Preparing for the Pandemic in Prisons

With the World Health Organizations raising the pandemic alert level to Phase 5 last week - which means human-to-human spread of the virus into at least two countries in one WHO region, a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short - preparations for a possible international pandemic take on even more urgency.

The head of the World Health Organization, Margaret Chan told Britain's Financial Times on Monday that the apparent decline in mortality rates did not mean the pandemic was coming to an end. It is quite possible that a second wave may strike "with a vengeance."

"If it's going to happen it would be the biggest of all outbreaks the world has faced in the 21st century," the business daily quoted her as saying. "We hope the virus fizzles out, because if it doesn't we are heading for a big outbreak. I'm not predicting the pandemic will blow up, but if I miss it and we don't prepare, I fail. I'd rather over-prepare than not prepare." She added the end of the flu season in the northern hemisphere meant any initial outbreak could be fairly mild, but a second wave reemerging in the fall could be more lethal.

Much of the preparedness from a local government perspective involves adequate steps to contain the contagion as it emerges. But what about prisons - places where people are locked up together in a closed environment?

With more than 9 million people incarcerated across the globe and 2.25 million in U.S. jails and prisons alone, it is vital that correctional officials and health professionals be prepared for a worst-case scenario that involves pandemic influenza reaching inmates and staff.

With collaborative planning and training, prison and public health officials can help control influenza outbreaks behind bars, according to an article in the April issue of the Journal of Correctional Health Care.

For a model of prison preparedness, the article cites a two-day conference on prison pandemic preparedness that was held in Georgia in 2007. Administrators, medical doctors, registered nurses, physician assistants, and pharmacists were among the participants, as well as state and local public health officials.This conference, suggest the authors, could serve as a model for such training.

The objectives of the conference were to educate participants about pandemic flu issues in prison settings, provide impetus for initial planning in Georgia's prisons, and elicit ideas about how the prisons could best prepare for and respond to pandemic flu.

Effective training about pandemic influenza requires more than just classroom lectures or checklists, the authors write. The conference employed interactive methods and educational games that proved effective in training participants.

For a limited time. the article, "How Public Health and Prisons Can Partner for Pandemic Influenza Preparedness: A Report From Georgia" in the April issue of the Journal of Correctional Health Care can be accessed free at http://jcx.sagepub.com/cgi/reprint/15/2/118.

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