Thursday, August 05, 1999

Adams County puts TB patient under guard




BY LEW MOORES
The Cincinnati Enquirer

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Deputy Tom Jones is part of a 24-hour detail ensuring that Barney Smith doesn't leave his mobile home.
(Michael Snyder photo)
| ZOOM |
        MANCHESTER, Ohio — The Adams County Health Department has taken the unusual step of quarantining a tuberculosis patient inside his mobile home — and posting a uniformed sheriff's deputy outside — to make sure he doesn't expose outsiders or visitors to the disease.

        County officials say Barney Smith needs to be guarded around the clock because they are not convinced he will remain at home if left alone. They would not explain why, saying that would violate Mr. Smith's privacy.

        Tuberculosis was once the leading cause of death in the United States. From the late 1800s through the 1940s, TB patients were isolated in sanitariums.

        In 1998, there were about 230 active cases of tuberculosis in Ohio. About a third were in urban Cleveland, according to Sherri Eley, a tuberculosis consultant for the American Lung Association, in Lima.

ABOUT TUBERCULOSIS
  • Tuberculosis (TB), once the nation's leading cause of death, is a bacterial diseasethat most often invades the lungs.
  • There were 230 active cases of TB in Ohio in 1998. Three or four had to be quarantined.
  • TB is more prevalent in urban areas.
  • TB is spread through sneezing and coughing.
  • Symptoms include coughing, sneezing, weakness or fatigue, weight loss, and fever. Symptoms may last for weeks.
  • TB is treated with antibiotics taken for six months to a year.
  • People at risk for TB are drug abusers, alcoholics, those who are HIV-positive, and the elderly, who may have been exposed to the disease when it was more common and now are carriers.
  Also susceptible are people ages 35-50 who have inadequate health care or inadequate living conditions.
  Sources: Ohio Department of Health, Centers for Disease Control and Prevention, American Lung Association
        Of the 230 active cases, only three or four had to be quarantined, said Shirley Dobbins, a tuberculosis nurse with the Ohio Department of Health.

        The deputy “is there to ensure that he does not infect other people,” said Glenn Jones, an assistant county prosecutor who worked with the Adams County Health Department in setting up the quarantine.

        Adams County Sheriff Ray Pendell says that in his 39 years of law enforcement, “I've never had to do anything like this.”

        Mr. Smith, 40, who is in the second week of quarantine, reads, watches TV and works on puzzles to pass the time. When he needs a breath of fresh air, he sits on his small porch. It is expected to take two to three weeks of daily antibiotics before Mr. Smith is considered to not be contagious.

        “I feel a little weak,” he said Wednesday. “It just runs your body down.”

        His wife and children come to visit, but can't go inside.

        Mr. Jones said Ohio law allows a local health department to confine a patient and post a guard when it is in the best interests of the community and the patient.

        Judge David Wilson of Adams County Common Pleas Court said a hearing on the quarantine has been scheduled, but “the health department felt they had enough authority to do something without the intervention of the court.”

        The health department said it is providing Mr. Smith's medicine and that his family is providing food.

        “I'm here to get better,” he said. “But it's a private thing. I went through a circus here with people coming by. I didn't ask to catch this.”

        Dr. Bruce Ashley, county health commissioner, declined to be interviewed. He would answer questions only in writing via a fax machine.

        Dr. Ashley wrote that the officer is there to keep Mr. Smith quarantined and to keep others “away from the patient.” He wrote that Mr. Smith is there voluntarily.

        Mr. Jones said he could not explain the action by county authorities because it would “breach a confidence. I would rather not answer that for fear of invading his privacy.”

        Some neighbors are fearful, while others are accepting, said one neighbor.

        Tammy Pollitt, who lives across the street, looked up the disease in an encyclopedia and talked with the health department.

        “I feel sorry for him,” Ms. Pollitt said. “But some people are scared they might catch it. I read up on it. We haven't had any problems. He's the one who is sick.”

        Dr. Ashley wrote that people who were in contact with Mr. Smith received TB skin tests to determine whether they have had the disease or whether they have become infected by him.

        Mr. Smith said he is not sure how he contracted the disease. He said he was diagnosed with it about two months ago when he went to a hospital in Adams County because he was feeling run down.

        “I'd rather be at home,” than in a hospital, he said. “I'm here to get better. I think it's working.”

        Sheriff Pendell said Mr. Smith has not tried to leave the house since deputies were posted a week-and-a-half ago.

        The cost for the 24-hour guard is about $4,000 so far.

        The guards are off-duty and special-duty officers.

       



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