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SAN FRANCISCO (AP) -- Authorities in California took the
unusual step of jailing and charging a tuberculosis patient who they say
refused to take medication to keep his disease from becoming
contagious.
Health officials said Armando
Rodriguez, 34, of Stockton has active pulmonary tuberculosis, which can
include coughing up blood or phlegm and can spread through the air.
Rodriguez
has been noncompliant with his treatment and could become contagious as
a result, Ginger Wick, nursing director for San Joaquin County, said in
a letter requesting a warrant for Rodriguez's arrest.
After
failing one time to give himself the drugs, Rodriguez told a nurse he
had gone on an alcohol binge and taken methamphetamine and didn't want
to hurt his liver, Wick said in her letter.
Rodriguez
was arrested Tuesday and is expected to be arraigned Thursday on two
misdemeanor counts of refusing to comply with a tuberculosis order to be
at home at certain times and make appointments to take his medication.
He will likely be appointed a public defender.
Tuberculosis
is a bacterial infection that usually attacks the lungs. Many people
have a latent form, and the active form usually only affects adults
whose immune systems are compromised, which can happen from drug use.
Public
health experts are divided on the issue of mandatory treatment and
criminal charges for patients who don't comply with treatment orders.
Many
of those who do support criminal prosecution in the rarest of cases
when public health is in jeopardy oppose the jailing of patients.
"I
think it's an error to confine someone in the criminal justice system
for a public health crime," said Lawrence Gostin, a Georgetown
University public health law professor who drafted a model law adopted
by several states struggling with the issue. "The whole intention is to
protect the public's health. It's not to lay blame on someone."
Implementing
mandatory treatment should be a last resort, and prosecuting someone
for disobeying a public health order is unhelpful and sends the wrong
message if protecting public health is the intent, Gostin said.
Instead,
the afflicted should be given incentives such as transportation to and
from treatments rather than punishment as an incentive to take their
medicine, he said.
The Centers for Disease
Control and Prevention said laws to control the spread of tuberculosis
have been in use for more than a century, though regulations differ in
each state.
As many as 12,000 new cases of
tuberculosis are reported in the country each year, the CDC reported.
California recorded 2,317 new cases in 2011, a low since records have
been kept.
Nonetheless, officials throughout
the nation continue to struggle to stop the spread of tuberculosis, with
several drug-resistant strains emerging in recent years.
Federal
and state officials don't keep records of the number of people
prosecuted for refusing to take their medicines. But some say it's
exceedingly rare to file criminal charges in such cases.
San
Joaquin County has had more than 30 tuberculosis prosecutions since
1984, prosecutor Stephen Taylor said, noting the county is more
aggressive than other jurisdictions in prosecuting patients to get them
to take their medication.
"The criminal cases
we're dealing with generally involve drug users who are harder to treat
and manage because the TB medicines conflict with street drugs," he
said. "We have to throw these people in jail and treat them as
in-patients. They don't cooperate as out-patients."
Karen
Furst, San Joaquin County public health officer, said the county
arranges transportation and other services to help patients stick to
their drug regimen and turns to the legal system only as a last resort.
"I
have to make sure that if I'm aware that somebody is in a position that
could possibly be spreading a disease to another person, that I take
steps that are necessary to prevent that from happening," she said.
Rodriguez
was discharged in March from San Joaquin General Hospital with four
medications for active tuberculosis and agreed to take the drugs under
observation by a county health official on weekdays and on his own on
weekends, authorities said.
He allegedly refused to take the drugs on another day and then was not at home on three occasions and missed an appointment.
Each
charge against Rodriguez carries a maximum penalty of a year behind
bars. In her letter, Wick said Rodriguez would need nine months of
treatment.
---
Associated Press writer Paul Elias in San Francisco contributed to this report.
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