When doctors told Francisco Santos he had tuberculosis Friday, health officials said the Gwinnett County 17-year-old refused to believe it.

Then the wiry, dark-haired youth refused to submit to any treatment. Worse, he said he was walking out of the Gwinnett Medical Center in Lawrenceville and heading back to his home country of Mexico, officials said.

"I think he was scared," said David Will, attorney for the Gwinnett County Board of Health.

Gwinnett health officials found themselves in a bind. They had a person with a case of active, contagious tuberculosis, refusing treatment and threatening to carry the disease to a foreign country.

They also were aware of the recent incident involving Atlanta lawyer Andrew Speaker, who also has tuberculosis. After Speaker left for his wedding in Greece, a national news conference set off an international health scare.

In this case, the Gwinnett officials acted decisively: They put Santos in jail Friday evening, in a rare act of a government agency confining a sick person. Santos is the only inmate in a special medical isolation cell designed for inmates with contagious conditions. The cell, which measures about 15 feet by 20 feet, has a special ventilation system that keeps the air from reaching other inmates.

The 5-foot-5 teenager has a toilet, sink, bed and a mirror made of polished metal. Two deputies guard him and the other medical inmates.

Will, the county health attorney, said Santos was detained because he is a public health threat.

"He has active, contagious TB," Will said Saturday. "He is at risk of communicating that with anybody he comes in contact with."

Will said Santos is being held under a court order for confinement. He'll stay in that cell until either he starts cooperating and accepting treatment, or a judge makes some other decision at a Sept. 5 hearing. At that commitment hearing, the judge could decide to place him in a hospital with security.

Looking for recent contacts

Meanwhile, Gwinnett health officials have started tracking down those people Santos may have come in contact with, such as family members. Will said Santos, who lists his address in jail records as Norcross, lives with at least one parent and several younger siblings. His jail records also indicate he is unemployed.

Santos listed his birth place as Mexico. Will said he did not know the status of Santos' citizenship. The Gwinnett jail has two federal immigration agents who screen foreign-born inmates to determine whether to investigate their status and potentially place a hold on them for deportation.

As early as Monday, Gwinnett health officials expect to speak publicly about the extent of Santos' disease and his treatment.

Right now, it remains unclear how long his confinement may go on. If he starts cooperating and obtaining treatment, he could be moved to a hospital and, when he is no longer contagious, sent home for further treatment. But if he continues his denials, the judge may commit him to a hospital with security for treatment, Will said.

Speaker case drew attention

His case arrives only about a month after Speaker, the Atlanta attorney, was released from hospital isolation in Denver. When the Atlanta-based Centers for Disease Control and Prevention interrupted his honeymoon in Greece, Speaker and his bride raced back to the United States to avoid detention in Italy.

Once back in the U.S., Speaker spent time under armed guard at Grady Memorial Hospital — the first person placed under a federal isolation order in more than 40 years. Speaker's case drew heightened concern because he was diagnosed with a particularly drug-resistant form of tuberculosis.

Will he did not know the extent of Santos' disease.

Speaker, commenting on the Santos case, said that if indeed the testing was accurate on Santos being contagious, then the Gwinnett officials acted appropriately.

"It's in the public's interest that he be forced to seek treatment," Speaker said Saturday.

At the same time, Speaker stressed that his case was different. When he left the country, Speaker said Fulton County health officials had said he was not contagious and not a threat to anyone. Fulton County health officials, however, have contended they clearly "advised" Speaker not to travel, and they have since been criticized for failing to sequester Speaker before he departed the country.

In the Santos case, custody was sought by the Gwinnett County health department through a petition for commitment. Such petitions are "extremely rare," Will said. "I personally have not been involved in one in more than a decade," he said.

In his isolation cell, Santos is alert and walking around, officials said. He does not have the appearance of a sickly person and has not been a problem for jail officials, apart from his unwillingness to accept treatment, officials said.

The Gwinnett officials hope his family members talk some sense into the headstrong youth.

"Everybody's hoping he will undergo the treatment," Will said.

Article at: ajc.com

Four family members also tested positive but are not contagious

By CRAIG SCHNEIDER

The Mexican day laborer jailed in Gwinnett County for refusing tuberculosis treatment is an illegal immigrant and officials have begun the deportation process, officials said Wednesday.

Gwinnett Sheriff Butch Conway said Francisco Santos acknowledged to agents of the U.S. Immigration and Customs Enforcement that he is in this country illegally.

old Santos, meaning he will be held and that the deportation process begins. But he said Santos' condition and his status as a minor could complicate a process that can take months.

