Robert Weinstein, Section Editor Infection Control in Jails and Prisons

At the end of 2005, ∼7 million people (or 1 of every 33 American adults) were either in jail, in prison, or on parole [1]. Compared with the general public, newly incarcerated inmates have an increased prevalence of human immunodeficiency virus infection, hepatitis B virus infection, hepatitis C virus infection, syphilis, gonorrhea, chlamydia, and Mycobacterium tuberculosis infection [2]. While incarcerated, inmates are at an increased risk for the acquisition of blood-borne pathogens, sexually transmitted diseases, methicillin-resistant Staphylococcus aureus infection, and infection with airborne organisms, such as M. tuberculosis, influenza virus, and varicella-zoster virus. While incarcerated, inmates interact with hundreds of thousands of correctional employees and millions of annual visitors [2]. Most inmates are eventually released to interact with the general public. Tremendous opportunities exist for infectious diseases specialists and infection-control practitioners to have an impact on the health of correctional employees, the incarcerated, and the communities to which inmates return. This article presents a brief review of some of the most important infection-control challenges and opportunities within the correctional setting. Most jails and prisons were constructed to maximize public safety, not to minimize the transmission of disease or to effi-ciently deliver health care. The probability of transmission of potentially pathogenic organisms is increased by crowding, de