Bloodborne Pathogens in Prisons

Prisons are scary for many reasons! But many of us do not think of bloodborne pathogens and the needlestick risks our prison healthcare workers face.

Even worse, sharps are common in prisons, even though officers try to keep them to a minimum. And cases of prisoners using sharp objects to harm their mates are not a new thing. This also points to a high count of people with infection.

Add to the sexual activity in prisons and you have a recipe for disaster because it further escalates the spread of some of bloodborne pathogens.

This article will focus on Bloodborne pathogens in a penitentiary setting and how to control the spread of infections.

OSHA, the body that protects US workers commissioned a research six years ago (2014). It was done in one prison to determine whether the officers in charge and other workers were at the risk of bloodborne pathogen exposure.

They also sought to determine if employees are exposed to other health hazards at their place of work. The Occupational Safety and Health Administration made realized that prison staffs are exposed to various highly infectious materials such as blood.

They also noted that every employer (prison management) should take care and take precautions in order to protect their employees. Prisons should set proper safety guidelines when handling health hazards and dealing with sick prisoners.

OSHA’s Recommendations to Prisons HealthCare Centers

During the study OSHA identified matters that prison authorities failed to address—and which could be potentially hazardous to their health.

  1. Training on Bloodborne infections.

Prisons should ensure all their staffs are trained on Bloodborne pathogens and how they can protect themselves. Also, while there is the need to undergo training, prisons should ensure that the trainers mandated to perform the coaching are conversant with the subject.

  • Provide personal protective equipment.

PPEs are a must-have. All healthcare facilities should provide workers with personal safety equipment including gloves, goggles and other safety equipment that can help reduce the spread of infections.

  • Safe disposal of sharps and medical wastes.

The employees are also mandated to use closed object containers in order to transport sharp objects or fluids to their disposal area without endangering themselves.

  • Emergency response or first aid training.

The organization noted and informed the correctional facility that it is a gross violation when a loss of life or even infection to occur and could have been prevented. Particularly if it is a result of something the employer knew or had knowledge.

  • Improve the quality of health care and control the spread of infections.

Also because many prisons and jails, were built to improve public safety, it means that those offenders are sent to correctional centers.

The standard of living in prisons can move from bad, to worse to pathetic. Correctional facilities are not effective in offering basic services like delivering universal health care or even controlling disease transmission.

  • Reduce crowding in prisons.

In these centers, there is a very high probability of pathogens infection among the inmates. This can be caused by overcrowding, medical evaluation and treatment delays, and so on.

  • Check health records before inmate transfers.

Another factor that causes the spread of these infections is the random transfer of inmates.

If an inmate was infected by Bloodborne pathogens infections, their transfer may affect their treatment.

 It can also endanger other inmates due to the fact such facilities may be holding many inmates who by chance share things in the cells. Such activities can result to outbreak of illnesses triggered by bloodborne pathogen exposures.

  • Streamlining health records management in prisons.

Many correctional facilities have poor health record management systems. The sharing of information among the facilities is poor, or sometimes impossible. As a result, prison authorities fail to share crucial health info concerning a convict.

  • Address Mental Illnesses.

In the correctional facilities, there are many cases of unaddressed mental illnesses among the inmates. Health workers find it very hard to contain contagious diseases in such an environment. In many cases, these facilities do not even think of requesting third-party assistance from outsiders like NGOs organization, well-wishers, among others.

  1. Follow OSHA Safety Guidelines.

Penitentiaries don’t even follow guidelines that are prepared and published by federally-accepted health bodies like OSHA when dealing in treatment or diagnosis of such ailments.

Infectious diseases control practitioners have to be more innovative so at to protects the wellbeing of the prisoners as well as the correctional facility workers.

Challenges Facing Correctional Facilities

As we have noted, there is the need to implement changes to control outbreaks, but still, there some challenges that can affect the control of bloodborne pathogens.

  1. Hand hygiene.

Clinical areas in correctional facilities lack proper hand washing equipment. The prison authorities feels like soap dispensers as well as soaps can be stolen by prisoners and they find it hard and expensive to replace.

  • Sharp objects.

When places for disposing sharp objects such as closed metallic containers are not available, inmates can get hands on such items and use them to injure themselves or others, fueling the spread of infections.

  • Inmate hygiene.

When it comes to personal hygiene, there are restrictions when accessing shower. Also there are only a few toilets to serve the populations in prisons.

  • Prison Housing.

Correctional facilities experience an acute shortages of cells to hold inmates, and the few cells must be shared by a crowd.  If there is an outbreak, the infections can spread very fast due to the congestions in the facilities.

 The lack of isolation cells that can be used to manage contagious diseases also contributes to more infections.

In conclusion, there significant number of people who stays in the facilities either workers or inmates. In these facilities, infectious diseases are very rampant among the inmates and the condition of the prisons and jails does not help to reduce spread of contagious diseases. 

