Jade01
05-02-2005, 08:42 PM
http://www.ardemgaz.com/ShowStoryTemplate.asp?Path=ArDemocrat/2005/05/01&ID=Ar01901
Staph outbreaks worrisome
BY CHARLIE FRAGO ARKANSAS DEMOCRAT-GAZETTE
Recent outbreaks of staph infections in Arkansas prisons have prompted prison officials to waive a new medical co-payment for prisoners to encourage them to seek treatment.
The outbreaks reflect a national trend among correction populations, raising the possibility of persistent, sometimes drug-resistant staph infections spreading outside prison walls as infected inmates are released.
Since early March, 37 of the 700 inmates at the women’s McPherson Unit in Newport were treated for staph infections, according to prison officials. Six of the women had staph infections that resisted antibiotics.
Other outbreaks occurred in the 1,632-bed East Arkansas Regional Unit near Forrest City, where exact numbers of infections were unavailable but had been "kind of rampant" before fading away in recent weeks, said Dina Tyler, spokesman for the Department of Correction.
Aside from some work-release units, most of the state’s prisons have seen at least some staph cases in the past few years. The painful, dangerous skin infections have rattled many inmates, Tyler said, prompting them to pay closer attention to hygiene.
"There’s a low-grade panic that sets in," she said. "They don’t want what is going around."
In an effort to encourage inmates to alert doctors when they think they have a staph infection, the $3 medical co-pay has been waived, Tyler said. The payment was started in January to cut down on what prison officials called unnecessary sick calls. Prison advocates and some inmates say making inmates pay to see a nurse or doctor makes them less likely to seek medical help.
1
In the past 1 /2 years, more than 2,000 skin infections have been reported among the approximately 13,500 inmates in the prison system, according to data from Correctional Medical Systems, a St. Louis-based medical provider that contracts with the state to provide health care to its inmates.
Correctional Medical Systems does not track whether those skin infections were staph-related, Tyler said.
Staph infections, which often begin with an injury to the skin, can cause a broad range of symptoms. Infection often results in redness, swelling and tenderness. Staph infections can penetrate into bones and lungs and can be fatal if left untreated.
Debbie Christian, one of the infected women at McPherson, had boils under her arms and on her stomach and face that worsened from late February to mid-April, according to a letter she wrote to Vickie Frazier, a Greenbrier resident and aunt of a McPherson inmate.
"The one on my nose got so big my eyes were almost swollen shut," wrote Christian, 33, imprisoned since 2003 on drug charges.
Scheduled for release in September, Christian worried about passing on the staph infection to her family. Antibiotics had not worked for her, she wrote.
"I want to be able to play with my kids when I am released," she wrote.
Another inmate, Janie Brooks, 38, in prison since 1999 on second-degree murder charges, described the pain as "like a needle being poked in my arm and my arm gets so hot it will start shaking."
A common bacteria found in the nostrils of one in three people, staph is easily transmitted in confined, high-density populations.
A study appearing in the April 13 issue of the New England Journal of Medicine found that staph infections are increasingly common in the general population and are more frequently drug-resistant. The study examined more than 1,600 cases in Baltimore, Atlanta and Minnesota.
The commonality of the infection makes it that much harder to keep out of prisons, Tyler said.
"Most of our staph is garden variety," Tyler said, "but you have to watch it because it could be serious."
Frazier said her niece, Tonya Hill, and f ive other women at McPherson contacted her after contracting staph infections. Hill had 11 boils at one time on her skin, Frazier said.
"Some of them are there for murder; some of them are there for drugs. It don’t matter what they’re over there for," Frazier said, adding that inmates should receive adequate medical attention.
The state Department of Health has advised the Correction Department on how to control the spread of the organism, including washing the laundry of infected inmates separately.
"The main thing is getting them to wash their hands," Tyler said.
Dr. Nate Smith, medical director for infectious diseases for the Health Department, said a complaint from a family member of an inmate prompted a call from a communicable disease nurse to McPherson’s head nurse in March.
A nurse trained in sanitary procedures also visited the McPherson’s kitchen and found everything to be in order, Smith said.
"The approach we have taken is an advisory approach. We don’t have regulatory authority over the Department of Correction, but they’ve been very open to our suggestions," Smith said.
Because staph infections are increasingly common in the outside community, new inmates bring in the organism all the time, making it difficult to stamp out, Smith said.
A bigger threat, say Smith and other doctors, is that inmates will spread the staph bacteria to their friends, relatives and co-workers after they are released from prison.
To prevent that, inmates and their doctors need to learn how to treat infections and keep them from spreading, said Dr. Rachel Gorwitz of the National Center for Infectious Diseases at the federal Centers for Disease Control and Prevention in Atlanta.
"Education is key. There are really some very basic things people can do," Gorwitz said.
The CDC completed a study in October 2003 of staph infections in correctional facilities in Georgia, California and Texas which identified the five "C’s" of the disease: crowding, frequent skin to skin contact, compromised or injured skin, contaminated personal items and lack of cleanliness.
Later that year, the federal Bureau of Prisons released guidelines for care that incorporated those findings. Some states, like Texas, have followed those principles and seen a decrease in staph infections in recent years.
Unlike Arkansas, the Texas prison system has tracked staph infections since 1996. In 2000, doctors saw a large increase that peaked in 2002 before slowly receding.
Last year, 4,980 cases appeared in a prison population of 150,000.
Dr. Michael Kelley of the state’s Health Services Division said outbreaks have been contained by public education among inmates, stressing personal hygiene and reintroducing antiseptic hand soap.
Requiring that all skin infections be cultured also keeps Texas prison doctors on top of new strains, Kelley said.
Arkansas does not plan to follow Texas’ model, Tyler said. Currently, Correctional Medical Systems tracks HIV and tuberculosis infection rates, but not staph.
