INFECTIONS IN NEWLY RELEASED INMATES ARE RISING CONCERN

MOUNT PLEASANT, Mich., Jan. 27 - Marva Johnson was thrilled when her
longtime boyfriend, Randy Vallad, was paroled from prison in 1999.

They went back to living together, and once when he had a bad cut on his
head, she took care of him. She was splattered with his blood, but the
couple did not think anything of it at the time.

It was not until Mr. Vallad was sent back to prison in 2001 for a parole
violation that he was accidentally shown his Michigan Department of
Corrections medical records. They reported that Mr. Vallad had tested
positive for hepatitis C, a blood-borne virus that can cause potentially
fatal liver disease, when he was first admitted to prison years before.

"They knew and didn't tell him," Ms. Johnson, 33, said today in this small
city in central Michigan. "As a result, they also let him infect me." For
the past 11 months she has been taking a powerful, enervating course of
drugs for hepatitis C.

Such cases are becoming increasingly common across the nation, as jails and
prisons have become giant incubators for some of the worst infectious diseases.

According to a study released today at a conference sponsored by the
federal Centers for Disease Control and Prevention, at least 1.3 million
inmates released from jail or prison in 1996 were infected with hepatitis
C. That was 29 percent of the 4.5 million cases nationwide.

Similarly, newly released inmates accounted for 35 percent of the 34,000
Americans with tuberculosis in 1996, the study found. And newly released
inmates accounted for 13 to 17 percent of Americans infected with H.I.V. or
AIDS, the study estimated.

The problem has become so acute that health care officials and prisoner
rights groups are calling for widespread testing of prison populations for
hepatitis C and faster treatment of prisoners.

"This is a public health problem that has been growing and growing, but we
are reluctant to do anything about it because these are bad guys," said Dr.
Robert Greifinger, a former chief medical officer for the New York State
Department of Correctional Services and the author of the study, which was
commissioned by Congress and prepared for the Justice Department.

The Centers for Disease Control held a conference of prison medical
officers in San Antonio devoted to the issue last weekend. During the
conference, the centers said that public vaccination efforts to prevent
hepatitis outbreaks should be extended to prisons.

The centers also issued new guidelines urging states to test all prisoners
with a history of intravenous drug use and other risky behavior for
hepatitis C. Sharing needles and unprotected sex are common ways the virus
is spread.

The problem is not that large numbers of prisoners are contracting
hepatitis C while incarcerated, experts say. Most were infected years
before. The experts say the high rate of communicable diseases among
inmates is a critical issue for two reasons: the danger inmates pose of
infecting others when they are released, and the opportunity to treat them
that is largely being wasted.

Dr. Greifinger said that Americans tended to forget that most inmates
eventually return home. In 2000, about nine million people were released
from jail and prison, according to Allen J. Beck, of the Bureau of Justice
Statistics, the statistical arm of the Justice Department.

In a sign that the problem is getting more attention, the C.D.C. made
public Dr. Greifinger's report today. It had been given to the Justice
Department in March 2001, Dr. Greifinger said, but never before released to
the public.

In a separate action, the American Civil Liberties Union and two dozen
other organizations interested in prison conditions issued a call today for
a Congressional investigation into the state of medical care in jails and
prisons.

"Correctional systems have buried their heads in the sand because they
don't want to know how many prisoners have hepatitis C," said Eric Balaban,
a staff lawyer with the National Prison Project of the A.C.L.U.

Russ Marlin, a spokesman for the Michigan Department of Corrections, said,
"We are treating hepatitis C in accordance with federal guidelines."

He said that Michigan did not do blood tests of all incoming inmates or all
those who engage in risky behavior. "Our position is that indiscriminate
testing is not useful," he said. In addition, it would cost $200 million to
test and treat all suspected cases of hepatitis C among Michigan inmates,
he said. Even more important, he said, is that the drug treatment - a
combination of interferon and ribarvin given over a 6 to 12 month period -
is very toxic.

Mr. Marlin said he had no information on why Mr. Vallad was not told he had
tested positive for hepatitis C and could not release it even if he did
because of the confidentiality of prisoners' medical records.

Mr. Vallad, was originally convicted for fleeing the police when he was
stopped for driving with a suspended license. It was not the last of his
problems. Today, the police raided the trailer where he lives with his
sister and brother, looking for drugs.

It was a bad tip from an informant, the police later said, and they found
no drugs. But they detained Mr. Vallad anyway.

Steven Croley, a lawyer for Mr. Vallad and Ms. Johnson, said Mr. Vallad had
stumbled on the information that he had tested positive for hepatitis C
when he asked to see some of his private medical records compiled by
doctors while he was out of prison.

At the time, in 2001, Mr. Vallad had just been sent back to prison because
of a urine test that showed evidence of drug use, a violation of his parole.

But the records he received accidentally included pages of his prison
medical file reporting on a blood test he had been given during his first
admission in 1998.

At the bottom of one page was the notation "Hepatitis C - Positive."

"I said, wait a minute, what's this?" Mr. Vallad recalled. He called Ms.
Johnson, who went for a test and discovered she was also infected.

Mr. Vallad, now 42, was never offered any treatment inside prison for
hepatitis C. His level of infection has steadily gone up and his health has
deteriorated, Mr. Croley said.

Mr. Croley said he will soon bring suits against the Michigan Department of
Corrections on behalf of Mr. Vallad and Ms. Johnson.