Most of the correctional facilities lack experts on infection control and that brings the need of collaborating with other institutions that can help in prevention of such diseases. Also there have been suggestions in the developing world that training medical practitioners should also study correctional public health.

Such a program will help create and raise a lot of awareness on the infection diseases control and prevention in correction facilities.

Understanding Bloodborne Pathogens

Bloodborne pathogens, are infectious disease-causing micro-organisms that reside in the blood— and transmit from one person to the next through blood and body fluids. In essence, they are viruses or bacteria that are carried through the blood.

When passed-on from an infected person to the next, they causes diseases in human beings. Unfixed tissues can also be part of blood-spread infections that can cause illnesses in human body.

Some of the bloodborne pathogens that are very common are hepatitis C (HCV), hepatitis B (HBV) and human immunodeficiency virus (HIV) which caused AIDS. Other Bloodborne pathogens includes syphilis, malaria and brucellosis.

Before we address how the pathogens are spread through human bodies, we will sample some of the diseases they cause. That way, we will be able to understand and learn various ways of spreading, prevention and cure in case of infections

1.     Hepatitis B.

This chronic disease is a very deadly and life threatening infection that affects the liver. It is caused by a virus called Hepatitis B.

The effects on the liver are caused by chronic infections and severe cases may threaten an individual’s life. The cause of death can be cirrhosis or liver cancer.

Hepatitis B Transmission.

One of the most common and popular ways HBV to spread is through mother-child transmission during birth. This type of transmission is referred to as perinatal transmission. Again it can be spread to another child who is uninfected through exposure of the blood.

This can be done in the first five years of child growth. This transmission is called horizontal transmission.  These infections have a very high rate of development to chronic ailments to children that are under the age of 5.

This infection can also be transmitted or spread through many other ways. Such ways includes tattooing, needle stick injury or even exposure of infected body fluids. Such fluids are saliva, vaginal, seminal or even menstrual fluids.

Many infections can be transmitted through sexual contact. In prison, this is particularly common in prison settings because unvaccinated males have sexual pleasures with other men. Outside the penitentiary, it is common in other heterosexual who have many partners and sexual workers.

Studies have been done and it shows that chronic hepatitis that occurs in adulthood is less than 5%—and 95% of the cases happens during infancy or early stages of childhood.

The reuse of needles in the prison hospitals or among drug addicts who share needles is also another cause.

In addition, hepatitis infections can also spread during dental and surgical procedures, tattooing, and use of sharp objects that can be tainted with infectious blood.

This type of infection can even survive out of the body for about seven days. At this time, the infections are still capable of happening to a person who comes into contact with it. Therefore there is need for people to be vaccinated with drugs that prevent Hep B infections.

Hep B can be identified after thirty days to sixty days from the time of infection. Those are the best days for detection since this virus incubate for around seventy days or vary between thirty to a hundred and eighty days. If the infections are not detected early enough, they lead to chronic hepatitis B.

HBV Symptoms.

Symptoms don’t start showing off immediately after someone is infected. After a period of incubation, several symptoms start showing up. It should be noted that infections vary from one individual to the next.

Some people will start experiencing several symptoms which include eyes turning yellow, fatigue, and urine that turns dark among others. Others will experience acute failure of the liver, and in most cases it leads to the loss of life.

Hepatitis B diagnosis.

For one to be diagnosed with this type of infection, laboratory confirmation is essential in order to differentiate this infection from viral agents that causes other forms of hepatitis.

Blood samples are taken and are tested for these infections.

Treatment.

An acute hepatitis B does not have a specific treatment. The main treatment is to make the patient as comfortable as he or she can be. This is by replacing fluids that have been lost and maintaining a good diet. Unnecessary medication should be done avoided at all cost.

In chronic hepatitis, medication of this condition should be done through medicines. The treatment slows the progression of this condition and can reduce chances of developing to liver cancer—and even improve survival rates.

Prevention.

The only way this type of disease is prevented is by a vaccine called hepatitis B vaccine.

2.      Hepatitis C (HCV)

This type of disease causes infections and leads to the liver inflammation. This disease grows when an individual is infected with hepatitis c virus.

Transmission.

Since this type of condition is blood borne, there various way it can be transmitted.

It can be transmitted by sharing of equipment used to inject drugs, unscreened blood transfusion, sexual contact, and also through medical equipment that are not well sterilized.

Hepatitis C virus can also be from mother to baby but studies show that this type of transmission is not common.

It should be noted that, unlike many beliefs, this virus cannot be spread through a mother breastfeeding a child. Neither can it be spread through kissing or hugging or even by sharing drinks or food with any infected person.

Symptoms.

It begins showing symptoms two to six weeks incubation. Researches show that about 80% of all the people infected with this virus do not show any symptoms.

