Government issues guidelines to stem rising tuberculosis rates in prisons

Article Abstract:

Tuberculosis, TB, is an infectious disease caused by the bacteria Mycobacterium tuberculosis. It is characterized by the formation of tubercles, which are elevated, round structures and generalized tissue damage, particularly in the lungs. Although TB rarely occurs in the general population, there is an increasing incidence of TB in prison populations. Since 1985, there have been 11 outbreaks of TB in prisons in eight states. Overcrowded and poorly ventilated prisons provide ideal conditions for the spread of tuberculosis. In addition, individuals who are at risk for TB comprise a large proportion of prison populations. Prisoners have a higher rate of human immunodeficiency virus, HIV, than the general population and the incidence of TB may be related to the HIV epidemic. For example, patients with HIV, which causes acquired immunodeficiency syndrome, AIDS, have weakened immune systems and are probably at high risk for developing TB. Although the relation between HIV and TB infections is not well known, one study showed that four percent of the AIDS patients in the United States also had TB. In addition to the risk of TB transmission within prisons, there is a danger that prisoners with TB may infect the communities into which they are released. As a result of the increased numbers of TB outbreaks in prisons, guidelines were developed by the Centers for Disease Control which focus on surveillance, containment, and assessment of TB. Recommendations also include cooperation of public health departments in training prison staff, reducing crowding and improving ventilation of prisons.

Demographic aspects

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Jails lead prisons in smoking bans

Article Abstract:

A smoke-free society by the year 2000 is a national health goal. If a recent trend continues, however, this goal may only be realized in jails. At the 1990 annual meeting of the American Jailers Association, a resolution calling for jails to be smoke-free facilities was approved. Jails, which are used for short-term holding of prisoners, are more likely to ban smoking than are prisons. Several jails now have smoking bans, and report greatly reduced costs of maintenance and cleaning as a result. Marked reductions in worker absenteeism and health care costs for both jail staff members and prisoners have been reported. Fears that bans on smoking would lead to violence within correctional institutions have not been realized, and in fact the imposition of smoking bans has proven relatively easy. The jailer of Fairfax County, Virginia reports that following the imposition of a ban in his overcrowded jail, the level of sick calls has declined by one third. The medical staff sees fewer smoking-related health problems, and the use of medication has also declined. Similar results and absence of violence were seen when the King County Correctional Facility in Seattle went smoke-free. No disturbances occurred, not even a petition from inmates, and significant gains in inmate health have been achieved. The ban also saved the facility from a threatened suit by inmates who objected to smoking within the facility. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Smoking, Jails

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Prevention and control of tuberculosis in correctional institutions: recommendations, advisory committee for elimination of tuberculosis

Article Abstract:

Tuberculosis, TB, an infectious disease caused by the bacteria Mycobacterium tuberculosis, is characterized by the formation of elevated, round tissue growths and generalized tissue damage. The lungs are the body organ most often affected by TB. Overcrowding and poor ventilation in correctional institutions provide ideal conditions for the spread of tuberculosis among prison populations. The incidence of TB among inmates in correctional institutions is three times higher than that of the same age group in the general population. Since 1985 there have been 11 known outbreaks of TB in prisons in eight states. Infection by the human immunodeficiency virus, HIV (which causes acquired immunodeficiency disease, AIDS), increases a prisoner's risk for developing TB. The transmission of TB is also a problem for the community into which an infected prisoner is released. Control of tuberculosis should be an important aspect of correctional health care, and should focus on surveillance, containment, and assessment of the disease. Aspects of diagnosis, case reporting, isolation of persons with TB, treatment, preventative therapy, and assessment are discussed. The role of the Public Health departments in assisting correctional institutions is also outlined.

Evaluation, AIDS (Disease), Preventive health services, Preventive medicine, AIDS (Disease) in prisons

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