CDC checks on positive TB tests at prison

Posted Nov. 05, 2010, at 7:02 p.m.
Last modified Nov. 06, 2010, at 1:16 p.m.

Inmate registers alarm, but no active cases seen

WARREN, Maine — A number of recent positive tuberculosis skin tests at Maine State Prison has caused alarm among the inmates, but a Maine Center for Disease Control official said there are no confirmed active cases of the dangerous disease.

Neither Maine Department of Corrections Assistant Commissioner Denise Lord nor Dr. Stephen Sears, state epidemiologist with the Maine CDC, was able Friday to say for sure how many prisoners have tested positive.

Sears said he met Wednesday with prison officials and is now trying to assess how many positive skin tests there are among inmates, all of whom are now being tested in order to know their status. The tests began about a month ago and may have triggered concerns among the prisoners, he said.

“It’s very clear to me that tuberculosis, which used to be the most common killer of people in the 1800s and early 1900s has become so uncommon that most of us don’t recognize the difference between positive skin tests and the disease,” Sears said. “Most people don’t understand that. They hear ‘TB’ and they get really scared.”

Positive tests mean the inmates have been exposed to the tuberculosis germ, but are not contagious. Such inmates may be considered for medical therapy, he said.

“Maine CDC is working closely with the prison authorities,” Sears said. “I’m always concerned about tuberculosis. I’m also concerned about it in populations where it can spread rapidly. This is our opportunity to work with corrections to make sure things are going well.”

Tuberculosis disease is caused by a bacterium called mycobacterium tuberculosis, according to the Center for Disease Control and Prevention. The bacteria usually attack the lungs but can attack any part of the body such as the kidney, spine and brain, causing symptoms including a bad cough, chest pain, coughing blood, weight loss, weakness, fever and sweating at night. If not treated properly, the disease can be fatal.

An inmate wrote to the Maine Prisoner Advocacy Coalition on Thursday to alert the group to the tuberculosis situation and to ask for help shedding light on what he termed the problem.

“There are a number of people here who have tested positive for exposure to TB,” wrote the man, who was not identified by the coalition. “The medical department is totally playing it down and treating the guys who are positive as if it is nothing out of the ordinary. I don’t know how one would go about trying to expose the truth, but I hope we can find out. It’s kind of scary. I would like to not catch TB in here!”

Tuberculosis is contagious and spreads through the air when someone with the active disease in their lungs or throat coughs, sneezes or speaks, according to the CDC.

The disease rate in prisons has been reported to be up to 100 times higher than the rate on the outside, often because of late diagnosis, inadequate treatment, overcrowding, poor ventilation and repeated prison transfers, according to the website for the World Health Organization.

But that rate is much lower in Maine prisons, Sears said. The prison population reflects the state’s overall population, which has a relatively low rate of tuberculosis. There is an average of nine or 10 active cases each year in Maine, Sears said, adding that those have been in very specific populations. Those include the Portland homeless community, the elderly and immigrants born in countries with high rates of the disease.

Although the disease rate is low in Maine, 3 or 4 percent of residents have positive skin tests, he said, meaning they’ve been exposed to the tuberculosis bacteria.

“There will always be people in the prison with positive skin tests,” Sears said.

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