By DAVID CLOUSTON

Salina Journal

A higher incidence of tuberculosis, primarily among Mexican-born prisoners, has Saline County corrections officials asking county commissioners for permission to spend $225,000 in next year's budget to build an isolation cell at the jail.

"It sounds like a lot of money," Beth Komarek, the jail's supervising nurse, told the commissioners Monday.

"Not 'sounds like' -- it is," Commission Chairman Craig Stephenson replied.

Komarek answered, "Right. But one active case is all it's going to take. And it will be a lot more money (to respond and treat) than that."

Tuberculosis is a potentially fatal bacterial disease usually affecting the lungs. It poses a great public health risk because it is spread through coughing or sneezing.

A skin test reveals those who are infected versus those diagnosed with an active case of the disease.

Statistics show that about 10 percent of people whose skin test is positive become active at some point in their lives, Komarek said.

In 2007, there were 1,074 Saline County Jail prisoners tested for infection. Of those, 54 were positive, and 27 of those were Hispanic, Komarek said. All Saline County Jail inmates are tested.

So far this year, she said, there have been 204 prisoners tested, and 16 were positive. Thirteen of the 16 were Hispanic.

"The average person with active tuberculosis will infect 30 other individuals, so if one person would show up at our jail with active tuberculosis, we would not only have to retest all the inmates, we'd have to test all the staff, and we'd have to find out where all the inmates (transferred to prison or other jails) went," Komarek said.

"So many of our clients are in-and-out, and they're noncompliant," she said of attempts to treat the infection with drugs before it becomes an active case of TB.

Commissioners took Komarek's presentation under advisement. They asked corrections officials to return later with information about how other areas of the state -- such as Garden City, Dodge City and Liberal -- have handled the problem.

Mexico a contributor

The Centers for Disease Control and the World Health Organization say Mexico is a contributor to higher incidences of tuberculosis among Hispanics migrating to the United States. That's due to Mexico's lower socioeconomic status and limited access to health care in rural areas.

The CDC and the World Health Organization are working with Mexico and other governments to create better laboratory systems and better train physicians in their countries, said Phil Griffin of the Kansas Department of Health and Environment, Topeka. Griffin directs the health department's tuberculosis response program.

Kansas had 59 cases of active tuberculosis in 2007, and of those, 64 percent were foreign born -- 28 percent from Mexico.

"We pretty much have it stabilized. It's pretty much going to range from 60 to 80 cases each year. I don't think it will get a whole lot lower," Griffin said.

He said the state yearly averages two to four active cases of tuberculosis in county jails and correction settings. The incidence of TB is 15 to 20 times higher in corrections situations than in the general population, Griffin said.

County jails deal with it

A growing number of county jails across the state are dealing with the issue, he said. Shawnee County is in the process of converting cells to an isolation area after two prisoners there in the space of 18 months were diagnosed with active cases of the disease.

Saline County corrections officials plan to convert a prisoner holding area and a vacant cell used for storage in the old portion of the jail into an isolation cell. It could hold up to six prisoners.

The cell would have a negative pressure ventilation system, which keeps the airflow in the isolation cell from circulating throughout the jail.

"Not only will it benefit other inmates because they won't be exposed," Komarek said, but it will protect "the staff and visitors who come into the jail. Attorneys, clergy, people who do other services."

Last year, she said, there was a scare when an inmate who showed symptoms of the disease was being booked into jail. Luckily for the county, he was turned him over to the custody of state prison officials.

"The same day he came in, we were able to get him to (prison) to a negative airflow isolation room," Komarek said.

The only local option corrections officials have now is to hospitalize inmates suspected of having tuberculosis or other contagious diseases, she said. Salina Regional Health Center has two negative airflow isolation rooms, but that would require posting guards to monitor the prisoner, at more cost and a greater risk to security.

Jails in larger counties such as Sedgwick, Wyandotte and Johnson already have built or converted their old cells to negative airflow isolation wards, said Komarek and Sheriff Glen Kochanowski.

"I believe at this point, most (new jails) are being equipped with negative air-pressure systems as they're being built," Griffin said. "That's certainly among the best practice standards now."

n Reporter David Clouston can be reached at 822-1403 or by e-mail at dclouston@salina.com.