Hepatitis in Correctional Institutions

By Chavez, R. Scott | Corrections Forum, July/August 2002 | Go to article overview

Hepatitis in Correctional Institutions


Chavez, R. Scott, Corrections Forum


Our country has not seen a more pressing issue than hepatitis in corrections. For many years, the HIV virus headlined articles as the most threatening viral infection among the incarcerated. However, hepatitis is increasing in the news due to its spread in correctional facilities across the nation.

Hepatitis is a viral infection that concerns the inflammation of the liver. Hepatitis B and C are bloodborne infectious viral diseases with the most serious consequences. Correctional workers need to be aware of these forms of hepatitis, mainly because the incarcerated have high rates of being infected with hepatitis B and C. Of the two viruses, correctional workers are at greater risk for contracting the hepatitis B virus.

HIGHLY INFECTIOUS

Hepatitis B is 100 times more infectious than HIV. There are more than 300 million people in the world who have hepatitis B and approximately 1.25 million people are chronically infected with HBV. HBV is transmitted through activities such as intravenous drug use or unprotected sex with an infected partner. The hepatitis B virus (HBV) causes inflammation of the liver and can cause liver cell damage leading to cirrhosis and cancer.

THE "SILENT KILLER

Hepatitis C is particularly dangerous because infected people feel and appear healthy; however, they are carrying the disease and have a damaged liver. Hepatitis C is transmitted through infected blood when contaminated needles are used during high-risk activities such as IV drug use, tattooing, or body piercing. In addition, the CDC reports that studies have shown that the HCV is not sexually transmitted.

HIGH-RISK ACTIVITIES

The incarcerated population has high rates of hepatitis B and C, since they typically have participated in high-risk activities. Studies have shown that 30% to 45% of the inmate population have the HBV. The National Commission on Correctional Health Care estimates that 17% of the inmate prevalence is more than 9 times the 1.8% HCV prevalence for the entire US population.

There is consistent literature that supports the premise that inmates spread infectious disease while incarcerated (CDC, 2001, Decker, et al., 1985; Hull, et al., 1985). This occurs through the sharing of personal care items such as electric razors and razor blades, or giving haircuts with unsterilized shears. As commonly occurs in prison and jail, tattooing and body piercing take place with needles that have not been sterilized. Unprotected sex, the use of IV drugs, and fighting also take place in jails and prisons.

ARE CORRECTIONAL WORKERS AT GREATER RISK?

Correctional officers are at risk because the HBV can be transmitted through a human bite with infected saliva. The hepatitis B and C viruses can be transmitted to correctional officers through contaminated sharp objects or the exchange of blood when fighting or physical restraint occurs. With the increase of epidemic problems of hepatitis in correctional facilities, health care workers are at great risk because they are exposed to bodily fluids and needle stick injuries. Health care workers have a 20 to 40 times greater chance of contracting HCV than HIV infection following an accidental needlestick.

TREATMENT

Interferon is the mainstay of therapy for both hepatitis B and C infections. The treatment of hepatitis C is limited to interferon and various combination therapies which can prolong life in mild cases of hepatitis C. Only 15 % of those infected with the hepatitis C virus recover after six months. The remaining 85 % of those with the HCV will not recover without treatment. Because treatment is so limited for these diseases the emphasis is on prevention.

PREVENTION

The prevalence rates of viral hepatitis A, B, and C can be reduced through appropriate and adequate prevention techniques. …

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