http://dailynews.yahoo.com/h/nm/20010628/hl/hepatitis_1.html
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Thursday
June 28 5:29 PM ET
By Emma Patten-Hitt, PhD
ATLANTA (Reuters Health) - An outbreak of hepatitis B virus (HBV) infection among
male inmates suggests that the virus spreads through risky behaviors such as
sex and intravenous drug use, even in prison. It also highlights the need for
HBV vaccination to be offered to inmates, the Centers for Disease Control and
Prevention (news
- web
sites) (CDC) in Atlanta said on Thursday.
HBV is a liver infection that can be transmitted through unprotected sex,
injection drug use and being exposed to infected blood. The infection can be
chronic and lead to liver damage and cancer.
In an outbreak at a long-term state correctional facility in an undisclosed
state, 11 patients who had been incarcerated for more than six months had acute
(recent-onset) infection--indicating that transmission had occurred within the
prison. An additional 10 inmates had previously unrecognized chronic hepatitis
B infection.
The investigation started in May 2000, after a 34-year-old man who had been
in the prison for more than 2 years developed jaundice, a yellowing of the skin
that signals a liver problem.
The man reported having had unprotected sex with his cellmate. Testing of
the cellmate confirmed that he, too, was infected with HBV.
Of 103 inmates who resided in the same dormitory, 97 consented to being
tested for HBV infection. Of those, six had had been infected within the last
six months, one was chronically infected, and 15 had had a previous infection
that had subsided.
The researchers then tested about 1,000 inmates in other dormitories. Of
those, five were identified with a previously undiagnosed HBV infection, 10
were chronically infected, and 178 had had a previous infection.
About half of the 907 inmates who a completed questionnaire reported
participating in behaviors that could cause HBV. Twenty-one reported injecting
drugs, 26 reported having sex with another man, 73 reported using another
inmate's razor, and 429 reported receiving a tattoo.
``Sex with another man accounted for only 20% of the new infections in this investigation.
However, this and other behaviors prohibited by the correctional facility (e.g.
injecting drugs) probably are underreported by inmates,'' the researchers write
in the June 29th issue of the CDC's Morbidity and Mortality Weekly Report.
``These findings support routine vaccination of inmates of correctional
facilities,'' the CDC's Dr. Amy Khan told Reuters Health. She pointed out that
only a handful of states offer hepatitis B vaccination to inmates.
But vaccination, Khan said, would provide ``an opportunity to prevent
infection both during incarceration and before they go out into the community
again.''
``A couple of barriers to administering routine HBV vaccine are cost and the
difficulty of completing the three doses required to complete the series of
vaccinations,'' she noted.
``But when vaccines are offered, the acceptance rate is about 70 to 80%--so
that's high,'' she added. ``There are definite benefits to society, as well as
to the prison system.''
SOURCE: Morbidity and Mortality Weekly Report 2001;50:529-532.
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