Teen Mexican Illegal with TB in Atllanta

When doctors told Francisco Santos he had tuberculosis Friday, health officials said the Gwinnett County 17-year-old refused to believe it.

Then the wiry, dark-haired youth refused to submit to any treatment. Worse, he said he was walking out of the Gwinnett Medical Center in Lawrenceville and heading back to his home country of Mexico, officials said.

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Francisco Santos lives in Norcross with at least one parent and several younger siblings, records show.

"I think he was scared," said David Will, attorney for the Gwinnett County Board of Health.

Gwinnett health officials found themselves in a bind. They had a person with a case of active, contagious tuberculosis, refusing treatment and threatening to carry the disease to a foreign country.

They also were aware of the recent incident involving Atlanta lawyer Andrew Speaker, who also has tuberculosis. After Speaker left for his wedding in Greece, a national news conference set off an international health scare.

In this case, the Gwinnett officials acted decisively: They put Santos in jail Friday evening, in a rare act of a government agency confining a sick person. Santos is the only inmate in a special medical isolation cell designed for inmates with contagious conditions. The cell, which measures about 15 feet by 20 feet, has a special ventilation system that keeps the air from reaching other inmates.

The 5-foot-5 teenager has a toilet, sink, bed and a mirror made of polished metal. Two deputies guard him and the other medical inmates.

Will, the county health attorney, said Santos was detained because he is a public health threat.

"He has active, contagious TB," Will said Saturday. "He is at risk of communicating that with anybody he comes in contact with."

Will said Santos is being held under a court order for confinement. He'll stay in that cell until either he starts cooperating and accepting treatment, or a judge makes some other decision at a Sept. 5 hearing. At that commitment hearing, the judge could decide to place him in a hospital with security.

Looking for recent contacts
Meanwhile, Gwinnett health officials have started tracking down those people Santos may have come in contact with, such as family members. Will said Santos, who lists his address in jail records as Norcross, lives with at least one parent and several younger siblings. His jail records also indicate he is unemployed.

Santos listed his birth place as Mexico. Will said he did not know the status of Santos' citizenship. The Gwinnett jail has two federal immigration agents who screen foreign-born inmates to determine whether to investigate their status and potentially place a hold on them for deportation.

As early as Monday, Gwinnett health officials expect to speak publicly about the extent of Santos' disease and his treatment.

Right now, it remains unclear how long his confinement may go on. If he starts cooperating and obtaining treatment, he could be moved to a hospital and, when he is no longer contagious, sent home for further treatment. But if he continues his denials, the judge may commit him to a hospital with security for treatment, Will said.

Speaker case drew attention
His case arrives only about a month after Speaker, the Atlanta attorney, was released from hospital isolation in Denver. When the Atlanta-based Centers for Disease Control and Prevention interrupted his honeymoon in Greece, Speaker and his bride raced back to the United States to avoid detention in Italy.

Once back in the U.S., Speaker spent time under armed guard at Grady Memorial Hospital — the first person placed under a federal isolation order in more than 40 years. Speaker's case drew heightened concern because he was diagnosed with a particularly drug-resistant form of tuberculosis.

Will he did not know the extent of Santos' disease.

Speaker, commenting on the Santos case, said that if indeed the testing was accurate on Santos being contagious, then the Gwinnett officials acted appropriately.

"It's in the public's interest that he be forced to seek treatment," Speaker said Saturday.

At the same time, Speaker stressed that his case was different. When he left the country, Speaker said Fulton County health officials had said he was not contagious and not a threat to anyone. Fulton County health officials, however, have contended they clearly "advised" Speaker not to travel, and they have since been criticized for failing to sequester Speaker before he departed the country.

In the Santos case, custody was sought by the Gwinnett County health department through a petition for commitment. Such petitions are "extremely rare," Will said. "I personally have not been involved in one in more than a decade," he said.

In his isolation cell, Santos is alert and walking around, officials said. He does not have the appearance of a sickly person and has not been a problem for jail officials, apart from his unwillingness to accept treatment, officials said.

The Gwinnett officials hope his family members talk some sense into the headstrong youth.

"Everybody's hoping he will undergo the treatment," Will said.