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| Pandemic “not so” preparedness |
| By Jim Montalto, News Editor |
| Published: 11/06/2006 |
The Infectious Diseases in Corrections Report recently published its combined October/November issue, which focuses heavily on pandemic flu preparedness and also covers important advances for the control of the Varicella zoster virus.As if the idea of a pandemic wiping out entire populations isn't scary enough, Dr. Rachel Schwartz, from the Saint Louis University School of Public Health's Institute for Biosecurity, begins her article, Pandemic Flu Preparedness and Response in Corrections Facilities with dismal news from the Far East. “In 2003, one person in China and three in neighboring Vietnam became infected with Avian Influenza (H5N1). All died. Last year, 95 human cases with 41 deaths from Avian influenza were reported to the World Health Organization (WHO), and already this year, there have been 94 cases with 63 deaths in Africa and Asia - including Turkey and Azerbaijan. Although the total number of cases has been low, and transmission has been primarily from animal to human, the high mortality rate and lack of effective treatments or vaccines for Avian influenza (H5N1) have fanned concerns that the virus could mutate to become transmittable between humans, and wreak the kind of worldwide devastation caused by the 1918-1919 Spanish Influenza pandemic - a global outbreak that caused approximately 50 million deaths worldwide, and created socio-economic and political havoc.” This information is not encouraging, and the fact that practitioners in the health and corrections arenas have already expressed worry about inadequate pandemic preparedness in correctional settings makes Schwartz's piece even more relevant. Health practitioners are saying that historical patterns of pandemic influenza cycling suggests that it is not so much “if” as it is “when” the next pandemic hits, and that H5N1 or a similar virus will be responsible. This potential threat has triggered efforts to increase the watch for influenza. Preparedness and response planning, along with research and development of therapeutic interventions, have also been stepped up. In the U.S. many hospitals, schools, utilities, communities and families are receiving support and information to help them prepare for widespread influenza. However, “to date, the unique issues of correctional institutions have largely been ignored.” According to, a study by the International Centre for Prison Studies, more than 9 million people are in penal institutions throughout the world, 2 million of which are in the U.S. This worries health care officials as this high number of confined prisoners could have a drastic impact on the public's health. Schwartz says “the fluidity of movement of individuals between correctional facilities and their communities can have serious public health implications were pandemic influenza to strike. Within the confined facilities of a jail or prison it is not difficult to image how the entry of even a single person, inmate or staff, incubating highly infectious pandemic influenza could spark a devastating outbreak - akin to the lethal waves of influenza that spread among the barracks of soldiers in the early twentieth century.” Schwartz, however, does bring to light important concepts that will help facilities prepare for pandemic flu in a prison environment. She suggests “increased surveillance of potential cases at commitment, the designation of specific areas which may serve as isolation and/or quarantine space in the throes of an outbreak, and the need to work closely with security personnel to formulate practical guidelines individualized to each facility.” Access to hospitals services and care, along with treatment and containment strategies, and steps to answer potential large absenteeism rates must also be considered. In his case study, Dr Joseph Bick, Chief Medical Officer at the California Department of Corrections medical facility, discusses the advances in controlling Varicella zoster virus (VZV). It is important to note that vaccinations can protect against primary varicella and boost the immune system to help those previously infected minimize VZV development. Bick also re-emphasizes that VZV outbreaks often incite fear among staff and inmates, so facilities should incorporate vaccinations in their employee immunization program to minimize a potential crisis and pro-actively protect staff. Visit the IDCR website to read the entire report. Related Resources: The next pandemic: Are we really prepared? 8/06 PandemicFlu.gov Jail can't handle flu, The Daily Journal, 10/13/06 |
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