A Tacoma woman is in custody after refusing tuberculosis treatment for more than a year

A Washington state woman who was diagnosed with tuberculosis has been taken into custody after months of refusing treatment or isolation, officials said on Thursday.

The Tacoma woman, who is identified in court documents as V.N., was booked into a room "specially equipped for isolation, testing and treatment" at the Pierce County Jail, the local health department said, adding that she will still be able to choose whether she gets the "live-saving treatment she needs."

A judge first issued a civil arrest warrant for V.N. in March, 14 months after he'd first approved of the health department's request to order the woman's voluntary detention.

Tuberculosis (commonly referred to as TB) is a bacterial infection that can spread easily through the air. Without treatment, it can be fatal, according to the Centers for Disease Control and Prevention.

Washington state law requires that health care providers report cases of active tuberculosis to the local health department for monitoring.

In Pierce County, the health department says it only sees about 20 active cases of the disease per year, and it works with patients, their families and communities to ensure that infections are treated.

V.N.'s case represents only the third time in the past two decades that a court order has been necessary to execute treatment, the health department said.

Over the course of 17 hearings, health officials repeatedly asked the court to uphold its order for V.N.'s involuntarily detention, which consistently ruled that the health officials had made "reasonable efforts" to gain V.N.'s voluntary compliance with the law.

Officers began surveilling the woman in March, and at one point observed her "leave her residence, get onto a city bus and arrive at a local casino," according to a sworn statement from the county's chief of corrections.

"Respondent's family members were also unresponsive [to] the officer's attempts to contact. It is believed that the Respondent is actively avoiding execution of the warrant," the chief said.

V.N.'s attorney argued that it was unclear whether her client willfully and intentionally defied the court's first few orders for treatment or isolation, according to a March report from NPR member station KNKX.

The attorney did not immediately respond to NPR's request for comment, and the court records cited by KNKX have since been sealed by the judge.

According to the news outlet, V.N.'s attorney cited "past behavior and interactions" that suggested V.N. may not have fully understood the significance of the proceedings and had "not acknowledged the existence of her own medical condition."

The attorney also argued that the Pierce County Jail did not meet the state's legal standards for long-term treatment of a tuberculosis patient, KNKX reported.

V.N. is being detained in a "negative pressure room," the Pierce County Sheriff's Department said in a statement shared with NPR. Such rooms are designed to restrict airflow in order to prevent the spread of disease.

The sheriff's department said V.N. was taken into custody at her home, without incident, and transported to the facility in a vehicle that blocked airflow between the cabin and backseat.

She is not facing criminal charges at this time, the department confirmed.

The court order authorizing her arrest says V.N. will be held in quarantine for no more than 45 days. She could be released earlier if medical tests "conclusively establish that she no longer presents a threat to public health," the judge said.

Tuberculosis cases have steadily declined in the U.S. since the 1990s, with only 7,882 cases reported in 2021, the latest year for which the CDC has released data.

In the late 1800s, tuberculosis killed one out of every seven people in the United States and Europe, according to the CDC. [Copyright 2023 NPR]