Las Vegas Sun

July 31, 2014

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OTHER VOICES:

Danger in the prisons

Advocating on behalf of prison inmates can be a lonely task. Politicians and taxpayers are understandably focused on the kids and the kitchen table and are largely unsympathetic to the problems of convicted felons.

But there’s an issue developing inside prisons that’s threatening to move outside those walls. It’s looming as a potentially catastrophic public health risk to the mainstream population.

The rate of hepatitis C in prison populations has raised red flags for at least a decade at the National Institutes of Health and the Centers for Disease Control and Prevention. A 2005 study published in the Journal of Epidemiology and Infections shows prison inmates are infected at a significantly higher rate than the population as a whole. It also suggests that person-to-person transmission, typically through tattooing, continues during incarceration, making infection all the more likely as more time is spent in an institution.

If you don’t find this sobering, you should, because more than 95 percent of prison inmates are released back into society, according to U.S. Department of Justice statistics. An unacceptable number will carry hepatitis C back into neighborhoods and workplaces, where they will continue living with the undetected disease for decades. They will have ample occasion to spread it in their social circles.

The incidence of hepatitis C among Nevada prison inmates is not known because the Nevada Department of Corrections doesn’t administer a test for it upon entry.

Nevada CURE, a nonprofit group devoted to reforms in the prison system, wants a statute in Nevada requiring the state to administer a routine hepatitis C test to inmates entering the system.

There’s a humanitarian concern: Untreated hepatitis C causes a lingering, painful death, ravaging the liver. But consider, too, the expense of treating the end-stage complications of cirrhosis or cancer, compared with the smaller, controllable cost of the test and some antiviral treatments that are available.

Attempts to discuss a hepatitis C testing regimen with the state prison director have been largely ignored. During a face-to-face meeting in June, Director James G. Cox said immediately that cost would be a concern.

We aren’t sure whether Cox meant the cost of the tests or the cost from the Pandora’s box that would surely follow — the necessity to give lengthy treatments to the hundreds of inmates who would be expected to test positive. It could conceivably be tens of thousands of dollars per case. And the treatment is not always successful, either.

It’s a stiff price tag, but it’s less costly, and less dangerous for everyone, than the current alternative.

In fairness, Cox has a challenging package of responsibilities. He’s running a crowded prison system that has had safety and labor issues. He’s doing the job in the face of a tightening state budget that has left him with limited options.

At our June meeting, Cox said he would investigate the health procedures related to hepatitis C in other jurisdictions. Despite several follow-up reminders to his office, we’ve heard nothing back.

Since we expect the prison director to take seriously a threat to people inside and outside the walls, we followed up this fall with a public records request for information. The state took longer than the law allows to respond, and the documents we received raise more questions than they answer.

Las Vegas is no stranger to the horrors of hepatitis C. Our city is still living with the fallout from an episode in which innocent patients were infected with the virus in a clinical setting.

The disease also is in the spotlight nationwide. After discovering a higher-than-expected rate of infection in Baby Boomers, the CDC recently recommended a hepatitis C test for all adults born between 1945 and 1965.

The rate among incarcerated people is higher still and can’t be viewed as contained if it isn’t even monitored.

Nevada CURE does not regularly tug on the sleeve of the average citizen to ask for help getting something done. But we believe this issue is a cause for general alarm.

Travis N. Barrick is a Las Vegas attorney and vice president of Nevada CURE.

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  1. A decade a ago I was a Nevada Corrections officer at Southern Desert Correctional Center. One day I reported to work and was told to report to the infirmary. I did and was told by a nurse there had been a TB outbreak in the unit that I was in. Now I know how TB is transmitted. I was tested and it was negative. Yet the rest of the prison population of inmates and staff were not tested with the exception of the inmates and staff of the unit were tested.

  2. A very serious issue indeed!

  3. It would be proactive to test prison inmates upon intake, as well as set into place policy to stop the practice of inmates tattooing while in the institution. When most individuals are sent to prison to both serve a sentence for their crime, as well as undergo a program to reform them (provide skills to assist them in becoming functional, productive citizens), there should also be safety nets to insure these inmates are not spreading letal diseases to the public upon their release.

    With this is mind, I support the letter writer's position and encourage the Director of Prisons to effectively address the issue.

    Blessings and Peace,
    Star

  4. If money spent on prisons is the answer, then California should have the best prisoner behavior in the country and the world. The only thing is that it [California] doesn't.

    Leave the prisoner care, spiritually, to the local visiting clergy and prayer groups who perform the calling free in accordance with the Beatitudes of Jesus. Like the Good Thief, St. Dismus, who died next to Jesus on Mt. Calvary and followed Jesus on that day to Paradise, if their hearts are gladdened, so will be their souls.

    CarmineD