Volume 27, Number 7—July 2021
Dispatch
Pneumococcal Disease Outbreak at a State Prison, Alabama, USA, September 1–October 10, 20181
, Constance L. Bourne, Sherri L. Davidson, Mark Ellis, Leora R. Feldstein, Katherine Fay, Nicole E. Brown, Evelyn F. Geeter, Lytasha L. Foster, Charlotte Gilmore, Mary G. McIntyre, Burnestine Taylor, Srinivasan Velusamy, Sopio Chochua, and Almea M. Matanock
Table 2
Administration of pneumococcal polysaccharide vaccine and antibiotic prophylaxis to reduce Streptococcus pneumoniae transmission in prison inmates during a pneumococcal disease outbreak, Alabama, USA, September 29–October 10, 2018*
| Prophylaxis type | Status | No. (%) |
||
|---|---|---|---|---|
| Inmates, n = 264† | Medical staff, n = 52 | Prison employees, n = 72 | ||
| PPSV23 vaccine |
Received | 206 (78) | 32 (62) | 62 (86) |
| Declined | 58 (22) | 18 (35) | 8 (11) | |
| Absent or unknown |
0 |
2 (4) |
2 (3) |
|
| Dose 1: azithromycin 500 mg‡ |
Received | 232 (88) | 11 (21) | 70 (97) |
| Declined | 15 (6) | 6 (12) | 0 | |
| Absent or unknown |
17 (6) |
35 (67) |
2 (3) |
|
| Dose 2: azithromycin 1000 mg | Received | 246 (93) | 35 (67) | 46(64) |
| Declined | 18 (7) | 16 (31) | 4 (6) | |
| Absent or unknown | 0 | 1 (2) | 22 (31) | |
*Because of rounding, all cells might not sum to 100%. PPSV23, 23-valent pneumococcal polysaccharide vaccine. †Inmates assigned to dormitory X (n = 255) or living in dormitory X without an assignment (n = 9) were offered prophylaxis. Not all inmates lived or slept in the dorm to which they were assigned. ‡Initial antibiotic prophylaxis dosing was chosen by the Alabama Department of Corrections as 500 mg offered on September 29 and a planned second dose of 500 mg 1 week later. This dose would have provided less antibiotic coverage than previous outbreak regimens. Based on Alabama Department of Health recommendations, a higher, single dose of azithromycin (1,000 mg) was offered during October 3–October 10.
1Preliminary results from this study were presented at the Centers for Disease Control and Prevention 2019 Epidemic Intelligence Service conference, April 29–May 2, 2019, Atlanta, Georgia, USA.