Las Vegas Sun

March 29, 2024

Tuberculosis strands man in LV, isolation

The New Mexico resident had made many doctor visits in the previous two years, but no one could explain his health problems. He had dropped about 70 pounds, suffered high fevers and night sweats, and his wheezing cough was worsening.

Spruill, 55, assumed he had lung cancer and was certain he was dying. His stop in Las Vegas was to visit family - the first leg of a road trip to see his children and grandchildren, possibly for the last time.

When he arrived in mid-July his condition was so grave his daughter rushed him to Spring Valley Hospital Medical Center. There he received a shocking diagnosis. He had active tuberculosis.

Spruill joined the ranks of about 100 Nevadans a year who are diagnosed with active tuberculosis - a potentially deadly disease that's closely monitored by authorities for its potential to become a public health crisis. The good news is that tuberculosis is curable. But treatment is strictly imposed and requires contagious patients to be quarantined.

Spruill was shut in a small, windowless room for 12 days at Spring Valley Hospital and now is stuck in Las Vegas for at least six months while his treatment is supervised by the Southern Nevada Health District. He's one of 67 current patients living with the stigma of the disease and being treated by the district, which is charged with monitoring public health.

Spruill isn't complaining, but it hasn't been easy, either. He's required to stay in Las Vegas or face "involuntary house arrest; and/or incarceration," according to his Aug. 14 order to comply with therapy.

"I no longer have any freedom," Spruill said. "I can't leave Las Vegas. If I left Las Vegas they would throw me in jail for a year."

Tuberculosis is airborne and can be transmitted by coughing, laughing or sneezing, though it usually requires repeated exposure for prolonged periods. In Spruill's case, his infection was passed on to his 6-year-old grandson during a December 2006 visit. The child is now being treated by the health district, too.

Tuberculosis was a scourge in previous centuries, but since antibiotic drugs were introduced to fight the disease after World War II, the numbers of deaths and infections have dropped steadily. In 1953, the first year statistics were kept nationally, there were 84,000 tuberculosis cases and 19,000 deaths in the United States. In 2004 the numbers dropped to 14,000 reported cases and 662 deaths. Nevada's rate of infected patients is about average compared with other states.

Doctors are required to report tuberculosis cases to public health agencies, and in Las Vegas that means patients are put under voluntary quarantine, said Patricia O'Rourke-Langston, a nurse who supervises the Southern Nevada Health District's tuberculosis program. Patients are contagious for only about six weeks after starting antibiotics, but it takes at least six months and as much as two years of monitored treatment for patients to be cured, she said. Patients must be monitored because if they stop their antibiotics before the disease is cured, it can morph into a drug-resistant strain.

The health district spends about $1.5 million a year containing tuberculosis. O'Rourke-Langston said it's unlikely the disease will ever be eradicated because it's worldwide - and international tourists visit Las Vegas. The World Health Organization estimates that in 2004 there were nine million new cases of TB worldwide, and 1.7 million deaths. For the past four years more than half of new TB cases in the U.S. were in foreign-born people, according to the American Lung Association.

Spruill is a free spirit who, after his stint in the Navy during the Vietnam war, has been a minister, homeless advocate, musician and diamond dealer for the past 30 years. Health departments throughout the country are required to provide care to TB patients, but the one nearest his home - on a remote New Mexico commune called "Sanctuary" - says it does not have the resources to directly observe his therapy.

So the divorced father of five rents an apartment near Sahara Avenue and Maryland Parkway. His daily routine is characterized by waiting and isolation. Thursday, he felt weak and needed a visitor's help to carry a chair from his apartment to the fresh air of a courtyard. There he discussed his predicament while waiting all morning for a health district investigator to bring his eight daily pills.

He thinks he contracted TB when he was doing ministry to the homeless and a prison chaplaincy in Houston, where he lived for about 13 years. On one occasion he said a prisoner who was dying of TB wanted to talk to him, and he could not bear to pray with the man while wearing a mask and gown.

"This guy hasn't seen an unmasked face in six months," Spruill recalled. "He's going to feel the touch of my hands when I pray for him."

There were other instances where Spruill says he put his care for people with TB above his own safety, and it caught up to him. He already had bad lungs and was on permanent disability from his stint in the Navy. The tuberculosis started with about 15 asthma attacks a day that developed into regularly coughing up thick yellow phlegm.

He went to Veteran's Administration facilities, but he said they never would perform a chest X-ray or take a sputum specimen - both of which could have diagnosed the disease.

Spruill moved to New Mexico in June 2005 because he hoped the dry climate would help his lungs. He improved for a time, but then the decline started again and reached its lowest point on his road trip.

The social isolation is one of the hardest parts of living with the disease, he said. Even health care workers cringe when he comes near - he's not even allowed to enter the V.A. facility where he picks up his pain medication. His love of Delta blues and Southern rock - he listens to both and plays them on the guitar - have kept him sane, he said. In the hospital, he wrote a blues song with lyrics that include, "Have you ever been unlovable, unwanted, untouchable?"

Spruill wanted to tell his story so people would understand the dangers of tuberculosis and that, "yes, there is a problem, but there's a solution, too," he said. "We need to remove the stigma and unfounded fears."

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