TB + PRISONS: THE FACTS FOR INMATES AND OFFICERS Introduction This pamphlet talks about tu

TB & PRISONS: THE FACTS FOR INMATES AND OFFICERS

Introduction

This pamphlet talks about tuberculosis ("TB") in prison and jail.  It will
tell you what TB is, what its symptoms are, what you can do to avoid
getting it, and what to do if you think you have it.  TB is usually
curable, but since it is very important to start treatment as early as
possible, the more you know about it now the better your chances are of
avoiding it. 


Definitions:

This booklet will be more helpful to you if you know the meaning of these
words: 

HIV - human immunodeficiency virus, the virus which causes AIDS

Immune system - your body's ability to fight off disease

Multiple-drug resistant tuberculosis (MDR-TB) - a form of TB which cannot
be killed by the standard anti-TB drugs

TB - short for tuberculosis

TB infection - You can be infected with TB and have no symptoms, no pain,
and not be contagious.  You could be infected your whole life and never
get sick. In fact, the majority of people infected with TB never become
ill with TB. 

TB disease - If you have TB disease you may get very sick, and can spread
the disease to others.  This happens when your body's ability to fight off
the infection is weakened for some reason and/or the TB germs multiply. 

Questions and Answers about TB

1. What is TB?
	
	TB is an infection that can make you very ill.  It is spread
through the air from person to person by tiny germs (bacteria). 

	TB germs can live in your body without making you sick.  This is
called TB infection.  Your body traps the TB germs with special germ
fighters, which keep TB germs from making you sick.  You can have TB
infection without having TB disease. 

	But sometimes the TB germs break through the body's defense
mechanisms, and cause TB disease.  The germs can attack the lungs or other
parts of the body, such as your throat, kidneys, brain, or spine.  People
who have TB disease need medical help.  Without medical help, people who
have TB disease may spread the disease to others, or they may die. 


2. How do you get TB?

	You may become infected with TB if you spend time near someone
with TB disease of the lungs or throat.  It is important to understand the
difference between the way the TB infection is spread and the way that the
HIV/AIDS virus is spread.  The HIV/AIDS virus is spread only through
sharing bodily fluids, that is, through having sexual contact or sharing
needles with someone who is infected.  In contrast, it is possible to get
TB infection by simply breathing in TB germs that a person coughed into
the air. 
  

	Since TB is spread through the air from person to person, it
spreads more easily in places that have a lot of people without fresh air,
such as crowded housing, homeless shelters, prisons, jails and lockups. 
Even hospitals have reported outbreaks of TB. These are the conditions in
which the TB germs thrive. 

	The increase of TB is highest in most states among incarcerated
African Americans and Latinos between the ages of 22 and 34 who come from
poor communities.  These communities are most likely to suffer from
overcrowded housing conditions, lack of fresh air, and poor health care
services. 

	But remember, anyone can get TB.  In a jail or prison setting, not
only are prisoners and their families at risk, but also correctional
officers and staff, their families and the community at large. 

3. How can I protect myself against TB?

	It is hard to stay healthy in prison for many reasons.  It is hard
to get good nutrition.  It is also difficult to get enough exercise and
fresh air, and life is more stressful than on the outside.  Drugs,
alcohol, and cigarettes can weaken your body and make you more prone to
disease.  Although quitting smoking is hard because of the stress you are
under, it can make a big difference in the health of your lungs and body,
which is important to fight off TB disease.  It is also important to stop
drinking and doing drugs, and to exercise and get as much fresh air as
possible. 

	If you do get TB, remember that it can be cured.  The most
important thing is to take your medication as often and as long as the
doctor or health care worker tells you to. 

	Eliminating overcrowding and improving ventilation in jails and
prisons can reduce the risk of spread.  Prison officials need to follow
strict standards regarding overcrowding, unsanitary conditions and
ventilation. 

4. How do I know if I have TB infection?

	A skin test (PPD) done by a health care worker is the only way to
know if you have been exposed to the disease.  A small needle is used to
put some testing material under the skin of the arm.  In two or three days
a health worker will check to see if you have had a reaction to the test. 
The bump needs to be read by a health care worker.  Don't be alarmed if a
bump appears in the first day;  you must have someone read it to tell for
sure.  The test is "positive" if a bump about the size of a pencil eraser
or larger appears on your arm.  This bump means you have been exposed to
TB and probably have TB infection.  You should then be given a chest X-ray
to see if you have TB disease.  This X-ray is safe and painless. 

	Be sure to tell a health care worker if you have ever been treated
for TB or if you have ever had a positive skin test. 

5. If I am infected, do I need treatment?

	Yes, you should be given the drugs which kill the TB germs and
prevent the spread of disease.  But it takes six to twelve months to wipe
them out, and you must take the medicine the whole time for it to be
effective! If you stop halfway through, the germs that are still alive may
become resistant to the drugs. 

	Early diagnosis and treatment of TB are very important.  If you
think you have been exposed to TB or you show any of the symptoms listed
in the next section, immediately talk to a health care worker or a doctor
about it.
	
	A few people experience side effects to anti-TB drugs.  You should
get tests to check on this.  If you turn yellow and have stomach upset,
seek medical help immediately. 

	If you have TB infection, you will probably need medical treatment
so you will not get TB disease.  Isoniazid (INH) is the drug most often
used to prevent TB infection from developing into TB disease.  Sometimes,
people with TB infection need more than one drug to protect them from
developing TB disease. 

6. How do I know if I have active TB disease?  

Here are some signs of TB disease to watch for:

*	Coughing that lasts more than two weeks (this is the most important sign
	to watch for); 

*  	Feeling weak or tired a lot;

*  	Weight loss without dieting;

*  	Loss of appetite;

*  	Unexplained fever; 

*  	Sweating a lot at night.

