
Top