The Tacoma-Pierce County Health Department in Washington has obtained multiple court orders requiring a tacoma resident to receive treatment for his active tuberculosis, officials told NBC News on Friday.

So far, the woman has refused to self-isolate or take necessary medication, according to Nigel Turner, director of the department’s Communicable Disease Control division.

“The court order is in effect ordering self-isolation and quarantine,” Turner said. «We’re working with her to assess compliance with that.»

The News Tribune, a local news outlet, reported Friday that over the past year, the health department has repeatedly requested and obtained court orders forcing the woman to self-isolate and receive treatment for tuberculosis. According to the Tribune, the department’s legal motions said the patient had failed to comply with previous orders and at one point she had started but stopped the medication. The health department confirmed the Tribune’s report to NBC News.

A judge issued the latest order on January 20, giving the department the authority to evaluate, treat and detain the woman, beginning next week.

The Department announced on monday that he was following up on the case and said at the time that he was working with the woman’s family to persuade her to agree to treatment.

The department declined to offer information on why the woman refused treatment.

Under washington state lawPublic health officials have the legal authority to seek a court order when a person’s refusal to take medication poses a threat to the public.

Tuberculosis can reach that level because it can be fatal if left untreated, and infected people risk further spreading the disease. The bacteria that cause tuberculosis can be spread through the air when a person with an active case coughs, sneezes, or talks.

The treatment process can last from three to nine months, according to the Centers for Disease Control and Prevention. People who stop drugs before completing treatment can also develop resistance to antibiotics.

Tacoma-Pierce County Health Department, in Tacoma, maps

When it comes to taking legal action, Turner said, «it’s very reluctant for us to do it because obviously we’re balancing the civil liberties of people with protecting the health of the public.»

In the past 20 years, the department said, it has had to enlist the help of law enforcement to detain three people who refused tuberculosis treatment until they were no longer contagious. Turner said the department typically exhausts other measures before seeking a court order, such as enlisting family members, medical providers or infectious disease experts to reason with a patient.

Treatment for tuberculosis usually consists of antibiotics taken daily or weekly over a period of months. People with infectious tuberculosis must be isolated during this time, until they can no longer transmit the disease to others. The vast majority of cases can be cured with medicationaccording to the World Health Organization.

Turner said the length of treatment or the possibility of side effects from the antibiotics could discourage some people from accepting the medication. People who don’t have reliable access to food or shelter may also be reluctant to follow isolation guidelines, she said, so the health department can provide those resources.

Regarding the current patient, he said, the department is «really looking at every opportunity for them to comply and work with us to resolve this as soon as we can.»

the tribune reported that a January legal filing from the health department said the woman had previously gone to the emergency room after a car accident, but had not disclosed her tuberculosis diagnosis to staff. Chest X-rays taken during the visit showed progression of the disease, per the petition, according to the Tribune. The Tacoma health department confirmed the report to NBC News.

Symptoms of active tuberculosis include a bad cough that lasts three weeks or more, chest pain, or coughing up blood or phlegm, according to the CDC.

Nationwide, the number of tuberculosis cases has steadily declined since 1992, According to the Centers for Disease Control and Prevention. The United States Recorded about 7,900 active cases in 2021. TB vaccines are not widely given in the US because the disease is rare and injections are not very effective in adults.

Pierce County sees about 20 cases of active tuberculosis per year, the health department saying.

But some people live with latent TB infections, which means the bacteria are inactive and the host is not contagious and has no symptoms. The CDC estimates that this affects up to 13 million people in the US about 5% to 10% of those latent cases, if left untreated, will develop into active disease at some point in people’s lives.