Area jails, prison keep watch for hard-to-treat skin infection

Sunday, October 19, 2003

Scott Welton

SIKESTON - A drug-resistant bacteria responsible for skin infections in prisons and jails across the country has raised concerns among Centers for Disease Control and Prevention but has not yet been a problem in Bootheel facilities, according to officials.

Staphylococcus aureus, a hard-to-treat strain of staph infection previously only found in hospitals, has spread over the last couple of years among military recruits, sports teams and inmates at prisons and jails.

"We haven't seen a lot of cases," said John Fougere, spokesman for the Missouri Department of Corrections, although he confirmed the DOC has noted "scattered cases" among its facilities.

"The Women's Eastern Reception Diagnostic and Correctional Center in Vandalia is the only place we've had a significant number of cases," Fougere said. About 20 cases were reported. "We've really had nothing that would stand out anywhere else," he said.

"Our medical staff there is working very closely with the Missouri Department of Health to assess the situation and see if there is a pattern," Fougere said, adding that the DOC is presently waiting for a recommendation for treatment.

Fougere said jails have had the biggest problem around the country. The Los Angeles County is listed as one of those having a big problem with it.

"We have not experienced anything like that yet," said Sgt. Jim Bonner, who oversees prisoner housing at the Scott County Jail. "Nor do I know of any local jails in the area that have."

Bonner added that jail personnel conduct "an extensive review of inmates during their interview upon entry" which includes questions about their health.

"We've had nothing," said Paul Johnson, assistant supervisor for the Mississippi County Detention Center. "As far as I'm aware of, we've had no problems with anything like that."

Elsewhere, however, the close contact of prison life has contributed to skin infection outbreaks in several prisons and jails as the bacteria is transmitted from person to person by skin-to-skin contact, exposure to contaminated surfaces and the sharing of personal items such as soap or towels.

With one in every 142 U.S. residents having spent time in prison or jail last year, however, health officials fear it could easily spread to the outside.

''If you look at especially jails, it is a dynamic equilibrium,'' said Dr. Dan Jernigan, a CDC epidemiologist. ''Individuals are coming in and out all the time.''

Thursday the CDC highlighted several recent outbreaks in Georgia prisons including the infection of more than 110 inmates last year at the Autry State Prison in Pelham which was among the largest outbreaks nationwide.

In 2001 and 2002 at Colwell Probation Detention Center in Blairsville, Ga., about 30 inmates were infected and 75 were infected at a jail in Floyd County, Ga., leading to two hospitalizations.

Staph infections can appear as ordinary skin boils or wounds. Diagnoses can easily be missed or result in treatments with ineffective antibiotics. While the infections are usually mild, they can lead to life-threatening blood or bone infections.

"You used to just see it in large referral centers," said Dr. Stephen Welton, a Sikeston physician.

Lately it has been seen in smaller hospitals and nursing centers, however. "It's just kind of spreading out," he said.

Welton added that while this variety of staph infection is resistant to many antibiotics, there are some new drugs available to treat it. "So far we haven't had major problems with it," he said.

Three years ago in Mississippi, the CDC conducted its first investigation of a prison skin infection outbreak.

Today the same problems that led to the Mississippi outbreak - bad hygiene and poor access to medical supplies and treatment - are still plaguing prisons, Jernigan said.

Efforts to fight the infections in prisons face several obstacles: Soap is a unit of currency for inmates and is considered to be a possible weapon by some prison officials; alcohol-based handwashing gels are highly flammable; and the hard plastic found inside soap dispensers can be broken and turned into makeshift knives.