Illness alert at city lockup

Inmate develops meningitis

officials distribute antibiotics

Disease can be deadly

About 300 guards, prisoners receive preventive treatment

May 26, 2000|By Peter Hermann | Peter Hermann,SUN STAFF

More than 300 correctional officers and inmates were given antibiotics yesterday after a prisoner at Baltimore's sprawling pretrial lockup was diagnosed with bacterial meningitis, a contagious and potentially deadly disease that affects the lining of the brain.

City health workers were searching yesterday for 23other detainees who came in contact with the sick inmate since he was jailed May 17. Those inmates had been released on bail before officials declared a medical emergency early yesterday.

Forty-four inmates who had contact with the man and are still jailed have received medication, though officials said there was only a remote chance of the disease's spreading inside the jail.

Medical officials were also searching for and passing out medication to others who might have had contact with the man, including police officers who arrested him, public defenders who talked with him about his case and their relatives.

About 60 staff members at the Central Booking and Intake Center on East Madison Street might have been directly exposed to the disease, officials said, though at least 260 sought medication.

"Although we understand the serious concern, there is no immediate crisis," said LaMont W. Flanagan, the commissioner of the Division of Pretrial Detention and Services. The inmate was identified only as a 41-year-old Baltimore man who was being treated yesterday afternoon at the University of Maryland Medical Center.

Leonard A. Sipes Jr., a spokesman for the state prison system, said the man was arrested on drug charges May 17 and arrived at the booking center at 11:50 that night.

He said the man showed no signs of illness during a medical screening that each inmate receives upon arrival. It includes a blood pressure check and other routine tests.

Meningitis is hard to diagnose during its early stages because symptoms at first resemble flu or a cold, doctors say. The first sign is a headache, followed by a stiff neck, nausea and a fever.

The infected inmate was housed with 67 other prisoners in the north tower, which is divided into dozens of cellblocks, as he awaited a court date next month.

On Tuesday, six days after he was brought in, the man complained of feeling ill and was found to have a high fever and diminished mental capacity; he suffered a seizure.

Correctional officers called 911, and the inmate was transported to the University of Maryland Medical Center. Doctors diagnosed meningitis Wednesday night, and Sipes said blood tests confirmed their diagnosis at 5:30 a.m. yesterday.

Doctors called the risk of the disease spreading, either inside the booking center or outside its walls, "very remote." The disease spreads primarily through saliva, kissing or sharing a drinking glass.

`Close contact' required

"You have to have had really close contact," said Baltimore Health Commissioner Dr. Peter L. Beilenson. "That's why we worry about people in college dorms sharing beer bottles or eating utensils."

Dr. John Stafford, the medical director of the state Department of Public Safety and Correctional Services, said no one aside from the affected inmate has shown signs of contracting the disease.

"If we have no other cases in the next 24 hours, we're home free," Stafford said yesterday afternoon, adding that meningitis is diagnosed in a state prison or jail about once every five years.

Bacterial meningitis is an infection of the membranes that cover the brain. It causes a severe headache, stiff neck, rash and fever, followed by drowsiness and a loss of consciousness - symptoms that can progress rapidly.

The disease can kill within a few days, sometimes within hours.

Despite what doctors said was a low risk even to people with close contact with the inmate, they administered medication on demand to staff members at the booking center.

More than 260 correctional employees - officials declined to say how many work there - took the oral antibiotic.

One correctional officer became so alarmed, doctors said, that he was rushed to a hospital for a spinal tap - in which a needle is inserted into the base of the spine - even though he exhibited no symptoms. The test was negative.

Forty-four inmates who had been housed in the sick man's block in the jail's north tower also were given medication. Prison officials said detainees are usually divided into groups for security purposes, making it easy for them to identify the ones who were with the sick inmate.

About 900 prisoners are held in the booking center at any time.

In 1999, Maryland recorded 55 meningitis cases, 11 of them fatal. In 1998, 35 cases were reported, with eight deaths. Sixteen cases, including the inmate's, have been reported this year; three of those people died. None of the cases was reported in a jail.

In the 1990s, Maryland recorded about 30 to 58 cases a year, about 12 percent to 20 percent of which are fatal; nationally, there are about 2,600 cases annually, 12 percent to 15 percent of them fatal.

Deaths at college campuses

Most cases that get publicity occur on college campuses.

A Towson University student died in March, and a Frostburg University student died in February 1999. The assistant principal of a city elementary school died of the disease in May 1999.

State prison officials said they were called to the booking center Wednesday night and began handing out medication and briefing workers.

Dr. Tony Swetz, the director of inmate medical services for the state prison system, said doctors believe the man contracted meningitis before he was arrested.

He said it takes seven to 10 days for symptoms to fully develop.

The doctor said there is a "great deal of over-concern" among staff members who have virtually no contact with inmates.

He said they are being given medication "just to put their mind at ease."

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