Thanks to all those who've taken the time to read and respond to the diary. It's clear that my friend is in the wrong on some details (though I don't doubt the truth of her experiences at all) and has been mislead on reporting requirements, somewhere along the line. Commenters have taken the time to correct those mistakes, and in the interest of not providing inaccurate information, I must point to the additional info offered in the commentary by those with far more knowledge (and know how on where to find it) on the regulations and requirements for reporting of infectious diseases withiin prison. They are required to report it to the state. Part of this also meshes well with her statement on local tracking, as well as how prisons can get around this. The original diary is below.
"What do you mean they don't have to report it?"
That was my response to my friend, who had just returned from quarantine after treating an outbreak of tuberculosis at a private prison in her home state of Texas. She then proceeded to tell me that they do not, in fact, have to report it at all to the CDC. Or anyone, really, for that matter. Outbreaks of infectious diseases in prisons are common, but unlike their publically run counterparts, have no obligtation or regulations in place to require them to report them, she told me.
My friend, who I'm going to leave nameless, is a health care professional and trained respiratory therapist. Recently, she vanished from our shared online space and, when she returned, she informed me she had been called to treat an outbreak of TB at a local, privately owned and operated prison. What she told me left flabbergasted and astounded. All I can offer is her perspective, here, and hope it's illuminating. I have asked her to state in her own words her experience with the private prison system.
Tuberculosis, a disease most people see as a third world disease, highly deadly, and difficult to treat.... We put patients in negative pressure rooms where the air is circulated separately because hospitals know how easy it is to transmit. Frequently, they're placed in full droplet isolation as well. Head to toe personal protective equipment (PPE). And prisons aren't required to report it to the CDC, so we have NO idea how much higher than average for a local population center such infectious diseases occur. Noone is tracking it. All I know is that this stuff breeds easy in conditions like that. US prisons are IDEAL breeding grounds for diseases like tuberculosis, in fact. And because they take a hit to their 'reputation' and chance for state money if prisoner health suffers due to poor healthcare... They choose not to report it. Why would they when they don't have to? Successful treatment of this crap can take over a year, for crying out loud, and can leave long term damage. Here's the thing... People have done studies on this... Hell, even the government has.... Numbers suggest the rate of TB is higher by as much as a hundred times in prison than the local population's average. But since prisons aren't required to report it... Local populations? Basically at the mercy of chance. And do you know why this is especially heinous for prison populations?: AIDs. Tuberculosis is one of the number one killers of HIV infected patients. Consider this also... How EXTREMELY mobile prisoners are. Transfers between facilities, contact with visitors, lawyers, staff, etc.. Any tracking of the disease in correctional facilities is done entirely at the state level.She then went on to add the following:
You know the number one way they get around reporting rates of Tuberculosis infection in places that require it? They ship them to a fucking hospital instead of testing/diagnosing for it. That way, the patient had TB while he was in the hospital. Not the infirmary. Which screws up TWO sets of numbers. Suddenly, the local population's TB rate suffers a 'spike'. Prison remains clean. But they don't do that just for TB, you see. The only way they get treated in a prison... Is if there are too many to fucking move. One or two TB patients can be treated. Five, or six? You cohort them. Even ten is usually enough to overwhelm a single well-staffed, well-supplied hospital.She also reccomended the following link, though it isn't specific to the US: http://www.ncbi.nlm.nih.gov/...
I believe my friend and trust her, but this is almost impossible to believe, even though I know it's perfectly believable. They don't have to report infectious diseases? They can just decide not to? I felt it the sort of thing that really ought to go on a DK diary because, well... this matters. A lot. She's right. People need to know this so that something can be done about this.
Meanwhile, I am left sitting here, bewildered, and saying: What the fuck?
4:40 AM PT: Wow. Er. Recc list. Can't say I was expecting that. I also want to point to Denise Oliver Velez's enlightening comment below about the CDC guidelines.
4:57 AM PT: It's been pointed a few times now that regulations do require them to report it to the stat.. It looks more and more that they are not not required to report it, but gaming the statistics so as to maintain the prison's 'clean' reputation. Next time I talk to my friend, I'll be sure to pass along the reccomendation that she in fact contact the CDC. As I said, I can only go off what she's told me, and I'm feeling a bit less alarmed than I was. Thus, I apologize for the alarmist tone of the diary. Thanks to MaryKK as well.