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Jail sends TB patient to hospital in Boston By DAVID HENCH, Staff Writer
http://pressherald.mainetoday.com/ne.../060928tb.html
A homeless man who was jailed after he refused to take his tuberculosis medicine was moved to a hospital in Boston on Wednesday as some inmates expressed dismay at being housed alongside him without being told of his disease.
John Donohue, 54, left the Cumberland County Jail in Portland and was taken to Lemuel Shattuck Hospital in Boston. The hospital has a secure tuberculosis ward where patients cannot simply leave if they want.
Maine officials took the unusual step last month of getting a judge to issue an arrest warrant for Donohue, not because of any criminal conduct but because he had walked away from a long-term care facility in Portland and refused to take medicine for his tuberculosis. The case has focused attention on how the state should handle people who refuse treatment for contagious diseases.
Although the symptoms of the respiratory illness are gone and Donohue is no longer contagious, he had stopped treatment once before and now has a strain of tuberculosis that is resistant to some drugs.
Officials say he infected three people in the Portland area this year before he was diagnosed in June after being jailed for drinking in public.
His failure to complete a six-month course of medication could lead to a resurgence of the disease in a drug-resistant form, health officials said.
"We do not want the people of Maine to be exposed to tuberculosis unnecessarily, especially multi-drug resistant TB. We would have a major crisis on our hands," said Dr. Dora Anne Mills, Maine's chief health officer and head of the Maine Center for Disease Control and Prevention.
Jail inmates reacted angrily when they learned that Donohue had been living among them.
After a story about Donohue appeared in Wednesday's Portland Press Herald, corrections officers transferred him to the jail's medical ward until he was taken to Boston around 2 p.m.
"They didn't tell us about this guy," said Michael Alexander, who is in jail on a charge of violating his probation. "He was in this pod with 75 guys in a small area. I feel they kind of put us at risk."
Cumberland County Sheriff Mark Dion said the jail would not have placed Donohue among other inmates if he was still contagious.
He said the jail screens all inmates when they arrive, in an effort to identify health problems.
While Donohue's situation has been resolved for now, state officials say the issue of where to house people who refuse treatment for contagious diseases still must be addressed.
Tuberculosis remains a dangerous and widespread disease in much of the world. The growth in international travel suggests that TB and other infectious diseases are likely to continue to arrive in the United States. Groups in close quarters, such as homeless people and those in jail, are particularly susceptible to the spread of such diseases and can be hard to monitor to ensure they take a full course of medicine.
Civil libertarians who have argued against mandatory treatment of people with mental illness have not objected to forced treatment for contagious diseases.
State officials were not aware of people elsewhere in the country who have been jailed for refusing treatment.
In most cases, people with tuberculosis are removed from jails so they do not infect other inmates.
In 1999, a similar case in Milwaukee pitted the county sheriff against a judge.
A man with active, contagious tuberculosis was arrested and charged with contempt of court after violating a court order to submit to treatment. He was eventually transferred to a private facility where he was placed under police guard.
Dion said suggestions that Maine make it a crime to defy an order to seek treatment would need careful study and the involvement of corrections officials.
"That would transform a non-compliant patient into a criminal," Dion said.
A similar approach to people with mental illness who display socially unacceptable behavior has led many mentally ill people to jail, at significant expense to taxpayers, he said.
The state will pay close to $1,000 a day to have Donohue treated at Lemuel Shattuck Hospital, which has one of nation's few secure tuberculosis treatment facilities.
Staff Writer David Hench can be contacted at 791-6327 or at:
dhench@pressherald.com
http://pressherald.mainetoday.com/ne.../060928tb.html
A homeless man who was jailed after he refused to take his tuberculosis medicine was moved to a hospital in Boston on Wednesday as some inmates expressed dismay at being housed alongside him without being told of his disease.
John Donohue, 54, left the Cumberland County Jail in Portland and was taken to Lemuel Shattuck Hospital in Boston. The hospital has a secure tuberculosis ward where patients cannot simply leave if they want.
Maine officials took the unusual step last month of getting a judge to issue an arrest warrant for Donohue, not because of any criminal conduct but because he had walked away from a long-term care facility in Portland and refused to take medicine for his tuberculosis. The case has focused attention on how the state should handle people who refuse treatment for contagious diseases.
Although the symptoms of the respiratory illness are gone and Donohue is no longer contagious, he had stopped treatment once before and now has a strain of tuberculosis that is resistant to some drugs.
Officials say he infected three people in the Portland area this year before he was diagnosed in June after being jailed for drinking in public.
His failure to complete a six-month course of medication could lead to a resurgence of the disease in a drug-resistant form, health officials said.
"We do not want the people of Maine to be exposed to tuberculosis unnecessarily, especially multi-drug resistant TB. We would have a major crisis on our hands," said Dr. Dora Anne Mills, Maine's chief health officer and head of the Maine Center for Disease Control and Prevention.
Jail inmates reacted angrily when they learned that Donohue had been living among them.
After a story about Donohue appeared in Wednesday's Portland Press Herald, corrections officers transferred him to the jail's medical ward until he was taken to Boston around 2 p.m.
"They didn't tell us about this guy," said Michael Alexander, who is in jail on a charge of violating his probation. "He was in this pod with 75 guys in a small area. I feel they kind of put us at risk."
Cumberland County Sheriff Mark Dion said the jail would not have placed Donohue among other inmates if he was still contagious.
He said the jail screens all inmates when they arrive, in an effort to identify health problems.
While Donohue's situation has been resolved for now, state officials say the issue of where to house people who refuse treatment for contagious diseases still must be addressed.
Tuberculosis remains a dangerous and widespread disease in much of the world. The growth in international travel suggests that TB and other infectious diseases are likely to continue to arrive in the United States. Groups in close quarters, such as homeless people and those in jail, are particularly susceptible to the spread of such diseases and can be hard to monitor to ensure they take a full course of medicine.
Civil libertarians who have argued against mandatory treatment of people with mental illness have not objected to forced treatment for contagious diseases.
State officials were not aware of people elsewhere in the country who have been jailed for refusing treatment.
In most cases, people with tuberculosis are removed from jails so they do not infect other inmates.
In 1999, a similar case in Milwaukee pitted the county sheriff against a judge.
A man with active, contagious tuberculosis was arrested and charged with contempt of court after violating a court order to submit to treatment. He was eventually transferred to a private facility where he was placed under police guard.
Dion said suggestions that Maine make it a crime to defy an order to seek treatment would need careful study and the involvement of corrections officials.
"That would transform a non-compliant patient into a criminal," Dion said.
A similar approach to people with mental illness who display socially unacceptable behavior has led many mentally ill people to jail, at significant expense to taxpayers, he said.
The state will pay close to $1,000 a day to have Donohue treated at Lemuel Shattuck Hospital, which has one of nation's few secure tuberculosis treatment facilities.
Staff Writer David Hench can be contacted at 791-6327 or at:
dhench@pressherald.com