State scrambles to keep man with TB in isolation
By Jim Dooley
Advertiser Staff Writer
A homeless man with a highly contagious form of tuberculosis was out of quarantine in Ala Moana Park last week but is back in isolation at a hospital and is not believed to have infected anyone, according to court papers and interviews.
The Attorney General's Office filed paperwork yesterday at Circuit Court seeking authority to quarantine the patient, identified as a 52-year-old man. The Advertiser is withholding his name because he is back in quarantine and the threat to public safety is diminished.
Deputy Attorney General Susan Kern said she could not discuss the case because of medical confidentiality and added that the quarantine papers were supposed to have been filed under seal, unavailable to the public.
NO RISK TO PUBLIC
Dr. Glenn Wasserman, head of the Tuberculosis Control Program in the state Health Department, likewise said he could not discuss details of the case but said no public health risk had been created.
The patient "left Leahi Hospital for a brief period wearing a (surgical) mask" but is back in quarantine, Wasserman said.
However, the seriousness of the case prompted the Health Department at one point to contact the federal Centers for Disease Control and Prevention, which contacted Homeland Security to keep the man from traveling by air.
Wasserman declined to say how long the man was at large in public.
The paperwork seeking authority to quarantine was prepared in anticipation that it might be needed but it turned out not to be necessary, said Wasserman.
It was not clear why the paperwork was actually filed yesterday afternoon or why it was not filed under seal.
The paperwork said the patient tested positive for "cavitary tuberculosis" last month "and a recent respiratory specimen showed he had the highest level of contagiousness."
"The risk of spread of infection to noninfected persons from individuals with cavitary tuberculosis is very high," Wasserman said in a sworn declaration.
WANTED TO TRAVEL
The man was at The Queen's Medical Center from Feb. 20 to 23 "where he was treated for tuberculosis and diagnosed with severe anxiety disorder," Wasserman's declaration said. He was relocated to an apartment at Queen's but did not want to stay there "and sought to travel to Kona," the doctor's declaration said.
The Health Department then notified the Centers for Disease Control, "who activated its Federal Do Not Board authority in coordination with the Department of Homeland Security," Wasserman said in the court papers.
That prevented the patient "from traveling by airline on Feb. 26, 2010, because that travel might result in harm to public health," the declaration said.
On March 1, he was transferred to Leahi Hospital , where he was treated for tuberculosis, the doctor said.
On March 9, he "left Leahi Hospital against medical advice," Wasserman's declaration said.
He "has contacted Department of Health by telephone, stating he is present at Ala Moana Park, but has not appeared to receive medication, which he is required to take on a daily basis," Wasserman said in the declaration filed yesterday.
The patient "has confirmed untreated active tuberculosis and is at a very high risk of infecting others," the declaration said.
Tuberculosis is spread through the air. It commonly affects the lungs, but also may affect other parts of the body. Symptoms of TB include prolonged coughing, weight loss, fever, weakness and fatigue. Left untreated, the disease can be fatal.
Hawai'i has had one of the highest rates of tuberculosis in the nation, due in part to a relatively high percentage of foreign-born residents.
In 2006, there were 115 total cases of TB, up from 112 cases in 2005, according to data released by the Health Department in 2008.