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02 March 2007

Russian Man Quarantined with "Extreme TB"

Title 42 United States Code Section 264 (Section 361 of the Public Health Service Act) gives the secretary of Health and Human Services responsibility for preventing the introduction, transmission, and spread of communicable diseases from foreign countries into the United States and within the United States and its territories and possessions.
The Centers for Disease Control and Prevention may detain, medically examine or conditionally release individuals reasonably believed to be carrying a communicable disease.
Source: Centers for Disease Control and Prevention


A man infected with an especially virulent strain of tuberculosis has spent eight months in a hospital jail ward under a court order and may be held until he dies.
Robert Daniels has not been charged with a crime, but the 27-year-old violated the rules of a voluntary quarantine, exposing others to a potentially deadly illness. Maricopa County public health officials got a court order to keep him locked up.
The TB strain Daniels has is so dangerous that he has never met his appointed lawyer, Robert Blecher, who describes the situation as "extremely unusual."
Daniels' hospital room is designed so that air flows in, never out, to prevent the bacterium from spreading.
Daniels, who has dual citizenship in the U.S. and Russia, contracted "extreme multidrug resistant tuberculosis" while living in Russia, court records show.
He was diagnosed two years ago in Russia, and said he came to Phoenix in January 2006 after being told drugs were hard to get and expensive.
Daniels went to a Phoenix hospital with respiratory problems in July 2006, and was sent to a Phoenix halfway house for indigent TB patients under a voluntary quarantine. He was ordered to continue treatment and wear a mask when he went out in public because the disease is spread by airborne contact.
Daniels stopped taking his medication and went unmasked to a restaurant, a convenience market and other stores, court records stated.
Robert England, Maricopa County's tuberculosis control officer, said in court filings that Daniels understands the rules, but "merely refuses to follow them."
England applied for and received a "compulsory detention" order for Daniels, a legal tool used about once a year in Arizona.
Daniels, who has a wife and child in Russia, said in a telephone interview with The Arizona Republic that he didn't want to confuse people by wearing a mask and that doctors at Russian clinics where he was treated didn't even wear masks.
The Centers for Disease Control and Prevention reported there were 14,097 cases of TB in the United States last year. Just 15 were of the rare strain Daniels has. Prospects for his release are unclear. A 2006 medical assessment indicated the disease was mutating in Daniels.


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