An Epidemic of Pneumococcal Disease in an Overcrowded, Inadequately Ventilated Jail

Abstract

Severe overcrowding, inadequate ventilation, and altered host susceptibility all contributed to this outbreak of pneumococcal disease in a large urban jail.

Household Air Quality Risk Factors Associated with Childhood Pneumonia in Urban Dhaka, Bangladesh

“…Crowding was particularly a risk factor for pneumonia in households that were not cross-ventilated, which is consistent with data from Hoge and colleagues, 20 who showed that the rates of S. pneumoniae incidence were highest in prison cell environments that were both crowded and poorly ventilated, compared with prison cells that did not share both of these risk factors. Crowding may be addressed in the long term by increasing the space allocated to households with large numbers of people, and reducing household size; by reducing the total fertility rate of women of child-bearing age, Bangladesh has made substantial strides in reducing household size.…”

Molecular Characterization of Streptococcus pneumoniae Serotype 12F Isolates Associated with Rural Community Outbreaks in Alaska

“…The multiple BTs found from this outbreak are consistent with ongoing transmission (i.e., growth and mutation) of the bacteria in a community over a period of time and contrasts with the indistinguishable BTs from the institutional outbreaks of 12F disease identified previously in Texas (1989) (22), Maryland (1992 with a single exception) (23), and California (2004) (19,24). Most pneumococcal outbreaks reported in the recent literature were short lived (1 to 2 months) and occurred among closed or institutional populations such as day care or military groups (7).…”

Factors in the Emergence of Infectious Diseases

“…The resulting mosquito population boom is complemented by the high human population density in such situations, increasing the chances of stable transmission cycles between infected and susceptible persons. Even in industrialized countries, e.g., the United States, infections such as tuberculosis can spread through high-population density settings (e.g., day care centers or prisons) (12,(26)(27)(28).…”