Rapid Report: NCCHC Shines in New Mexico
The 25th National Conference on Correctional Health Care ended last month in Albuquerque, NM. The weather cooperated nicely and a string of beautiful days in very pleasant surroundings enhanced this premier correctional health care meeting, which lasted from November 10 through 14, 2001. Total attendance was close to the 2,000 mark.
Prior to the conference proper, there were a number of seminars including an in-depth look at the NCCHC Standards, a meeting of the Society of Correctional Physicians, and a well-attended HEPP symposium entitled "Bridging the Gap: Getting High Risk Patients into Treatment." The HEPP meeting covered current topics in infectious disease in corrections including the outbreak of hepatitis B in the Georgia Department of Corrections. Dr. Joseph Paris from the Georgia Department of Corrections related the episode, presenting Dr. Amy Kahn's, Centers for Disease Control, findings.
Dr. Paris stated that following the discovery of an acutely jaundiced male in a Georgia prison, the CDC interviewed and tested potential contacts at the same dormitory and was able to initially uncover an additional group of 5 more inmates acutely infected with hepatitis B but completely asymptomatic. Additional interviews and testing of the remainder of the prison population revealed the presence of another group of 5 acutely infected, asymptomatic hepatitis B patients. None of the 11 developed serious complications of hepatitis B. Risk factors for intramural transmission of hepatitis B in the prison settings were tattooing, homosexual sex, and body fluid exposures in general, activities that are clearly not condoned by the Georgia DOC.
This was the first completely documented example of intramural transmission of hepatitis B in prison settings. Furthermore, it seems that for every overt, symptomatic acute hepatitis B case, one would expect the presence of 10 more cases. However, testing and interviewing in a timely manner are necessary to discover these cases. Vaccination of the susceptible inmates did take place at the Georgia prison, but vaccination for the entire state prison population has not yet occurred; however, a budget for that purpose was requested by Dr. Paris and is being considered by the Appropriations Committee of the Georgia legislature.
A companion presentation on the national picture on inmate risk of hepatitis B was given by another of the CDC researchers involved in the outbreak, Dr. Robert Lyerla. Additional presentations at the HEPP symposium included a discussion of tuberculosis in corrections as presented by Dr. Anne De Groot, which highlighted the TB situation in prisons with "real life lessons" learned from TB outbreaks in New York, South Carolina, and California. Dr. De Groot also gave a talk on HIV-infected women, highlighting the differences in the way HIV affects women and men including the new information on differences in viral load between men and women when they progress to AIDS.
Dr. Joe Bick of the California Department of Corrections gave a presentation entitled "Getting Transgendered Patients Into Treatment" in which he explained the issues these patients face and described how their gender identification affects their HIV treatment.
Dr. Eric Avery, a psychiatrist from the University of Texas Medical Branch in Galveston, presented the various anti-depressant medications available along with their side effects. He also described how mental health and HIV treatment information must be available in pictorial form for incarcerated patients, as many of them do not read.
Dr. Michael Wong also gave a comprehensive presentation on the hepatitis C virus (HCV) in corrections at the HEPP symposium. Dr. Wong presented HCV as a single infection as well as the interaction of HCV and HIV in a coinfected individual.
During the Conference proper, there were Plenary Sessions and Concurrent Sessions including HCV-related sessions delivered by Newton Kendig, M.D., Arthur Brewer, M.D., Berel Arrow, M.D., Joseph Paris M.D., and Anne Spaulding M.D.; HIV-related sessions delivered by Bill Ruby, D.O., John Bartlett, M.D., and David Thomas, M.D.; a session describing Research in Corrections by Thomas Conklin, M.D.; sessions describing legal issues delivered by Roderic Gottula, M.D., William Rold, J.D.; a session on Oral Health presented by Thomas Shields, D.D.S. and John Battle, D.M.D.; a session on Diabetes Monitoring presented by Michael Puerini, M.D.; and a session on Correctional Physician Productivity presented by Joseph Paris, M.D.. Other concurrent sessions tackled important issues in Nursing, Pharmacy, Mental Health, Education, Juvenile Offenders, Female Prisoners, Medical School Involvement, among others. The Conference provided a veritable cornucopia of timely topics and attendees had to make agonizing choices between outstanding, simultaneous sessions.
The next NCCHC Meeting will be held in October 19-23, 2002, in Nashville, Tennessee.
Back to the HEPP News December 2001 contents page.
This article was provided by Brown Medical School. It is a part of the publication HEPP News.