CHAMPAIGN — For the second time in recent years, local health officials are turning to a state judge for help to keep a patient with tuberculosis from potentially spreading it around the community.
In a hearing set for Friday in which everyone in the room will be required to wear protective, tight-fitting masks, the Champaign-Urbana Public Health District will ask Champaign County Associate Judge Chase Leonhard to order home isolation for the patient, Christian Mbemba Ibanda, of 100 Kenwood Road, C.
Public Health Administrator Julie Pryde said she hopes the judge will order Ibanda to wear an electronic monitoring ankle bracelet.
"He couldn't go out, or it would beep and I'd have the police there," she said. "Without that, I have nothing I can do about it other than camping outside his door."
TB, a contagious bacterial disease that typically attacks the lungs, has been on the decline in the U.S.
But there's still enough of it around to require one full-time public health nurse to tend to patients who have either active or latent TB in Champaign-Urbana, Pryde said.
To keep known TB infection from spreading in the community, patients who have been identified with this disease are asked to sign a contract with the health district to stay home during their entire course of directly observed therapy, in which a nurse brings medication to them and watches them take it. The patients don't leave their homes unless they have medical appointments, and if they do go to the doctor, they must wear masks, Pryde said.
"If anyone comes into their place, which we don't encourage, they wear a mask," she said.
But Pryde says Ibanda hasn't been living up to his end of the treatment bargain.
A petition filed in Champaign County Circuit Court on April 3 by Assistant State's Attorney David DeThorne alleges Ibanda visited a Carle doctor on March 10, and was complaining of a cough since January. A lab test for the bacteria that causes TB came back positive on March 14, with findings confirmed by the state public health lab on April 2.
The petition states public health nurses met with Ibanda on March 11 and discussed his illness and home isolation with him, provided him medication, and Ibanda agreed to a voluntary isolation contract with the health district. He was asked to complete a list of his contacts by the next day, so those people could be tested for TB infection, but he hasn't completed the contact list.
Also alleged in the petition:
— On March 24, nurses found Ibanda sitting on interior hall stairs in his apartment complex without a mask on.
— On March 25, nurses came to his apartment and he wasn't home. They called him on his cellphone, and he told them he was out shopping for things he needed.
— After issuing warnings about the importance of remaining in isolation and wearing a mask to Ibanda, a nurse said she would be making unannounced visits. Ibanda said he had "things to do" and couldn't be expected to stay home, but would wear a mask when he went out.
— On an unannounced nurse visit on March 28, Ibanda didn't respond to prolonged knocks at his door or calls to his cellphone.
— The health district served Ibanda with an order for isolation on April 1, and he refused to consent to it.
— On April 2, a nurse went to Ibanda's home and found an adult woman and 5-year-old girl sleeping there with him present, and neither he nor the visitors were wearing the required masks.
Pryde said this has been "extremely frustrating" for the health district because TB is a potentially deadly disease and some people — babies, the elderly and those with compromised immune systems — are even more vulnerable to being infected.
Other factors that increase the infection risk are having diabetes, undergoing chemotherapy for cancer and being HIV-positive or having AIDS.
The petition asks the court to order Ibanda to be isolated in his apartment during the rest of his treatment (other than for emergencies and medical appointments) unless he has the permission of the health district; to wear a mask if he must leave his home; and to comply with electronic home/GPS monitoring.
It also asks the court to direct Ibanda to take his medication in the presence of a public health nurse, to comply with any testing or other medical recommendations, and to keep people out of his apartment other than government officials performing their duties and his three roommates, two of whom have latent TB.
The hearing is set for 1:30 p.m. Friday at the Champaign-Urbana Public Health District at 201 W. Kenyon Road, C. Anyone attending will need to be there earlier for a protective mask fitting, Pryde said.
Proceedings like this are rare in Champaign County, but it's the second time in her career with the health district that the county has had to bring a petition before the court to try and compel a TB patient to comply with home isolation and treatment, Pryde said.
In 2009, the health district brought a defiant TB patient to court and a judge ordered the patient to stay in his home for treatment and comply with electronic monitoring.
"The community needs to know that every time we have an infectious TB case that we are aware of, we put them in isolation and therapy and the vast number of times people comply with that," Pryde said.
TB spreads through the air through the coughing, sneezing, speaking and singing of an infected person.
TB doesn't spread by kissing, touching someone's hand or touching bed linens; contact with a toilet seat; or through sharing food, beverages and toothbrushes.
TB has been on the decline annually in the U.S. since 1992.