Maryland health officials are testing inmates and staff at two of the state's prisons in downtown Baltimore for tuberculosis after an inmate was found to be infected with a rare strain of the disease resistant to seven drugs.
Of 82 staff members who had the most contact with the prisoner, five have tested positive for TB bacteria, said Gino R. Secola, director of employee infection control for the state Division of Correction.
So far, none of those infected employees have developed active tuberculosis, he said. Skin tests and X-rays on about two dozen inmates housed near the infected man also were negative, said Dr. Newton E. Kendig, medical director for the prison system.
But officials said testing of all 400 staff members at the Maryland Reception, Diagnostic and Classification Center would not be complete for another month or so. Skin tests are to be redone on those who were exposed to the inmate, because an infection can take several months to show up, said Sarah Bur, chief of tuberculosis control for the state Department of Health and Mental Hygiene.
The inmate is the third in the Maryland prison system diagnosed with multiple-drug resistant TB -- and the first in Maryland to be resistant to so many drugs. Commissioner of Correction Richard A. Lanham Sr. said the inmate was given a TB skin test Sept. 30 when he entered the center after being returned to Maryland from New York City, where he had been arrested for a parole violation.
That test and a subsequent chest X-ray were negative for TB, said Dr. Kendig. But the inmate began to show symptoms of the disease several weeks later. He was moved to a special hospital unit at the nearby Maryland Penitentiary, where his diagnosis was confirmed.
"He wasn't in what we would define as general population for a long time," said Mr. Secola. "We feel very confident this person was not infectious."
The inmate remains in the tuberculosis-control unit at the penitentiary, where he is responding to treatment, Dr. Kendig said. Doctors, nurses and other staff who had come into contact with the inmate at the penitentiary also will be tested for TB bacteria, he said.
Employees were first notified of their possible exposure to the disease about a month ago, around the time officials were conducting regular yearly TB tests, Mr. Secola said.
Herbert Berry Jr., staff director of the Maryland Correctional Union, said he had heard of a number of officers with recent positive skin tests, though he could not provide precise figures. "It's like an epidemic going through there," he said.
Officials would not release the inmate's name or discuss his medical condition in detail. Dr. Kendig did say he believed the inmate contracted the disease in New York, where multiple-drug-resistant TB is much more common.
False negative TB skin tests and X-rays can be caused by the presence of the virus that causes AIDS, according to a report on tuberculosis in correctional facilities issued last year by the National Institute of Justice and the Centers for Disease Control and Prevention.
Several correctional officers who work at the 800-inmate prison yesterday voiced fears about their possible exposure to the disease. Inmates travel through the reception center when they are first sentenced to prison to have their security levels and placement determined.
The officers, who asked not to be identified, said that makes them particularly vulnerable to infection from inmates who may not have been diagnosed with TB or other diseases. They also said they are not given sufficient safety equipment, such as masks, with which to guard against infection. "They don't inform us of the inmates' conditions; they tell us nothing," one officer said.
In 1992, tests showed one-third of prisoners and 10 percent of the staff at the Roxbury Correctional Institution in Hagerstown carried tuberculosis bacteria after being exposed to an inmate with TB resistant to two drugs.