Because of Santos' age, officials would have to make sure before his return that he has family in Mexico or that the Mexican government would take a role.

Gwinnett County health officials jailed Santos Friday after he refused treatment for an active, contagious case of tuberculosis and threatened to flee to his native Mexico. Santos, who lives in Duluth, has since started taking medicine, but will remain in jail at least until a Sept. 5 hearing in Gwinnett Superior Court on his isolation.

Attempts to reach the ICE agency were unsuccessful Wednesday. Two ICE agents are stationed at the Gwinnett County jail and screen each foreign-born person taken into the jail.

Conway said he does not believe any significant action will be taken to deport Santos until he is "medically clear," meaning that he is no longer contagious. Santos' treatment is expected to last about a year until he is cured, but he is expected to be no longer contagious in about three weeks.

Also on Wednesday, four family members of Santos tested positive for the disease, but they are not showing symptoms, are not contagious and will not be isolated, health officials said.

"They are not actively ill," said Gwinnett health spokesman Vernon Goins. "They've been exposed but they're not contagious."

Health officials have started the four family members on a nine-month regimen of antibiotics, and health workers will be present when every dose of medicine is taken. That will keep them from becoming contagious, Goins said.

One other household relative and three non-household relatives tested negative for exposure to tuberculosis, according to the determinations made Wednesday. Five more came in for testing Wednesday, with results expected Friday. And three more people will be tested Monday, officials said.

Since none of the relatives tested positive for an active, contagious case of tuberculosis, health officials do not plan to expand the testing at this point. In addition, since Santos is responding to the antibiotics, health officials do not plan to test him for the more serious drug resistant type of tuberculosis.

Article at: ajc.com

Teenage patient wanted to leave for Mexico, health department says

A judge ordered a Gwinnett County resident into custody on Friday after he refused medical treatment for a case of "active, contagious tuberculosis," officials said.

The resident, identified as Francisco Santos, was ordered to remain under arrest until a Sept. 5 hearing, said David Will, attorney for the Gwinnett County Board of Health.

Santos allegedly went to the Gwinnett Medical Center in Lawrenceville, where he was found to have tuberculosis.

"He refused to accept the diagnosis, and refused treatment," Will said.

Will identified the patient as "17 or 18." Although a Gwinnett resident, Will said he did not know the status of the patient's citizenship.

"He did say he wanted to leave the hospital and go to Mexico," Will said.

Atlanta attorney Andrew Speaker created an international incident last spring when he was diagnosed with tuberculosis and then left the country for his own wedding in Greece. When the Centers for Disease Control and Prevention interrupted his honeymoon, he and his new wife raced back to the United States to avoid detention in Italy.

Once back in the United States, Speaker spent time under armed guard at Grady Memorial Hospital — the first person placed under a federal isolation order by the CDC in more than 40 years.

In the Santos case, custody was sought by the Gwinnett County health department. The petition was granted by Superior Court Judge Michael C. Clark.

On Friday evening, Santos was transferred from the Gwinnett Medical Center to the county jail, where he will wait until his hearing, the Sheriff's Department confirmed. Will said the jail has an isolation unit with a separate air filtration system.

Petitions for commitment are "extremely rare," Will said. "I personally haven't been involved in one in more than a decade," he said. Under Georgia law, health officials have said they can't obtain a court order restricting a patient's movements until there is a violation of a written directive.

According to the CDC's Web site, in 2006, a total of 13,767 TB cases were reported in the United States, a 3.2 percent decline from the 2005 rate.

Since the resurgence of TB in the United States during 1985-1992, the annual TB rate has decreased steadily. A disproportionately high rate of TB in this country has been seen among Asians and Hispanics, and the CDC is working with international health organizations to help reduce TB in affected countries.

In 2006, 55 percent of TB cases among foreign-born people were reported in people from five countries: Mexico, the Philippines, Vietnam, India and China.

How is tuberculosis spread?

TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks or sings. These germs can float in the air for several hours, depending on the environment. People who breathe in the air containing these TB germs can become infected.

Is it easy to catch TB?

TB isn't spread by touching surfaces or casual contact. Rather, it's airborne -- and requires close and continuous contact. Family members and close friends are the most likely to catch it if anyone does.

What are the symptoms?

The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever and night sweats. The symptoms of TB disease of the lungs may also include coughing, chest pain and coughing up blood.

Source: Centers for Disease Control and Prevention Web site

Article at: ajc.com