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National Commission on Correctional Health Care Position Statement

In 1988, the National Commission on Correctional Health Care released a position statement urging responsible health authorities and health care staff of adult and juvenile confinement facilities to undertake aggressive anti-tuberculosis control programs. These programs include screening, diagnosis, treatment, and prevention. It has been well established TB is and has been a major health issue in correctional facilities for a very long time. TB cases occur on average at least 3 times more often in correctional facilities today than in the general population. TB rates began to increase in the mid 1980s. At the same time, multiple-drug resistant strains of tuberculosis (MDR-TB) began to surface. These strains of TB mutate, and are resistant to two or more of the first-line drugs used to treat TB. As a result of MDR-TB, mortality rates for TB have increased. This increased mortality rate is a result of the difficulty in treating the disease as well as the number of people with MDR-TB who are severely inmuno-compromised as a result ofHIV infection making identification and treatment of TB more difficult. Please note the Commission's policies do not address fully the medical management or clinical issues of tuberculosis. Such information is available from the Centers for Disease Control and Prevention. The Commission's Board of Directors believes the medical management of TB-positive inmates and health care workers should parallel that offered individuals in the noncorrectional community. Tuberculosis is an airborne disease which can be spread by such simple actions as coughing or sneezing. Although research has demonstrated non-infected persons need to be exposed to tuberculosis bacteria for more than a brief duration before coming infected, there is no confirmation as to how much exposure to