Prison jail mental health
A detainee at the Cook County Jail in Chicago, Illinois. Close living conditions in Alabama prisons has led to a TB outbreak there, health officials say. Reuters

Alabama prisons are facing their worst outbreak of tuberculosis in five years, a state health official told the Associated Press on Thursday. The state is facing a lawsuit over its medical treatment of inmates in a crowded system. Officials have diagnosed nine cases of tuberculosis, the state’s largest outbreak in five years, the report said. Since 2009, Alabama has averaged fewer than five cases of TB every year.

The disease is spread through the air, suspended on tiny droplets released in a sneeze or a cough, according to the Mayo Clinic. The World Health Organization notes that TB is the second-deadliest infectious disease in the world behind HIV/AIDS, causing 1.3 million deaths worldwide in 2012.

Pam Barrett, director of tuberculosis control for the Alabama Department of Public Health, told the AP that the state's prisons had no cases of the respiratory disease in 2013. "This is a very serious outbreak," Barrett said.

Eight of the nine inmates infected with TB were housed at the same prison: the St. Clair Correctional Facility. Opening in 1983, it was originally designed for only 984 men. It housed as many as 1,292 prisoners as of the end of May.

The prison, which is located in Springville, Alabama, is no longer accepting any new inmates, Barrett told the AP. It's also no longer transferring any of its prisoners, as the state tries to prevent the airborne disease from spreading through a system that houses more than double its capacity.

Alabama’s Equal Justice Initiative called in June for the removal of St. Clair’s warden due to a “dramatic increase in serious violence” at the prison. The nonprofit claimed that prison leadership had lost control of the situation after inmate Jodey Waldrop was the third inmate to be murdered there in the past year.

Officials Say They’ve Seen No New Cases In Weeks

No new cases have been diagnosed for weeks, Barrett said, which gave hope to health officials hoping for “the end of it.” Inmates are treated for six months following a diagnosis, she said.

"The Department of Corrections is a hotbed of TB because of the living arrangements," she said.

Tuberculosis is a serious problem in all prisons, according to the Centers for Disease Control, which says that “inadequate ventilation” also plays a large part in outbreaks.

Doctors often don’t suspect it immediately since its symptoms mimic those of “pneumonia or bronchitis,” according to the AP. "It's unfortunate doctors are not thinking about TB, but… [m]ost doctors have never seen TB. It's easy to miss,” Barrett said.

Alabama is being sued by the Alabama Disabilities Advocacy Center and the Southern Poverty Law Center over claims it fails to provide basic care for inmates with medical and mental health problems, the AP reported. The state corrections department denies the allegations.