Woman jailed to force TB cure

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This article was published 06/06/2008 (6560 days ago), so information in it may no longer be current.

A woman infected with a virulent and potentially deadly form of tuberculosis is being forced to undergo medical treatment in a provincial jail after health officials obtained a rare court order to detain her by arguing she is a threat to public health, the Free Press has learned.

Dorothy Bittern has been detained at an undisclosed location since January. Manitoba Justice and Winnipeg Regional Health Authority officials refused to confirm which facility Bittern is being held at, nor would they disclose whether any inmates or correctional staff have been tested for TB since her arrival.

The Winnipeg Regional Health Authority filed a court application in May to extend Bittern’s detention by 90 days, saying she “remains a threat to the health of the public until such time as she has been cured of her disease.”

The document suggests Bittern is the first person to be legally mandated to undergo medical treatment for posing a danger to public safety in the province, but health officials couldn’t confirm if the extraordinary step has never happened before.

“It’s very rare, and the reason it’s rare is because most patients who have sexually transmitted infections or TB do comply with their treatment,” said WRHA medical officer Margaret Fast.

According to court documents, Bittern has repeatedly stopped medical treatment for TB and received only four sporadic months of the nine-month minimum treatment to cure the disease — putting her at a higher risk for developing drug-resistant TB that is difficult or impossible to treat.

A “contact” of Bittern’s has contracted TB, and health officials allege it’s “highly probable” the person was infected by Bittern.

If Bittern is not detained in hospital or in a provincial correctional facility, the WRHA alleged she will continue to pose a danger to the public.

Bittern did not have a lawyer during the court proceedings. An order to mandate her medical treatment was granted by the Court of Queen’s Bench on May 13, allowing her to be detained at Health Sciences Centre or an “appropriate correctional facility.”

A WRHA spokesman confirmed Bittern is not at HSC.

“Each time she stops treatment prematurely, the likelihood increases that Ms. Bittern may become more resistant to the drugs used to treat her disease,” the WRHA said in the court application.

TB bacteria can be spread to others by coughing or sneezing in the air. Since the bacteria can remain in the air for several hours, anyone who shares the same airspace as a person with an active infection is at risk of infection.

Court documents reveal Bittern was first admitted to the HSC with TB on Aug. 21, 2007, and left the hospital against medical advice on Sept. 11. Bittern was later readmitted to the HSC on several occasions in September 2007, and entered a community outreach program to monitor her TB treatment in October.

The program lost touch with Bittern and she was later found using crack cocaine. She is addicted to crack cocaine and is known to exchange sex for money or drugs. She has a limited support network of family and no permanent place to live.

On Nov. 7, Dr. William Libich, a WRHA medical officer, filed a court order requiring Bittern to show up for treatment at HSC. Bittern didn’t comply and a warrant was issued. She was later brought to HSC by a justice of the peace.

During the first three weeks of treatment, Bittern made attempts to escape from the hospital, causing damage to her room in the process.

She was released from hospital in December back into community therapy, where she immediately fell out of contact with the program.

A subsequent court order was issued to force her into treatment in January.

“Ms. Bittern is upset and hostile toward public health staff for requiring her to receive treatment,” the court document said.

Fast said it’s important the public realize that TB is not a disease of the past and that public health staff use strict infection-control practices when dealing with it.

jen.skerritt@freepress.mb.ca