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Protecting the Health of Incoming Prisoners: Six Diseases Correctional Administrators Should Be Aware Of
By Robert Kravitz, President AlturaSolutions
Published: 04/15/2019

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Incoming prisoners tend to be at higher risk of contracting a disease, virus, or infection than those inmates that have been living in the same correctional facility for several months or years. Very often, the new inmate has a weakened immune system due to several factors, making them more susceptible to acquiring an illness upon entry.

However, what might be an even more significant factor is the fact that germs, bacteria, and viruses may already be present in the facility that staff and inmates have developed immunities to. As a result, new inmates often become ill, with minor and sometimes serious illnesses shortly after entry. According to Seven Todts with the European office of the World Health Organization, the following are some of the most common infections – apart from HIV and TB – that new correctional inmates may contract:

Influenza

Since the 1880s in the U.S., there have been several major outbreaks of influenza in correctional facilities. In fact, an outbreak that began in 1918 at San Quentin prison in California may have been the source of a pandemic which spread around the world between 1918 and 1920. Prisoners should be given flu vaccination shots upon entry and if they still become ill with influenza, separated from the general population if possible until they are well.

Measles, Mumps, and Rubella

These are highly contagious viral diseases. For instance, just a droplet of the germs that cause measles, becoming airborne by coughing, can cause someone that does not have the proper immunities or is malnourished to become ill. Inmates should be asked if they have received vaccinations against the measles, mumps, and rubella. If not, they should be vaccinated. Further, this is strongly advised for female prisoners of childbearing age upon entry.

Viral Hepatitis

While this is a problem in correctional facilities around the world, in Europe, prison populations are disproportionately affected by viral hepatitis. The reasons this is true in Europe are the same reasons it is likely true in the U.S., and that is the lifestyles of many prisoners before entering the correctional facility. These lifestyles often include drug use and the sharing of needles; tattooing, and risky sexual behavior. Once again, vaccinations of new prisoners are highly recommended to prevent viral hepatitis. Related to this is the transmission of hepatitis A. If a prisoner has already had hepatitis A, they are now immune. However, for those that have not, the unfortunate thing about hepatitis A is that prisoners may have the disease for several weeks before they are aware of it. During this time, these prisoners are contagious and can spread the illness to many others. If possible, Todts suggests “it is sensible to vaccinate all non-immune incoming prisoners.”

Tetanus

Tetanus is caused by a bacterium that enters the body through a small but open wound. Very often these wounds become soiled, which can put prisoners at even higher risk. Tetanus can cause generalized muscle spasms, but what correctional administrators should know is that it can also cause death. While tetanus is rare, compared to the other diseases mentioned so far, “nevertheless, incoming prisoners should be vaccinated unless they have proof of their immune status,” according to Todts.

Diphtheria

Similar to tetanus, diphtheria is also caused by bacteria. It is typically spread by someone with the disease sneezing or coughing. Contracting diphtheria, the prisoners can experience mild to severe nose and throat problems as well as difficulty breathing. Diphtheria can even cause heart failure or paralysis. According to Todts, mortality rates are about five to 10 percent. Once again, “incoming prisoners should be vaccinated unless their immune status can be proven, using the combined diphtheria/tetanus vaccine for adults.”

Ectoparasites

Scabies and lice are not uncommon in prisons, and very often it is new inmates that are most susceptible to what is broadly termed ectoparasites. There are no vaccines for scabies or lice. However, if not treated, new inmates can spread ectoparasites to others in the correctional facility. Very often, this problem is self-diagnosed. The prisoner complains to correctional staff of skin lesions or sensitive areas, especially on the scalp. These complaints should be addressed by medical staff quickly. Topical treatments are available, and very often, treatment includes allowing the infected inmate to take more frequent showers until signs of the problem have lifted.

It appears the key takeaway here for correctional administrators is to interview new prisoners, asking questions about their vaccination history. In all too many cases, new prisoners have not been vaccinated for any of the diseases mentioned here or may not know if they have or not. In such cases, it is best to take a proactive approach, vaccinating all new prisoners upon entering the correctional facility.

Robert Kravitz is a frequent writer for the correctional industry.


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