Homeless Man with Active Tuberculosis Defies Isolation Orders in New Hampshire
A homeless man in New Hampshire, who has been carrying active tuberculosis for at least eight months, has created a major public health conundrum. State authorities have repeatedly failed to secure his compliance with isolation mandates, despite multiple attempts to enforce treatment and containment.
Persistent Non-Compliance and Legal Actions
Nearro F. Forbes, aged 41, has been roaming the streets of Manchester and Nashua, consistently rebuffing offers of medical intervention. The state has issued isolation orders to force him into three different hospitals, all of which he has defied. In a recent escalation, the New Hampshire Department of Health and Human Services petitioned a judge to order his isolation at a male prison in Concord, selected for its airtight negative pressure room designed to prevent airborne transmission.
Despite legal concerns raised by the state attorney general's office regarding detention by the Department of Corrections, Merrimack County Superior Court Judge Martin P. Honigberg ruled on Tuesday that the DHHS isolation order was justified. The judge directed Forbes to immediately isolate at a fixed place of his choosing and submit to medical treatment and observation for thirty days. Non-compliance could result in contempt of court charges, potentially leading to jail time.
Public Health Risks and Exposure Concerns
This situation follows a state announcement in October revealing that over 650 individuals were potentially exposed to active tuberculosis at homeless clinics and correctional facilities in Nashua and Manchester during the first half of 2025. Officials have not confirmed whether Forbes was the source of these exposures. Testing of 100 potentially exposed individuals identified two additional active tuberculosis cases. New Hampshire typically records around twelve tuberculosis cases annually, though official figures for last year remain unreleased.
Elizabeth Maynard, a DHHS attorney, stated that the state has provided tuberculosis testing clinics and contact-tracing services for those who believe they may have been exposed. She indicated that this approach will likely be the ongoing strategy, rather than allocating extensive resources to detain Forbes, who is expected to remain non-compliant.
Failed Isolation Attempts and Ongoing Challenges
Judge Honigberg noted in his order that officials have attempted to place Forbes in less restrictive environments than a prison, including an outpatient substance abuse treatment facility, a transitional housing unit, and even a motel. In October, Forbes was ordered into isolation at Elliot Hospital in Manchester but did not comply. Authorities took him to Southern New Hampshire Medical Center in Nashua last week, but he left before receiving treatment. A November order to isolate at Catholic Medical Center in Manchester also failed, as he departed after a few hours.
Authorities lost contact with Forbes for three months until he was spotted exhibiting symptoms at a warming station in Nashua. Tuberculosis spreads through the air, and symptoms may not appear immediately, with bacteria capable of lying dormant for months. As the infection progresses, symptoms can include chest pain, weakness, weight loss, loss of appetite, chills, night sweats, and in severe cases, coughing up blood. Without treatment, Forbes's condition could be fatal.
Recent Developments and Resource Constraints
Forbes was intercepted by authorities last week while attending a court hearing on unrelated charges. He was taken to Southern New Hampshire Medical Center in Nashua and ordered to remain there, but he left again. The hospital has stated it will only readmit him if the state provides round-the-clock security, a requirement Maynard says her department cannot afford due to budgetary limitations.
Maynard's final hope is that Forbes is charged with a misdemeanor for violating the DHHS isolation order. In such a scenario, she expressed concern about detaining him in a county facility, which could risk exposing other inmates to tuberculosis. This ongoing case highlights the complex intersection of public health, legal enforcement, and resource allocation in managing infectious disease outbreaks among vulnerable populations.
