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2.
Emerg Infect Dis ; 30(13): S17-S20, 2024 04.
Article in English | MEDLINE | ID: mdl-38561633

ABSTRACT

The large COVID-19 outbreaks in prisons in the Washington (USA) State Department of Corrections (WADOC) system during 2020 highlighted the need for a new public health approach to prevent and control COVID-19 transmission in the system's 12 facilities. WADOC and the Washington State Department of Health (WADOH) responded by strengthening partnerships through dedicated corrections-focused public health staff, improving cross-agency outbreak response coordination, implementing and developing corrections-specific public health guidance, and establishing collaborative data systems. The preexisting partnerships and trust between WADOC and WADOH, strengthened during the COVID-19 response, laid the foundation for a collaborative response during late 2021 to the largest tuberculosis outbreak in Washington State in the past 20 years. We describe challenges of a multiagency collaboration during 2 outbreak responses, as well as approaches to address those challenges, and share lessons learned for future communicable disease outbreak responses in correctional settings.


Subject(s)
COVID-19 , Tuberculosis , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Public Health , Prisons , Washington/epidemiology , Pandemics/prevention & control , Disease Outbreaks/prevention & control , Tuberculosis/epidemiology , Tuberculosis/prevention & control
3.
MMWR Morb Mortal Wkly Rep ; 72(12): 309-312, 2023 Mar 24.
Article in English | MEDLINE | ID: mdl-36952619

ABSTRACT

During 2014-2020, no tuberculosis (TB) cases were reported within the Washington state prison system. However, during July 2021-June 2022, 25 TB cases were reported among persons incarcerated or formerly incarcerated in two Washington state prisons. Phylogenetic analyses of whole genome sequencing data indicated that Mycobacterium tuberculosis isolates from all 11 patients with culture-confirmed TB were closely related, suggesting that these cases represented a single outbreak. The median infectious period for 12 patients who were considered likely contagious was 170 days. As of November 15, 2022, the Washington State Department of Corrections (WADOC) and Washington State Department of Health (WADOH), with technical assistance from CDC, had identified 3,075 contacts among incarcerated residents and staff members at five state prisons, and 244 contacts without a known TB history received a diagnosis of latent TB infection (LTBI). Persons who were evaluated for TB disease were isolated; those receiving a diagnosis of TB then initiated antituberculosis therapy. Persons with LTBI were offered treatment to prevent progression to TB disease. This ongoing TB outbreak is the largest in Washington in 20 years. Suspension of annual TB screening while limited resources were redirected toward the COVID-19 response resulted in delayed case detection that facilitated TB transmission. In addition, fear of isolation might discourage residents and staff members from reporting symptoms, which likely also leads to delayed TB diagnoses. Continued close collaboration between WADOC and WADOH is needed to end this outbreak and prevent future outbreaks.


Subject(s)
COVID-19 , Latent Tuberculosis , Tuberculosis , Humans , Prisons , Washington/epidemiology , Phylogeny , COVID-19/epidemiology , Tuberculosis/prevention & control , Latent Tuberculosis/epidemiology , Disease Outbreaks
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