----- Original Message -----
From: H Jones
Sent: Saturday, January 25, 2003 12:41 AM
Subject: [patrickcrusade] FW: Center for Disease Control Calls on all states to test some prisoners for hepatitis C
Jan. 23, 2003
CDC calls on all states to test some prisoners for Hepatitis C
BY JENNIFER LIN AND MARK FAZLOLLAH
Knight Ridder Newspapers
PHILADELPHIA - (KRT) - With a million inmates infected by hepatitis C leaving jails each year, the Centers for Disease Control and Prevention Thursday called on states to test all prisoners with a history of intravenous drug abuse - a common way the virus is spread.
It also set guidelines for educating and treating prisoners with the potentially lethal disease, now an epidemic behind bars.
But the federal agency stopped short of pressuring states to test entire prison populations - a subject of intense debate among corrections officials because of the cost.
If more inmates are screened for the blood-borne virus, more are likely to qualify for medicines. The year-long treatment can effectively cure half the cases but costs as much as $25,000.
New Jersey estimates that if it tests 25 percent of its inmates, it will have to spend about $4.5 million on hepatitis C therapy. But if it tests 75 percent of its population, the cost will jump to $8 million.
In making its recommendation, the CDC said targeted testing of inmates would catch most cases of hepatitis C. But it advised states to make sure that approach was working with periodic reviews.
Pennsylvania currently tests all prisoners, not just those at high risk. It says 20 percent are infected and hundreds are being treated.
In New Jersey, The Philadelphia Inquirer reported last summer, prisons were failing to monitor the epidemic and were treating only one inmate. The state has since launched a plan to expand care.
New Jersey was also releasing prisoners without telling them that they had tested positive for the virus - a problem it says has been corrected.
Of the nation's one million infected prisoners released each year, it is unknown how many have been told of their hepatitis C, the CDC said Thursday. If inmates aren't informed, they can unwittingly spread the disease.
In its announcement Thursday, published in its Morbidity and Mortality Weekly Report, the CDC spelled out inmate care after prisons diagnose hepatitis C. Those showing signs of liver disease should be assessed by hepatitis specialists to determine whether they need the latest dual-drug therapy. Those who qualify should get the medicines.
Although the CDC cannot mandate policy for prisons, its recommendations will influence how states wrestle with the explosion of hepatitis C cases in corrections. The CDC says various states have reported that 16 percent to 41 percent of prisoners are infected.
Cindy Weinbaum, a CDC hepatitis specialist who prepared the recommendations, said some prison officials argue that money is not available for treatment. But federal law requires
states to treat sick inmates.
"Denying treatment that would be a standard of treatment on the outside would not be acceptable," she said.
The CDC said 39 percent of the 3 million Americans with chronic hepatitis C infection will pass through prisons or jails each year, which puts the institutions on the frontlines for screening, counseling and treating the disease.
Medical advances make it harder for prison officials to ignore the hepatitis C problem.
"Two or three years ago, therapies were not very effective," said Joseph Paris, medical director for the Georgia corrections department. "But there's less and less justification for not treating as therapies are becoming more effective."
With many states now grappling with the problem, the CDC will host a conference in San Antonio next week to address management of the disease in corrections.
The virus, which attacks the liver, must pass directly into a person's blood. Injection drug users run the highest risk of infection, which is why prisons are overrun with cases. The CDC said 83 percent of state prisoners and 73 percent of federal prisoners reported past drug abuse.
Jeffrey Beard, Pennsylvania's corrections secretary, said he believed the state's program of universal testing was better than the CDC's recommendation of screening only those at high risk.
"If you go the other way, you'll miss a substantial group," Beard said Thursday.