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Arrest warrant is issued for woman who has refused tuberculosis treatment

Public health officials can take legal action as a last resort if a person with an active tuberculosis case refuses treatment.

Police have been dispatched to arrest a Washington state woman with an active case of tuberculosis who, for over a year, has repeatedly refused to isolate or get treatment for the infectious disease, health officials said Friday.

The woman, whose name the Tacoma-Pierce County Health Department declined to divulge but who was identified in court papers by the initials V.N., was given plenty of chances to isolate or seek treatment.

Judge Philip Sorensen signed the arrest warrant "as a last resort" on Thursday after health officials appealed to him for a 16th time on Feb. 24 to get the woman to comply with his order that she either resume taking her medication or voluntarily isolate herself.

“Respondent’s objections to the order of February 24, 2023 are noted, preserved, and are insufficient to alter the court’s order,” Sorensen wrote. "The Pierce County Jail shall be authorized to transport V.N. to an appropriate designated facility within Pierce County including, but not limited to Department of Corrections facilities."

Sorensen did not elaborate in his order on why V.N. has refused to comply. But he did warn the arresting officers that they would be transporting "a patient with active tuberculosis" and to take "appropriate precautions."

The woman’s court-appointed attorney, Sarah Tofflemire, suggested in a filing Wednesday, which was obtained by The Tacoma News Tribune newspaper, that part of the reason the woman has been refusing treatment is because she does not understand what is happening. And Tofflemire requested that a guardian be appointed to help her.

"She has not acknowledged the existence of her own medical condition," Tofflemire said, noting that when she has taken part in court proceedings "she has spoken out of turn with rapid, disorganized speech.”

“She has primarily focused on how she dislikes papers coming to her home, and not the import of the process in which she finds herself," Tofflemire stated. "She has repeatedly threatened suicide in relationship to papers being served upon her home.”

NBC News has reached out to Tofflemire for comment but she has not responded.

Local health officials said that a court-certified interpreter has been present at every court hearing and that Tofflemire, from the moment she was appointed the woman's attorney in March 2022, has had numerous opportunities to request a guardian.

Kenny Via, a spokesman for the health department, said in a statement the woman will be taken "to a facility equipped for isolation, testing and treatment."

"We will continue to work through the court and to pursue all our options to protect the community and persuade the patient to voluntarily seek the life-saving treatment she needs," Via said.

The Tacoma-Pierce County Health Department has declined to offer information about why the woman has steadfastly refused treatment. But under Washington state law, public 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 be deadly if left untreated, and infected people risk spreading the disease to others. The bacteria that causes tuberculosis is spread through the air when a person with an active case coughs, sneezes or speaks.

Typically, tuberculosis treatment takes three to nine months, according to the Centers for Disease Control and Prevention. But patients who stop taking their medications before the treatment is done can also develop antibiotic resistance.

Earlier, Nigel Turner, the county health department’s division director of Communicable Disease Control, said the department had to resort to legal action just three times in the last 20 years to get TB patients to comply with treatment orders.

V.N. landed on the health department's radar around January 2022 after she turned up in an emergency room following a car crash and X-rays of her chest revealed she had TB and the disease was progressing.

The woman has also tested positive for Covid-19, "which also strongly suggests that she is not isolating as per this court’s order," the News-Tribune reported.

Once a worldwide scourge that killed millions of people, tuberculosis has declined steadily since 1992 in the United States, according to the CDC.

The U.S. recorded around 7,900 active cases in 2021, the agency reported. And tuberculosis vaccines are no longer widely administered in the U.S. because the disease is not that prevalent and the shots are not highly effective in adults.