American Liver Foundation Commends the CDC for Recommendations
Addressing Viral Hepatitis in the Nation's Prisons

CDC Calls for Hepatitis A and B Vaccinations to Prevent Spread of
Viral Hepatitis to Greater Community

NEW YORK, NY -- (INTERNET WIRE) -- 01/24/2003 -- The American Liver
Foundation (ALF) applauds the new recommendations issued today by the
Centers for Disease Control and Prevention (CDC) to prevent the
spread of viral hepatitis in the nation's corrections facilities. The
recommendations, published in this week's "Morbidity and Mortality
Weekly Report," call for prison vaccination against hepatitis B
regardless of the length of stay and vaccination against hepatitis A
for at-risk inmates. With prison hepatitis B rates four times the
national average, vaccinating the nearly two million inmates in this
country before they are released is a vital public health initiative.

"These new recommendations show that the issue of viral hepatitis in
the corrections setting cannot be ignored," said Alan P. Brownstein,
president and chief executive officer of the American Liver
Foundation. "Vaccinating inmates against hepatitis A and B not only
protects the inmate population and correctional employees, but also
prevents the spread of these diseases to the greater community upon
release. The failure to vaccinate inmates can have a devastating
effect on the public health."

Coming two decades after the CDC first recommended that only
long-term inmates be vaccinated against hepatitis B, the new
recommendations acknowledge the increasingly clear link between
prison health and general public health. The ALF seeks to educate the
public about this link and the dangers of viral hepatitis with the
intention of encouraging more state- and federally-funded vaccination
programs targeted to those populations most vulnerable to viral
hepatitis.

Examining the Link Between Public and Correctional Health

In order to reduce the $700 million annual cost of treating hepatitis
B, the CDC has recommended vaccinating adult groups at increased risk
of contracting the disease. With up to one third of the incoming
inmate population already infected with hepatitis, the corrections
setting provides a clearly defined risk group for targeted
vaccination. Considering that infected prisoners will be released
back into the greater community, from a public health and economic
standpoint, stopping hepatitis before it spreads is essential.

In fact, a recent Congressional report commissioned by the Department
of Justice on the health status of soon-to-be-released inmates by the
National Commission on Correctional Health Care (NCCHC) determined
that more than 155,000 inmates were released with acute or chronic
hepatitis B infection in 1996 alone. For this reason, the NCCHC
recommended in 2000 that all inmates should be vaccinated against
hepatitis B and that prisons should comply with all CDC vaccination
recommendations.

At the time of their report, the NCCHC called for a clear set of
federal guidelines to assist state and local governments in designing
appropriate screening and immunization programs. With today's
announcement, the CDC has given state and local governments clear
recommendations, which if followed, can lead to significant
reductions in cost and loss of life due to viral hepatitis.

Hepatitis A and B: Serious, Yet Preventable Diseases

Hepatitis B is a serious disease caused by a virus that attacks the
liver. The hepatitis B virus, which is transmitted through blood or
bodily fluids, is 100 times more contagious than HIV. Hepatitis B
virus can cause lifelong infection, cirrhosis (scarring) of the
liver, liver cancer, liver failure, and even death. According to the
CDC, more than 1.25 million Americans have chronic hepatitis B
infection, with an estimated 78,000 new infections in 2001 alone.

Hepatitis A is a serious liver disease caused by infection with the
hepatitis A virus. The disease, transmitted through the fecal-oral
route, is spread through close personal contact or contaminated food
and water. Each year, 200,000 Americans are infected with the virus,
with up to 22 percent of infected adults requiring hospitalization.
Because the symptoms of hepatitis A infection often take weeks to
manifest, many carriers of the disease are unaware that they are
infected and can unknowingly infect others.

About the American Liver Foundation

The ALF is a leading national voluntary health agency dedicated to
the prevention and cure of viral hepatitis and other liver diseases
through research, education, and advocacy on behalf of those at risk
or affected by liver disease. The ALF's programs and services are
supported by a nationwide network of state chapters. For additional
information about hepatitis A and B and other livers diseases,
contact the ALF at 1-888-4HEP-ABC or visit www.liverfoundation.org.

Contact: Bob Madison
Phone: 212-668-1000, ext. 137

Contact: Vilena Katanova
Phone: 212-798-9737

+++++++++++++++++++++++++++++++++++++++++

DC attempts to reduce hepatitis in prison

By Steve Mitchell
UPI Medical Correspondent
From the Science & Technology Desk

Published 1/23/2003 6:32 PM

WASHINGTON, Jan. 23 (UPI) -- The Centers for Disease Control and
Prevention Thursday issued recommendations for controlling the
transmission of hepatitis in prisons because of high infection rates
among inmates.

