Lately I have been talking about measles, a highly contagious virus that is seeing a resurgence in the U.S. However, there are plenty of other infections that invade our workplaces. Indeed, infection spread is a major concern in any overcrowded setting with tight living quarters and questionable hygiene practices. Understanding some basic infection transmission principles can help you determine when to sound the alarm to lockdown the spread of a viral or bacterial infection on your watch.
Chain in; chain out
Chains are a familiar sight in the criminal justice system. The chain of infection, though invisible, is all too common, as well. While a strong chain is needed for security during inmate movement or restriction, infection disruption is all about breaking or weakening the infection chain to stop the spread of the infection to other inmates or even staff in the facility. Here are the six elements of the infection chain.
- Organism – a virus, bacteria, or parasite
- Reservoir – location where the agent goes
- Port of exit – location of movement out of the reservoir
- Mode of transmission – way organism moves from one host to the next
- Port of entry – location of movement into a new reservoir
- Susceptible host – new victim of the organism
In a secure setting, highly contagious organisms are those that spread through the air by breathing or by droplets through coughed or sneezed. Coughing into a shoulder is preferred over coughing into hands to reduce contact spread of these types of infections. Infected individuals may need to wear masks during transport through the facility to reduce exposure to the general population.
Infections that invade the intestinal tract like norovirus or salmonella are also easily spread; especially when vomiting and diarrhea are present. Scrupulous hand washing and cell cleaning is necessary to avoid viral spread through contact with body fluids.
Create a security perimeter
In a tight environment like a jail or prison, the chain of infection transmission can be broken through the segregation of known or potentially infected individuals. This most often involves lockdown of an area of the facility to create a security perimeter around those who are contagious.
Isolation. Isolating infected individuals is a time tested method for breaking the infection chain that involves separating infected individuals from the general population. This creates is a physical barrier keeping the organism from reaching a susceptible new host.
Isolation cells like those in an infirmary are ideal for one or two inmates who are being evaluated for something like tuberculosis. Here, health care staff with specific training on isolation protocols can monitor and treat patients while testing continues or until treatment is extended long enough to render the person not contagious.
Large scale infections in an institution, though, will overwhelm an infirmary. Entire cell blocks, pods, or housing units may need to be locked down so that infected inmates can be separated from healthy inmates while they recuperate. A good example of a unit lockdown is that imposed at an Illinois prison site when influenza struck several of the cell blocks.
Quarentine. Quarantine, on the other hand, is the separation of potentially infective but asymptomatic individuals from the general population. Lockdowns for quarantine can also be initiated as a preventative measure while a suspicious condition is investigated. For example, Harris County, TX, Jail locked down a cell block when a young inmate died of suspicious circumstances. The other inmates did not have symptoms. The lockdown was precautionary to keep a potential infection from spreading among the general population.
Missing links
Eliminating links in the chain of infection can break the spiral of infection spread. Here are some other ways to disconnect the infection chain to disrupt the infection cycle.
Hand washing
- Hand washing is the single best way to keep from being a link in the infection chain. Be sure you have regular access to hand washing supplies such as hand sanitizer or soap and water.
- Frequent hand washing can also cause skin breakdown so regularly use some type of skin protection such as a lotion or salve.
- Wear gloves when coming into contact with body fluids or inmate personal effects that could contain infectious waste.
- Enforce hand washing and good hygiene practices among the inmates you manage.
Distance
- Increase social distance when possible. For example, halt visiting hours or group meetings during an infection outbreak.
- Do not allow inmates on work details involving food preparation or grooming functions like hair cutting if they may be infectious.
Cleaning
- Regularly disinfect frequently touched surfaces such as hand rails, elevator buttons, telephones, door knobs, and inmate cell bars.
- Consider increasing the cleaning cycle of cells and shower areas during an outbreak.
The close quarters of a correctional setting means infection can easily spread among staff and inmates. Isolating infected inmates and quarantining those potentially infected can reduce the spread of disease to maintain a healthy work place.