Those who exhibit signs include high fever, low appetite vomiting and pain in their abdomen. Other sign ranges from nausea, pain in the joints, skin turning yellow, dark urine among others.

Diagnosis.

Hepatitis C virus is generally asymptomatic. This means that there very few people that can be diagnosed with the virus.

These infections can remain undetected for decades due to the fact that they are asymptomatic. When they will manifest themselves they would have caused serious damages in the liver. Normally, the hepatitis C virus is diagnosed in mainly two steps.

  1. By testing anti-hepatitis C virus antibodies which is done by serological test, it identifies individuals who are infected
  2. When the tests are positive, certain tests have to be done in order to check the extent infection has progressed. This also will try to address the level of treatment that would be used. 

A study that was conducted shows that at least 30% of the individuals that are infected just need a strong immune system. The other 70% of individuals would require further tests in order to access the extent of infection. And medics can check for damage has done to the liver through a process called biopsy of the liver.

Treatment.

When a person gets infected, some of the pathogens are retracted naturally if one has a strong immune system. If the virus becomes chronic, treatment is required and is normally through medication.

Prevention.

Unlike the Hepatitis B, this condition does not have any vaccines that have been developed to act as a prevention mechanism.  Therefore, its prevention is by reducing a person’s chances of infection by avoiding risks that would expose one to the virus.

3.      Human Immunodeficiency Syndrome (HIV)

This is a virus that affects the immune system in the human body. Basically, the immune system in our bodies helps us to fight infections.

When this virus is uncontrolled, it kills immune cells which are normally called T cells. The most affected cells are the CD4 cells. This makes the body to be venerable to many infections as.

When this condition is not treated in advance, it leads to a more serious medical condition known as acquired immune deficiency syndrome (AIDS). When this infection reaches that stage, the body becomes very weak and unable to fight infections as well as diseases.

AIDS became more critical that if one went untreated for a period of three years, death was imminent. Medical practitioners advanced their technology and developed ways to deal with this situation through antiretroviral (ARVs) drugs. It prolongs life expectancy after HIV infection.

Transmission.

It must be noted that anybody can contact this condition because it is transmitted mainly by the fluids in the body.

The fluids that act as a main source of transmission are unscreened blood during transfusion, semen and vaginal fluids, mother to child through breast feeding.

HIV spreads mainly via unprotected sexual contact. Also there is sharing of injection equipment among drug users as well as the equipment that need sterilization before they are used again

Another common mode of transmission is through during breast feeding. Infected mother can pass the virus through milk. Also, during child birth, there are many risk-factors that could lead to infection in newborns.

Blood transfusion is another way these infections can spread. Sometimes organ transplant can lead to HIV— though not common in developed countries as a mode of transmission.

However, people should note that when a person is infected by HIV and is under treatment, they may have an undetectable viral load. In this case HIV transmission is very low.

Symptoms.

A person with HIV can last several years without knowing unless they get tested.

Some of the symptoms that appear are called non-specific symptoms. These are symptoms that do not indicate specific conditions.

Such symptoms includes fatigue, vomiting, diarrhea, headaches, skin rushes, pneumonia, recurrent fevers among others

Diagnosis.

When diagnosing if someone is HIV infected there several tests that can be done. The type of test is usually determined the medical practitioner who is conducting the test.

One ways to test is the antibody test. It is the most common to diagnose HIV. This type of test checks the antibodies—a type of protein which fights infections— produced by the body.

The tests are done by use of blood and are very effective that they give a result after 30 minutes. Because testing can bring a negative result (even in infected people) and a person is exposed  to the virus from time to time, tests should be repeated after ninety days.

Another way testing is done by use of nucleic acid test which is very expensive. It is particularly used to test individuals who are known to be in a risk of contracting the virus. These tests focus on the virus itself, that’s why they are very expensive.

Treatment.

When one gets tested and the results are positive, treatments should begin immediately. The main form of treatment for this condition is what is referred to as antiretroviral (ARVs) drugs. These are daily medications that help to boost CD4 cells by keeping them immune and empowering them to fight diseases.

It also reduces the chances of the HIV infection to progress to AIDS. Furthermore, the treatment can reduce chances of transmitting infections to others.

Medical researchers are still looking for ways to develop a vaccine that can reduce or stop transmission of the virus. But individual steps and principles can reduce the rate of infection.

Such principles include that a person can decide to practice safe sex, avoid sharing of sharp objects that can lead to infections.

Final Words

All these are part of Bloodborne pathogens infections, their causes, treatments, diagnosis and how they can be prevented from spreading.

Correctional centers should use this information to improve the quality of heathcare in their penitentiaries and protect convicts from infection.

Healthcare workers who are dedicated to serving prisoners are even at a higher risk than convicts. That explains why prison authorities should change their approach when it comes to protecting their employees.