"People who spent time in jails ... have increased risks of
infections ... including hepatitis," Cindy Weinbaum of the CDC and
lead author of the recommendations, said during a teleconference from
Atlanta.

One concern is most prisoners eventually will be released and could
then spread the disease to the general public, Weinbaum said.

The annual turnover rate in jails is 100 percent and in prisons it
is 40 percent, Weinbaum said. In addition, 12 percent to 15 percent
of those with hepatitis B have been incarcerated along with 39
percent with hepatitis C, she said.

Hepatitis is caused by viruses that primarily attack the liver.
Hepatitis A causes fatigue, abdominal pain and diarrhea but generally
is not fatal. Hepatitis B causes fatigue and jaundice and can lead to
death. Hepatitis C is often chronic and can lead to the need for a
liver transplant. It can result in death in rare cases.

The CDC attributes injection drug use as the primary cause of
spreading these diseases, saying in a written statement prisoners
"have high rates of certain risk behaviors, such as the use of
injectable drugs, which expose them to infections with (hepatitis B)
and (hepatitis C)."

Lara Stemple, executive director of the non-profit human rights
group Stop Prisoner Rape, said that view is "absolutely negligent"
because these diseases, particularly hepatitis A and B, often are
spread by rape in prisons.

"If the CDC is refusing to address sexual violence as part of the
cause of spreading disease behind bars, they are really like
ostriches burying their heads in the sand," Stemple told United Press
International, noting "sexual violence is a part of everyday life in
so many prisons."

One in five prisoners in the United States has been sexually
assaulted and one in 10 has been raped, she said.

Weinbaum said the CDC was not addressing the spread of hepatitis by
consensual sex or rape in prisons as a means of spreading hepatitis
in prisons. She acknowledged hepatitis B could be transmitted by sex
but hepatitis C was "not effectively transmitted" in that manner.

The National Institute of Allergy and Infectious Diseases Web site,
however, lists multiple sex partners as one of the greatest risk
factors for acquiring hepatitis C.

Stemple said 12 million inmates are released from jails and prisons
every year and 95 percent of all prisoners are eventually released.

"It's especially noteworthy that the people who are most likely to
be released are the most likely to be preyed upon" -- sexually
assaulted and perhaps infected with one of these diseases, she said.

The recommendations, which are published in Friday's issue of CDC's
Morbidity and Mortality Weekly Report, call on prison officials to
vaccinate all people in correctional institutions and juvenile
facilities against hepatitis B. Hepatitis A vaccination is urged in
men who have sex with men or who use injection drugs. There is no
vaccine for hepatitis C.

Inmates with risks factors for acquiring hepatitis C should be
tested for the disease and treated if they have chronic infection.
Inmates with either disease also should receive substance abuse
treatment. In addition, all inmates should receive education about
how to prevent hepatitis.

Dan Dunne, spokesman for the Federal Bureau of Prisons, told UPI the
agency already has policies in place to test inmates with risk
factors or symptoms of hepatitis B or C. Nearly 8 percent of the
federal prison population has hepatitis C and about 2 percent has
hepatitis B, Dunne said.

"We are reviewing the new CDC guidelines and will take appropriate
action," Dunne said. "The BOP plans to issue revised guidelines in
the near future" for treating inmates infected with hepatitis, he
added.

Copyright © 2001-2003 United Press International

Subject: Infections in Newly Released Inmates are Rising Concern

By FOX BUTTERFIELD
OUNT PLEASANT, Mich., Jan. 27 — Marva Johnson was thrilled when her longtime boyfriend, Randy Vallad, was paroled from prison in 1999.

They went back to living together, and once when he had a bad cut on his head, she took care of him. She was splattered with his blood, but the couple did not think anything of it at the time.

It was not until Mr. Vallad was sent back to prison in 2001 for a parole violation that he was accidentally shown his Michigan Department of Corrections medical records. They reported that Mr. Vallad had tested positive for hepatitis C, a blood-borne virus that can cause potentially fatal liver disease, when he was first admitted to prison years before.

"They knew and didn't tell him," Ms. Johnson, 33, said today in this small city in central Michigan. "As a result, they also let him infect me." For the past 11 months she has been taking a powerful, enervating course of drugs for hepatitis C.

Such cases are becoming increasingly common across the nation, as jails and prisons have become giant incubators for some of the worst infectious diseases.

According to a study released today at a conference sponsored by the federal Centers for Disease Control and Prevention, at least 1.3 million inmates released from jail or prison in 1996 were infected with hepatitis C. That was 29 percent of the 4.5 million cases nationwide.

Similarly, newly released inmates accounted for 35 percent of the 34,000 Americans with tuberculosis in 1996, the study found. And newly released inmates accounted for 13 to 17 percent of Americans infected with H.I.V. or AIDS, the study estimated.