	These signs may last for several weeks.  If you do not get
treatment, they will usually get worse. Usually, these symptoms are caused
by other illnesses, but you should check with a doctor or health care
worker about them.  If they turn out to be signs of TB, the sooner you
start taking your medication, the better your chances are of recovery.  It
will also lessen your chances of spreading the disease to others. 

	If the TB disease is in your lungs, you may cough a lot, cough up
mucus or phlegm ("flem"), or cough up blood.  You may even have chest pain
when you cough.  You should always cover your mouth when you cough. 

	If you get TB disease in other parts of your body, the symptoms
will be different.  Only the health care worker can tell if you have the
disease. 

7. Does HIV infection affect TB?

	The virus that causes AIDS is called HIV (Human Immuno-deficiency
Virus).  HIV is a virus that destroys your body's ability to fight off
even small infections.  Having HIV is not the same as having AIDS. 

	Having HIV infection and TB infection at the same time is a bad
combination, because HIV helps the TB germs make you sick by attacking the
germ fighters.  If you have both HIV infection and TB infection, your
chances of getting TB disease are much larger.  TB germs are more likely
to attack your lungs and other parts of your body.  You can be cured, but
it takes longer. 

	If you think you may have been exposed to HIV, talk to a health
care worker or doctor.  Ask to be tested for TB even if you show no
symptoms.  If you have HIV infection and TB infection, the sooner you
start with anti-TB medicine, the better your chances are of staying
healthy. 

	If you have HIV infection, it is important to get tested for TB
infection at least once a year.  If you are HIV-infected, it is possible
to have TB infection even if you have a negative skin test for
tuberculosis.  Anti-TB drugs are strong enough to prevent or cure TB
disease even in people with HIV infection. 

	It is very important that you take your preventive treatment as
the doctor recommends.  It takes at least nine months to a year to kill TB
germs.  Remember, you will always have TB germs in your body unless you
kill them with the right medicine. And, the anti-TB drugs work only when
you take them! 

8. What is multiple drug-resistant TB?

	There is a different kind of TB which is even more dangerous than
"regular" TB because its germs cannot be killed by the usual anti-TB
drugs.  We have seen more of it recently in prisons, jails, and hospitals. 
It is called multiple-drug resistant TB (MDR-TB).  MDR-TB requires longer
and more expensive treatment.  For someone with HIV, it is serious enough
to be life-threatening. 

	If you have been diagnosed with MDR-TB, you need to start taking
medicine immediately.  It is urgent that you do that!  Again, it is very
important that you take the medicine exactly the way you are told to take
it. 

9. What will happen if I get active TB disease?

	If you have TB, you will most likely need to be isolated from
others so the infection will not spread.  If you have TB of the lungs or
throat you will need to be placed in a room with special ventilation--it
may have special lights as well--until you are no longer contagious.  You
will be told to wear a mask, which is important to keep you from spreading
the TB germs.  You might be transferred to a hospital for treatment. 

	You may not be allowed visits for awhile because you can spread
the TB germs.  Talk with a doctor or health care worker about how long
that period may be so that you and your family will know what to expect. 
You may want to discuss with your health care worker whether or not your
family members should get tested for TB. 

10. Can I still go to work or school if I have TB?

	These decisions have to be made on a case-by-case basis.  The
important thing to know is that it is a decision that should be made by a
medical person, not a staff person. 

11. What if I am released before I finish my medication?

	Ask the health worker where you should go to get the rest of your
medicine.  The local health department or your outside doctor will make
sure you get the right medicine.  Your taking the anti-TB drugs will also
help protect your family and friends from getting TB.  You may begin to
feel fine, and taking the drugs may be a hassle, but you need to keep
taking the drugs for the prescribed amount of time! 

	Finally, if you have any symptoms of the disease, go to sick call
and make sure your symptoms are checked and you are tested for the
disease.  Medical screening and quick medical care are extremely important
to help combat the disease.  Since good medical care is often hard to get
in jail and prison, you will need to keep trying to get decent care. 
Friends and family on the outside may also have to talk to staff on your
behalf. 

	You may have many other questions about TB.  In general, local Red
Cross chapters and public health departments will be able to answer these. 

How to Get More Information About TB

1.	Consult with the medical staff at your fail or prison.
2.	Contact your local American Red Cross office.
3.	Contact your local Public Health Department.
4.	Contact the Centers for Disease Control
	Division of Tuberculosis Elimination
	1600 Clifton Road NE, MS-E-10
	Atlanta, GA 30333

NPP TB Information Order Form

TB & PRISONS: THE FACTS

Bulk orders available for:
_____	100 copies, $25
_____	500 copies, $100
_____	1,000 copies, $150
Single copies free.

Also available:

_____	AIDS & PRISONS: THE FACTS. Single copies free; contact NPP for
bulk orders. 

_____	NPP JOURNAL.  Quarterly journal featuring articles on TB, AIDS,
and other health matters affecting prisoners.  The JOURNAL focuses on
corrections and criminal justice issues.  $30 prepaid/$2 for prisoners. 

Fill out and send with check payable to National Prison Project to:  TB
booklet, National Prison Project, 1875 Connecticut Ave. NW, Washington,
D.C. 20009; or call 202/234-4830; or FAX 202/234-4890.

=============================================================
ACLU Free Reading Room   | A publications and information resource of the  
gopher://aclu.org:6601   | American Civil Liberties Union National Office
ftp://aclu.org           | 
mailto:infoaclu@aclu.org |  "Eternal vigilance is the price of liberty"