Paul Egan
Detroit Free Press
LANSING – The Women’s Huron Valley Correctional Facility will be closed to visitors most of next week as all 2,000 women at the prison are isolated and treated for scabies, officials said Monday.
Officials hope the move will resolve a yearlong mystery in which more than 200 women have complained about itchy rashes from an unknown cause at Michigan’s only women’s prison, near Ypsilanti.
Back in February, officials suspected scabies — microscopic mites that can live on skin for months, burrow and lay eggs, causing a red and itchy rash. But after treating some women for the infection, which can be spread through skin-to-skin contact and through clothing, bedding and furniture, officials began looking for another cause because skin tests came back negative.
Officials recently returned to their original theory after a top dermatologist was brought to the prison after Christmas and began testing women again and training prison health officials in the best way to take the skin scrapings.
Dr. Carmen McIntyre, chief medical officer for the Michigan Department of Corrections, wouldn’t acknowledge any mistakes in the prison’s handling of the outbreak during a conference call Monday. But she said it would have helped if dermatologists had been brought into the prison sooner, rather than officials sending samples and some prisoners outside the prison to dermatologists.
It’s not surprising so many of the initial tests came back negative because it is difficult to take a skin scraping in just the right place to show signs of the mites, McIntyre said.
Corrections Department spokesman Chris Gautz said 39 women have now tested positive for scabies and have already been isolated and treated with Ivermectin, a pill used to fight parasites.
On Monday, another 224 women who have complained about skin rashes, along with some of their cellmates, will be isolated for 24 hours, have their clothing and bedding laundered, and also receive the pills, Gautz said.
And next week, officials plan to do the same with all 2,070 inmates, in groups of 500, he said. That process is expected to begin Tuesday and last through Friday, during which time the prison will be closed to visitors, he said.
Gautz said he wasn’t aware of any precedent for such a mass treatment.
“This is an unusual event, but we want to solve this, and this is the best way the experts say to do it,” he said. “People may be carrying it and have no symptoms, and have no idea, so it’s best to treat everyone.”
Prisoners who refuse treatment will be placed in isolation until officials are satisfied they are not a risk to spread the infection, he said.
“Everybody wants to see this come to an end,” Gautz said. “We’re hopeful we’re not going to see too many people decline to take it.”
McIntyre said the medication should kill the mites immediately, but itching, which can be worse at night, could continue for four to six weeks.
Though Gautz said reaction to the treatment plan from prisoners has been largely positive, several prisoners and their family members have expressed skepticism at the scabies diagnosis and believe the rash is being caused by mold or some other environmental problem inside the prison.
The Free Press first reported on the outbreak in March, after officials in February quarantined and treated for scabies prisoners who were housed in only the two Gladwin units, where the outbreak appeared concentrated at that time.
But the problem persisted and spread to at least eight of the prison’s 15 units as skin scrapes on prisoners continued to test negative for scabies and officials looked for other possible sources for the rash. Over several months, numerous samples collected inside the prison and sent to outside doctors for analysis came back negative for scabies, McIntyre and Gautz said.
In early December, Gautz blamed prisoners, saying unauthorized mixing of cleaners for self-laundering of clothes appeared to be the cause of the rash. McIntyre said Monday that’s still suspected as a cause for some of the rashes.
Gautz has also said repeatedly that the rash was not contagious. Scabies is contagious through skin-to-skin contact, as well as through contact with contaminated clothing, bedding, or furniture.
As the problem persisted and spread, an outside dermatologist was brought to the prison a few days after Christmas and began to test women for scabies with positive results, Gautz said. Those findings were recently confirmed by a second dermatologist, after which an epidemiologist recommended the extraordinary measures the prison plans to take this week and next week.
Last year, about 10 women had been sent to outside dermatologists, Gautz said. Their tests came back negative, as did about 10 skin scrapings sent to dermatologists outside the prison.
McIntyre said not all of the women have scabies, even those with rashes. Some are suffering from other skin conditions, she said. Some women have also been carrying scabies without showing symptoms, resulting in some women who were already treated being reinfected through skin-to-skin contact, she said.
Tests have shown no signs of mold or mildew problems at the prison, she said.
Asked whether there was anything she would have done differently in handling the outbreak, McIntyre said: “Not really.” Asked whether it would have helped if dermatologists had been brought to the prison sooner, she said, “yes.”
McIntyre said there are no significant health effects from having scabies for an extended period of time, but itching over an extended period can break the skin and lead to scarring, she said.
University of Michigan professor Carol Jacobsen, who works with female inmates and parolees as director of the Michigan Women’s Justice & Clemency Project, sees the issue differently.
“Because the prison and MDOC have denied the women’s suffering and complaints for so long and changed the diagnoses to minimize their illness, I believe this epidemic now has caused lasting damage to many women’s health,” Jacobsen said Monday.
Ivermectin is not recommended for people who are allergic to it, are pregnant, or are breastfeeding. McIntyre said there is an alternative treatment, a cream called permethrin, for those women.
A second round of treatment, which will not require isolation, is planned for several weeks from now, Gautz said.
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