The problem has become so acute that health care officials and prisoner rights groups are calling for widespread testing of prison populations for hepatitis C and faster treatment of prisoners.

"This is a public health problem that has been growing and growing, but we are reluctant to do anything about it because these are bad guys," said Dr. Robert Greifinger, a former chief medical officer for the New York State Department of Correctional Services and the author of the study, which was commissioned by Congress and prepared for the Justice Department.

The Centers for Disease Control held a conference of prison medical officers in San Antonio devoted to the issue last weekend. During the conference, the centers said that public vaccination efforts to prevent hepatitis outbreaks should be extended to prisons.

The centers also issued new guidelines urging states to test all prisoners with a history of intravenous drug use and other risky behavior for hepatitis C. Sharing needles and unprotected sex are common ways the virus is spread.

The problem is not that large numbers of prisoners are contracting hepatitis C while incarcerated, experts say. Most were infected years before. The experts say the high rate of communicable diseases among inmates is a critical issue for two reasons: the danger inmates pose of infecting others when they are released, and the opportunity to treat them that is largely being wasted.

Dr. Greifinger said that Americans tended to forget that most inmates eventually return home. In 2000, about nine million people were released from jail and prison, according to Allen J. Beck, of the Bureau of Justice Statistics, the statistical arm of the Justice Department.

In a sign that the problem is getting more attention, the C.D.C. made public Dr. Greifinger's report today. It had been given to the Justice Department in March 2001, Dr. Greifinger said, but never before released to the public.

In a separate action, the American Civil Liberties Union and two dozen other organizations interested in prison conditions issued a call today for a Congressional investigation into the state of medical care in jails and prisons.

"Correctional systems have buried their heads in the sand because they don't want to know how many prisoners have hepatitis C," said Eric Balaban, a staff lawyer with the National Prison Project of the A.C.L.U.

Russ Marlin, a spokesman for the Michigan Department of Corrections, said, "We are treating hepatitis C in accordance with federal guidelines."

He said that Michigan did not do blood tests of all incoming inmates or all those who engage in risky behavior. "Our position is that indiscriminate testing is not useful," he said. In addition, it would cost $200 million to test and treat all suspected cases of hepatitis C among Michigan inmates, he said. Even more important, he said, is that the drug treatment — a combination of interferon and ribarvin given over a 6 to 12 month period — is very toxic.

Mr. Marlin said he had no information on why Mr. Vallad was not told he had tested positive for hepatitis C and could not release it even if he did because of the confidentiality of prisoners' medical records.

Mr. Vallad, was originally convicted for fleeing the police when he was stopped for driving with a suspended license. It was not the last of his problems. Today, the police raided the trailer where he lives with his sister and brother, looking for drugs.

It was a bad tip from an informant, the police later said, and they found no drugs. But they detained Mr. Vallad anyway.

Steven Croley, a lawyer for Mr. Vallad and Ms. Johnson, said Mr. Vallad had stumbled on the information that he had tested positive for hepatitis C when he asked to see some of his private medical records compiled by doctors while he was out of prison.

At the time, in 2001, Mr. Vallad had just been sent back to prison because of a urine test that showed evidence of drug use, a violation of his parole.

But the records he received accidentally included pages of his prison medical file reporting on a blood test he had been given during his first admission in 1998.

At the bottom of one page was the notation "Hepatitis C — Positive."

"I said, wait a minute, what's this?" Mr. Vallad recalled. He called Ms. Johnson, who went for a test and discovered she was also infected.

Mr. Vallad, now 42, was never offered any treatment inside prison for hepatitis C. His level of infection has steadily gone up and his health has deteriorated, Mr. Croley said.

Mr. Croley said he will soon bring suits against the Michigan Department of Corrections on behalf of Mr. Vallad and Ms. Johnson.

How is it that they can get away with not telling people they are infected . My man tested positive two years ago and is just now finding out. How is it so many get denied treatment. Can we do anything to change this?

Carol

Libra Darling:

Welcome to our Hep C family. This is exactly why this forum has just been created! A)We hope to start finding out how many PTO members are part of this Hep C neglect B) We hope to tell some truths about the Hep C neglect. C) AND most importantly we hope to get some talk going to raise the issue loud and clear to the "powers that be".

I'd be happy to hear "your man's" story. You might begin with his first name. ALL these people's names are VERY important TO ME!

Hopefully, in the next little while, we will get the very info up, in this forum, that you need to know.