"It’s just not something they do," Tyler said.
Staph outbreaks worrisome
BY CHARLIE FRAGO ARKANSAS DEMOCRAT-GAZETTE
Recent outbreaks of staph infections in Arkansas prisons have prompted prison officials to waive a new medical co-payment for prisoners to encourage them to seek treatment.
The outbreaks reflect a national trend among correction populations, raising the possibility of persistent, sometimes drug-resistant staph infections spreading outside prison walls as infected inmates are released.
Since early March, 37 of the 700 inmates at the women’s McPherson Unit in Newport were treated for staph infections, according to prison officials. Six of the women had staph infections that resisted antibiotics.
Other outbreaks occurred in the 1,632-bed East Arkansas Regional Unit near Forrest City, where exact numbers of infections were unavailable but had been "kind of rampant" before fading away in recent weeks, said Dina Tyler, spokesman for the Department of Correction.
Aside from some work-release units, most of the state’s prisons have seen at least some staph cases in the past few years. The painful, dangerous skin infections have rattled many inmates, Tyler said, prompting them to pay closer attention to hygiene.
"There’s a low-grade panic that sets in," she said. "They don’t want what is going around."
In an effort to encourage inmates to alert doctors when they think they have a staph infection, the $3 medical co-pay has been waived, Tyler said. The payment was started in January to cut down on what prison officials called unnecessary sick calls. Prison advocates and some inmates say making inmates pay to see a nurse or doctor makes them less likely to seek medical help.
1
In the past 1 /2 years, more than 2,000 skin infections have been reported among the approximately 13,500 inmates in the prison system, according to data from Correctional Medical Systems, a St. Louis-based medical provider that contracts with the state to provide health care to its inmates.
Correctional Medical Systems does not track whether those skin infections were staph-related, Tyler said.
Staph infections, which often begin with an injury to the skin, can cause a broad range of symptoms. Infection often results in redness, swelling and tenderness. Staph infections can penetrate into bones and lungs and can be fatal if left untreated.
Debbie Christian, one of the infected women at McPherson, had boils under her arms and on her stomach and face that worsened from late February to mid-April, according to a letter she wrote to Vickie Frazier, a Greenbrier resident and aunt of a McPherson inmate.
"The one on my nose got so big my eyes were almost swollen shut," wrote Christian, 33, imprisoned since 2003 on drug charges.
Scheduled for release in September, Christian worried about passing on the staph infection to her family. Antibiotics had not worked for her, she wrote.
"I want to be able to play with my kids when I am released," she wrote.
Another inmate, Janie Brooks, 38, in prison since 1999 on second-degree murder charges, described the pain as "like a needle being poked in my arm and my arm gets so hot it will start shaking."
A common bacteria found in the nostrils of one in three people, staph is easily transmitted in confined, high-density populations.
A study appearing in the April 13 issue of the New England Journal of Medicine found that staph infections are increasingly common in the general population and are more frequently drug-resistant. The study examined more than 1,600 cases in Baltimore, Atlanta and Minnesota.
The commonality of the infection makes it that much harder to keep out of prisons, Tyler said.
"Most of our staph is garden variety," Tyler said, "but you have to watch it because it could be serious."
Frazier said her niece, Tonya Hill, and f ive other women at McPherson contacted her after contracting staph infections. Hill had 11 boils at one time on her skin, Frazier said.
"Some of them are there for murder; some of them are there for drugs. It don’t matter what they’re over there for," Frazier said, adding that inmates should receive adequate medical attention.
The state Department of Health has advised the Correction Department on how to control the spread of the organism, including washing the laundry of infected inmates separately.
"The main thing is getting them to wash their hands," Tyler said.
Dr. Nate Smith, medical director for infectious diseases for the Health Department, said a complaint from a family member of an inmate prompted a call from a communicable disease nurse to McPherson’s head nurse in March.
A nurse trained in sanitary procedures also visited the McPherson’s kitchen and found everything to be in order, Smith said.
"The approach we have taken is an advisory approach. We don’t have regulatory authority over the Department of Correction, but they’ve been very open to our suggestions," Smith said.
Because staph infections are increasingly common in the outside community, new inmates bring in the organism all the time, making it difficult to stamp out, Smith said.
A bigger threat, say Smith and other doctors, is that inmates will spread the staph bacteria to their friends, relatives and co-workers after they are released from prison.
To prevent that, inmates and their doctors need to learn how to treat infections and keep them from spreading, said Dr. Rachel Gorwitz of the National Center for Infectious Diseases at the federal Centers for Disease Control and Prevention in Atlanta.
"Education is key. There are really some very basic things people can do," Gorwitz said.
The CDC completed a study in October 2003 of staph infections in correctional facilities in Georgia, California and Texas which identified the five "C’s" of the disease: crowding, frequent skin to skin contact, compromised or injured skin, contaminated personal items and lack of cleanliness.
Later that year, the federal Bureau of Prisons released guidelines for care that incorporated those findings. Some states, like Texas, have followed those principles and seen a decrease in staph infections in recent years.
Unlike Arkansas, the Texas prison system has tracked staph infections since 1996. In 2000, doctors saw a large increase that peaked in 2002 before slowly receding.
Last year, 4,980 cases appeared in a prison population of 150,000.
Dr. Michael Kelley of the state’s Health Services Division said outbreaks have been contained by public education among inmates, stressing personal hygiene and reintroducing antiseptic hand soap.
Requiring that all skin infections be cultured also keeps Texas prison doctors on top of new strains, Kelley said.
Arkansas does not plan to follow Texas’ model, Tyler said. Currently, Correctional Medical Systems tracks HIV and tuberculosis infection rates, but not staph.
"It’s just not something they do," Tyler said.