Ticking Time Bomb: Prisons Unprepared for Flu Pandemic,
Says New SLU Research

As the fear of an impending avian flu pandemic is compelling hospitals, businesses and cities to develop preparedness plans, one of the most potentially dangerous breeding grounds of disease is woefully ill-prepared for a crisis, according to a new study being presented today by researchers at the Institute for Biosecurity.

"There’s a real failure to recognize how important the health status of inmates is to the public health of all of us," says Rachel Schwartz, Ph.D., a researcher at the Institute for Biosecurity. "Nearly 85 percent of those in jails and prisons will be released within a year. So even if we as a society don't think protecting them from disease is a priority, prisoners released into the general population pose a real threat to society."

The research was presented this month at the Correctional Medicine Institute’s 2006 Conference in Baltimore.

There are more than two million prisoners in the United States, making up what Schwartz calls "a highly vulnerable population."

"There’s a much higher level of disease among prisoners—people with HIV, drug-resistant tuberculosis, hepatitis C and other diseases," she says.

She adds that 80 percent of inmates come to prison with some sort of illness.

"And once they’re incarcerated, they’re more likely to get other diseases. It makes correctional facilities into ticking time bombs. Many people crowded together, often suffering from diseases that weaken their immune systems, form a potential breeding ground and reservoir for diseases."

Schwartz and fellow researchers studied research and protocols from the Centers for Disease Control, the World Health Organization and other governments to identify what plans were in place for prisons should an infectious disease break out.

Many of the correctional facilities that Schwartz and colleagues studied have acknowledged they don’t have an adequate plan to deal with a pandemic or similar health crisis. Schwartz says there’s reluctance among government leaders to provide prisoners with medical care, such as flu vaccines.

"The thinking is that there won’t be enough for the general public, and that they should get the shots first," she says. "We tend to think of all inmates as being violent offenders, but the average length of incarceration is only 48 hours. Many are not convicted criminals, but rather people merely accused of crimes and awaiting trial.

"We know that illness among prisoners will eventually spread and cause illness in society, so we must address this now."

The solution, says Schwartz, is to spend more energy and money on preparedness. She and fellow researchers developed a plan to educate the judicial and prison systems on ways to prevent the spread of disease, from meticulous hand-washing to appropriate use of quarantine and isolation in prison and jail settings.

The pandemic plans are designed to provide useful information for many kinds of crisis situations, Schwartz says.

"Ideally, they will help authorities prepare and respond to anything from a bird flu breakout to a biological attack. The information is also critical for existing illnesses within prisons, like HIV, not just emerging infections."