All My Love,
Menolly

My fiance has hep-c found about 3 months ago, but i see he may be one of the lucky ones, he is recieving interveron
treatments, shots and takes pills also, he is on the treatment for 6 months, but is having severe side effects, but he chooses to deal with them until the treatment is over, it is working very well for him, and he said the doctors say all blood tests are looking good, thank god for that, he is in a wisconsin prison and i wish all the best, treatment is diffinetley
needed for all that have hep-c.......................merilee

I WANT TO FIND OUT MORE INFORMATION ON HEP C, HOW CAN I FIND IT. HOW ITS TREATED ETC.

DeDe check out the different post on this forum, if you have any questions, please feel free to post your question, or PM one of the moderators with it, & we will try our best to answer any questions you have.---Kenm

DeDe,

Here's where I've found the best information:

Center for Disease Control
http://www.cdc.gov/ncidod/diseases/hepatitis/c/

Dr. Everett Koop
http://www.epidemic.org/

MEDLINE Plus
http://www.nlm.nih.gov/medlineplus/hepatitisc.html

HealthTalk
http://www.healthtalk.com/hepc/

Hepatitis Network
http://www.hepnet.com/

Also, WebMD has some good, easy-to-understand articles. That might be the best place to start.

A good support website is:

http://www.hcvanonymous.com/

They have some book recommendations, and you can email them for a pdf file of their 12-step program workbook designed for people who are dealing with HCV.

I print out all info I can about Hep C and send it to Sonny. He asked me why I do that? Then he started telling me all he had learned from this stuff and I said "that's why!" The more you know, the better off you are!!! This new Forum is great!!

Praise God for this forum!!
I am Hep C postive, chronic and active.....I have been treated once and the side effects were so severe I had to stop...I am starting next week on the new Peg treatment...if anyone has questions,,,Please ask!! My husband and I run a support group in our home town for Hep c and I have a petition on PTO to test prisoners upon entry like HIV and TB!!!

We need to push and shove our way to getting tested and for those who need it treatment...

If you know anyone who is on treatment...they need ALOT of support....the medicane is a type of chemo!!! and it makes you very very sick physically and it most diffenantly messes with your mind and emoitions

I am not trying to upset or scare anyone...but the truth needs to be told so everyone will know what to expect!

Thank you again and God bless

I have come to find out that there is only a small percent of inmates in the Federal system that actually recieve any form of treatment for Hep.C . Now We as human beings need to make a stand and let them know we will not give up till proper medical care is given, Plus the fact remains the inmates are NOT animals and are people who still have family, friends, and loved ones who will not give up till they change the way they pick and choose who gets treatment. I feel if they treat one then they should treat them all, if not then it's descrimation in my eyes. Yet my dad tells me i do not think as most people do so who knows if my views are normal or not. Thanks for the wonderful post and helpful information.

Stay Strong............ Chnadra

My dearest Chandra!

You are a girl after my own heart! It is people like us, who "do not think as most people do", who despite "our views not being normal", CHANGE THE WORLD!

THAT, my dear girl, is called BEING A UTOPIAN DREAMER! It is a MOST DARING THING TO BE, for we look not at how the world is, but at what the goodness of the human spirit CAN BE. Then, unlike most, we FIGHT LIKE HELL to make it a reality!

You go, girl. You have MY vote, and I mean that WITH ALL MY HEART! For I too am a fellow "Utopian Dreamer"!!!

Today, on Valentine's Day, I extend you most deeply,

All My Love,
Menolly

I am a survivor of the Hep C treatments. Barely, as man that is a tough road to hoe! I still do not know the final outcome that will have to wait until September.
My husband is incarcerated in Texas. He is Hep C positive. I have sent him information and asked him to be vaccinated against Hep A and Hep B. Repeatedly the medical unit has denied his requests. First they stated that if he was Hep C positive he could not be vaccinated against the others. Now they state that they no longer give those vaccinations. Wondering if anyone knows what TDC's actual policy is and who to contact to get him vaccinated. I don't want him getting another form of Hepatitis that would ensure him having a death sentence instead of 2 years on a technical violation!

Cajun
My friend is having Hep C treatments in Texas, though it did take alot of pushing. He did end up with Hep B as well, because they refused to treat him. Keep pushing for treatment, write the ombudsman, and all your local groups.
The thing is, they will only treat hep C at a certain level, so it depends what level he is.

I know this is an old thread, and it may have been brought up several times.....BUT, do they now give the prisoners Hep A,B or C vaccination series now in the Federal System? It is too late for my son to go through any of the series as he will have to report in 5-7 weeks. I am planning to take him for a flu shot and a tetnus shot at our local health deparment. Besides getting his physical from the doctor and dentist (which he will have work on in a quick manner), is there anything else he needs to do...medical wise?
Thanks for all of your help!!!

SCMom, I don't know about the vac. series in Fed System. Maybe you could PM someone in the Fed forum or ask in there. It sounds like your getting everything else handled for your son. Good luck to both of you.