Influenza Outbreak Prevention and Management in U.S. Carceral Settings: A Scoping Review

BackgroundDetention settings preparedness against respiratory virus outbreaks is essential, with implications for preventing illness and deaths from future pandemics. We sought to identify influenza outbreak prevention and management evidence in U.S. detention settings. MethodsWe conducted a scoping review, first searching PubMed, OVID, Google Scholar, Medline databases and the reference lists of identified manuscripts published on outbreak prevention and management of influenza in detention settings in English. Search terms included prison, jail, vaccine, influenza, outbreak, management, prevention, carceral. ResultsTwenty-five studies met the search criteria, ultimately narrowed down to seven studies. Four studies focused on prevention and three on management. The studies on prevention identified restructuring housing, vaccinations, and widespread screening to prevent outbreaks and highlighted the importance of collaboration between prison staff and public health departments. The management studies emphasized hygiene, isolation of sick individuals, and vaccination of unexposed patients. Staff expressed the concern that the public may view prisoners as low priority based on prior experiences with influenza vaccine shortages, with a spillover effect in obtaining vaccines and medications for staff. No studies mentioned decarceration as a prevention and mitigation measure. ConclusionThere is limited data on influenza outbreak prevention and management in detention settings. The approaches described are partially in line with public health recommendations but fall short due to lack of, and delays in resource allocation. There is an urgent need for researchers and public health officials to examine and report influenza outbreak prevention and mitigation strategies in detention settings to develop scalable interventions and a national standard for all detention settings.