More than 1,500 people were vaccinated last year after a sick inmate at Men's Central Jail inadvertently exposed thousands of detainees to hepatitis A before medical staff discovered what was wrong with him, according to a report released this week. by the United States Centers for Disease Control and Prevention. Prevention.
At the time, Los Angeles County officials said no one else contracted the virus, and the CDC report attributed successful containment to the county's rapid response. Within 48 hours of detecting the highly contagious virus, officials identified nearly 6,000 people the infected man may have come into contact with and offered free vaccinations to more than 2,500 of them.
“This exposure response highlights the importance of initiating a rapid response to hepatitis A exposure in a jail to minimize the risk of transmission and help prevent an outbreak,” says the report, written by several medical staff at the Los Angeles jail.
In a statement Thursday, the county Sheriff's Department emphasized that jail officials worked with medical staff to make widespread vaccinations possible.
“The health and safety of our entire incarcerated population, as well as our custodial staff, is very important to us,” the statement said.
The county's Correctional Health Services had no immediate comment.
Because of communal living and crowded conditions, jails and prisons are often high-risk environments for infectious diseases, including COVID-19, influenza and hepatitis A. Even outside of jails, health officials say, Hepatitis A outbreaks have increased in recent years. — especially among men who have sex with men, people who use drugs, and the homeless.
The man who fell ill at Men's Central Jail was initially jailed on April 27. He reported a history of injection drug use and homelessness and said he was in alcohol withdrawal, according to the CDC report.
Nearly a month later, on May 25, he visited the jail clinic and told medical staff that he had been vomiting for two days. She was given anti-nausea medication and antacids, and she reported feeling better that same day, according to the report. But over the next three days she got worse. When he saw medical staff again on May 28, he appeared jaundiced and said he had not eaten in four days due to stomach pain, nausea and vomiting, all symptoms of hepatitis A. He was sent to a hospital for evaluation and tests. of emergency. He soon confirmed his infection.
On May 30, public health officials informed the jail of the test results and determined that he may have been contagious as early as May 9. Because the incubation period for hepatitis A is so long (15 to 50 days), it was unclear whether he contracted hepatitis. virus in jail or before his arrest, according to the report.
Although officials immediately began identifying who he may have been in contact with in his living area, it was not until May 31 that the county Department of Public Health's Acute Communicable Disease Control branch interviewed the man and learned he had been an Inmate Worker assigned to prepare meals in the prison kitchen.
Once county health officials informed members of the jail's medical staff that, they expanded the list of potential contacts to account for his work at the jail.
On June 1, authorities launched a mass vaccination campaign, starting with people who had been housed with the infected man. Over the next two days, they offered the vaccine to other kitchen workers and, eventually, to anyone who had been in Men's Central Jail during the infectious period.
In total, officials identified 5,830 people who had been housed in the jail during that period, of whom 4,128 were still incarcerated. Of them, 1,362 had been vaccinated or previously had the virus. On June 12, officials offered vaccines to the remaining 2,766 people, nearly 55% of whom accepted them. Kitchen workers who refused and had not been previously vaccinated were reassigned until the end of the incubation period.
Jail employees and medical staff were notified of the possible exposure and offered vaccinations. And although officials said last year that the timing of the incubation period coincided with a tour by a large group that included a federal judge, U.S. Justice Department officials and lawyers from the American Civil Liberties Union, leaders The Sheriff's Department said they did not believe the visitors had been exposed.
“They did not visit the affected housing area or eat any food,” Deputy Sheriff Sergio Aloma said at the time.
As of October, no additional cases of hepatitis A had been reported or identified in any of the county jails.
Hepatitis A is very contagious and people can spread it before they feel sick, according to the county Department of Public Health. The virus causes a short-lived liver infection and is found in the feces and blood of infected people. It is usually spread by eating contaminated food or by close contact with someone who is contagious.
There is no specific antiviral therapy for the infection, which partly explains why officials focused on a mass vaccination campaign.
This is not the first time Los Angeles jail officials have quickly vaccinated large numbers of people against hepatitis A, according to Thursday's report. From 2007 to 2010, Los Angeles prisons had several hepatitis vaccination campaigns targeting gay men, and from 2017 to 2019 prison officials offered vaccines to the entire population after a hepatitis A outbreak in San Diego.
This time, improvements in electronic medical records made it easier for officials to identify people who had been vaccinated and focus outreach efforts on those who did not have any immunity. The report said that because prisons present “a unique opportunity to reduce hepatitis A transmission and disease through vaccination,” Correctional Health Services “may consider a more comprehensive routine vaccination strategy, which includes offering vaccination at the time of admission.”
