“She’s cured!”

Health officials in Washington state are celebrating the clean bill of health for one particularly notable resident: the woman who refused to isolate and get treatment for her active case of infectious tuberculosis for over a year. She even spent around three months on the lam, dodging police as they tried to execute a civil arrest warrant. During her time as a fugitive, police memorably reported that she took a city bus to go to a casino.

The woman, identified only as V.N. in court documents, had court orders to get treatment for her tuberculosis infection beginning in January of 2022. She refused to comply as the court renewed the orders on a monthly basis and held at least 17 hearings on the matter. The judge in her case issued an arrest warrant in March of 2023, but V.N. evaded law enforcement. She was finally arrested in June of last year and spent 23 days getting court-ordered treatment behind bars before being released with conditions.

This week, James Miller, a health officer for Washington’s Tacoma-Pierce County, where V.N. resides, announced the happy ending.

“The woman cooperated with Pierce County Superior Court’s orders and our disease investigators. She’s tested negative for tuberculosis (also called TB) multiple times. She gained back weight she’d lost and is healthy again,” Miller reported. He noted that V.N. and her family gave the county permission to share the news and said they are now happy she received the treatment she needed.

Amid the legal attempts to get V.N. treated, the health department noted in court documents that V.N. had been in a car accident in January 2023, after which she had gone to an emergency department complaining of chest pain. Doctors there—who did not know she had an active case of tuberculosis—took X-rays of her lungs. The images revealed that her lungs were in such bad shape that the doctors thought she had cancer. In fact, the images revealed that her tuberculosis case was worsening.

Risky infection

Tuberculosis is a potentially life-threatening bacterial infection caused by Mycobacterium tuberculosis, which mostly infects the lungs but can invade other areas of the body as well. The bacteria spread through the air when an infected person coughs, sneezes, spits, or otherwise launches bacterial cells into the air around them. Although transmission mostly occurs from close, prolonged contact, inhaling only a few of the microscopic germs is enough to spark an infection. According to the World Health Organization, tuberculosis killed 1.3 million people in 2022 and infected an estimated 10.6 million. Worldwide, it was the second leading infectious killer after COVID-19 that year.

Treatment for tuberculosis requires lengthy antibiotic regimens, which are typically taken for four to nine months. Drug-resistant infections require second-line, more toxic drugs. In the past, treatment for multi-drug resistant tuberculosis could last up to 20 months, but newer clinical guidances prioritize shorter regimens.

Given the risks to herself and those around her, county health officials did all they could to get V.N. treated. “Seeking a court order is our last resort after we exhaust all other options,” Miller said. “It’s a difficult process that takes a lot of time and coordination with other agencies.”

But according to Miller, V.N. softened to the idea of being treated once she was in custody and county disease investigators worked to gain her trust. “At that point, she realized how serious her situation was and decided to treat her illness,” he said. With treatment, she “regained her health over time.”

“She is now cured, which means that tuberculosis no longer poses a risk to her health,” he concluded. “This also means she is no longer at risk of infecting others.”