Kansas City, Mo. ? A report released this week by the Centers for Disease Control and Prevention says that for nine months in 2002 a Kansas man passed through three county jails and a state prison before officials diagnosed him with the infectious lung disease tuberculosis.

Of the 318 people that health care workers determined the prisoner had contact with, 47 tested positive for the disease and 60 couldn’t be found or refused to be tested.

Close confines

State and federal officials cautioned that they cannot confirm that those who tested positive were infected by the inmate, but they are using the case to impress on other states and counties how quickly tuberculosis can spread in the close confines of prison.

“We want to get that information out there for medical professionals to have TB control plans in correctional facilities,” said Dr. Renee Funk, who served as epidemic intelligence officer for the CDC during the six-month investigation.

Phil Griffin, director of the Kansas Tuberculosis Control Program, said the case has led to more cooperation between local health departments and jails as well as a tighter screening of inmates coming into the state prison system.

“I think the thing to take away from this is that there were some mistakes made but there were also some important lessons learned and the situation has greatly improved,” Griffin said.

Neither Funk nor Griffin would name the inmate or say where the jails or state prison are, saying to do so would violate patient confidentiality.

However, the Kansas Department of Health and Environment announced in October 2002 that it was testing people for tuberculosis after diagnosing an inmate at the state prison in Lansing. The department at that time said it tested 154 people in the counties of Neosho, Cherokee, Crawford and Linn, saying the inmate had spent time in several county jails. Twenty-seven people tested positive.

Officials said this week that while two prisoners have been diagnosed with tuberculosis since the incident included in the CDC report, both were caught early on and didn’t require extensive testing of prior contacts.

Bounced between jails

According to the CDC report, the tubercular inmate’s story begins in October 2001 when the then 36-year-old was living in a California homeless shelter and coughing up blood. A physician at the shelter examined him in December, suspected tuberculosis and recommended that the man get a chest X-ray. He never did.

In January 2002, he returned to Kansas and turned himself in on an outstanding warrant. He spent three days in one jail and seven weeks in a second jail, where medical personnel diagnosed his condition as asthma.

He got out of jail in March 2002 but was arrested again in June and bounced between two jails, neither of which looked into his condition.

In August 2002, he was sent to the state prison, where he spent at least six weeks among the general prison population before medical personnel performed the necessary tests to determine he had infectious tuberculosis.

The man was isolated from other prisoners and treated while health investigators began tracking down everyone with whom he had had contact.

Officials said they tested 256 people, finding 47 infected with the disease. Two of those people, both of whom had shared a cell with the inmate, had the full-blown infectious version of the disease.

Treatable disease

Tuberculosis can lie dormant in an infected individual for decades and may never develop into the full-blown infectious disease. The disease, at one time a virtual death sentence, is now easily treated with a six- to nine-month regimen of medicines.

“The reason we try to identify the individuals early is that within the first two years after infections, you have the greatest chance of contracting the disease,” Griffin said.

State Department of Corrections spokesman Bill Miskell said the department had tightened up its policies for screening new inmates at its eight state prisons and increased training for medical personnel.

Miskell said the department has no control over local jails, and Griffin said his experience in getting local corrections officials to develop tuberculosis plans has been mixed.

“With 104 counties, there is a very hodgepodge response,” he said. “Some are doing a better and better job while others say they don’t think it’s an issue.”