When deputies stopped Eduardo Rosas Cruz's vehicle Monday evening in Lamont, they didn't treat him like they would any other traffic violation.
He was ordered to put on a protective face mask they gave him. They put on masks, too, as well as latex gloves.
Deputies hadn't stopped the 25-year-old Cruz for speeding or unsafe driving. He'd been the subject of an ongoing Central Valley manhunt since March, and they recognized his car.
Cruz, a transient who's a Mexican national, is infected with a drug-resistant strain of tuberculosis, or TB. He'd been ordered to take medication after being diagnosed in March at French Camp's San Joaquin General Hospital emergency room. He had complained of a cough and shortness of breath. Court records also show he had used crack cocaine and methamphetamine for the past year.
A San Joaquin County public health nurse said in court documents she had ordered Cruz to stay in isolation in his Stockton hotel room for treatment of his TB. Instead, he fled.
State law allows county public health officials to request arrest warrants be filed by the county district attorney's office in some matters of public health. And that's what Stephen Taylor, San Joaquin County's deputy district attorney, did.
TB is caused by inhaling a bacteria -- commonly spread through the air by coughing and sneezing -- and usually attacks the lungs. The bacteria, however, can affect any part of the body such as the kidneys, spine and brain. People with compromised immune systems, such as the homeless, those with HIV and AIDS, and inmates, are particularly susceptible. If not treated properly, TB can be fatal.
Taylor said it is common for TB patients who are addicts to not take their medication and ignore the potential public danger in order to find drugs.
"TB meds have side effects," Taylor said. "It's difficult to get high (while on them) so it will push them into withdrawal. So they have to take more narcotics to get high."
At any given time, San Joaquin County Public Health Services handles about 50 TB cases with patients who are under orders to take medications, Taylor said. Most of the people not complying are active drug users, he said.
Once Cruz bolted, deputies and police throughout San Joaquin County had been searching for him at homeless shelters and jails throughout the county.
After learning he might be in Bakersfield, Kern County deputies received information on the type of vehicle he was driving. They spotted Cruz around 8:10 p.m. Monday, Kern County Sheriff's spokesman Ray Pruitt said. Deputies stopped him near Bonita Road and Velma Avenue in Lamont on the public health safety warrant out of San Joaquin County. He was taken to Kern Medical Center for treatment.
The hospital has various levels of isolation rooms equipped with filtration systems and negative airflow that prevent air particulates from exiting, said KMC CEO Russell Judd. TB patients are often put in those rooms.
Judd said anyone entering such rooms wears appropriate protection. The hospital has several different protective face masks depending on the patient's type of airborne disease.
Cruz remains at KMC undergoing treatment.
Cases of TB in the United States have decreased dramatically since the 1950s. In 1953, when nationwide reporting of TB cases began, there were more than 84,000 new cases reported. By 2013 there were 9,588 new TB cases, according to the Centers for Disease Control and Prevention.
Foreign-born TB, likely the type Cruz is carrying, is an ongoing problem in Mexico. According to the CDC, in 2013 there were 6,172 TB cases among foreign-born people living in the U.S. Of those, 20 percent were Mexican nationals. Research shows many cases of TB from Mexico are drug-resistant strains.
Such drug-resistant forms of TB are relatively low in the U.S., but worldwide an estimated half-million people contract them. Those types of TB can be treated, but take longer and are more expensive.
In 2010, the most common form of TB cost a patient about $17,000 to cure, including lost productivity during treatment, according to a CDC study. An extensively drug-resistant form of the disease could cost up to $554,000 to cure.
Refusing to comply with a tuberculosis order in California is a misdemeanor crime punishable by up to one year in jail.
Pruitt would not say whether the arresting deputies would undergo testing for tuberculosis.
He did confirm one thing, however: The patrol vehicle used by deputies to take Cruz to KMC was later decontaminated.