2 Trusties Taken Ill at Jail Led County to Treat 2,000 Inmates : Meningitis: The death of another prisoner had little to do with the massive response at the Castaic facility. Federal officials call the reaction appropriate.

County officials said Monday they decided to quarantine and give antibiotics to more than 2,000 inmates at a jail in Castaic over the weekend because two inmate trusties were stricken with meningitis--not because an inmate had died from the infectious disease.

The death last Thursday of Alexander Betancourt, 45, in the South facility of the sprawling Peter J. Pitchess Honor Rancho had little to do with the massive response at the jail’s nearby Ranch facility, because Betancourt had been fairly isolated and all those he had come in contact with already were treated with preventive measures, sheriff’s officials said Monday.

But the cases involving the trusties raised worries because--unlike other inmates--trusties are given much freedom to move around the complex and mix with other inmates and staff members, doing odd jobs and repairs under supervision.

As such, the fact that the two trusties were diagnosed with meningitis on Saturday prompted health and Sheriff’s Department officials to embark on what several described as an “extraordinary” response. That included shutting down the jail facility to visitors, preventing inmate transfers and bringing in nurses who spent all of Saturday night and Sunday morning giving antibiotic tablets to inmates at the Ranch and more than 200 staff members.

“Certainly that was one concern--they were pretty much all over that facility,” said Dr. John H. Clark, chief medical officer for the Sheriff’s Department, who identified the two men as trusties. Clark also said he was prompted to call for round-the-clock preventive measures because both men came down with a virulent strain of bacterial meningitis on the same day in the same part of the complex. “That raised a red flag,” he said.

The two trusties, who authorities have not identified, remained in critical condition late Monday at the Henry Mayo Newhall Memorial Hospital in Valencia.

Clark also said that as part of an epidemiological study into how and why the meningitis outbreak occurred, county health officials will look into the deaths of any other inmates who died recently from infectious diseases.

Sheriff’s and county health authorities said Monday that they do not know when or how Betancourt contracted the virus or how long he may have been contagious. But they stressed that unlike the common cold and other infectious diseases, it is extremely hard to transmit the meningitis virus from one to another person without contact between body fluids. That can include a sneeze, said Dr. Laurene Mascola, chief of the county Health Services Department’s Acute Communicable Disease Control Unit.

Even though two potentially mobile trusties had meningitis, Mascola said the need to pass out antibiotic tablets to more than a few dozen inmates probably was an unnecessary precaution. “They went to different places and different exposures,” Mascola said of the two trusties. “But it probably was a little over-necessary.”

Clark and other county officials defended their actions, saying it was better to take the safest measures, especially when dealing with a crowded inmate population and the possible hysteria that could be caused by the existence of a dangerous infectious disease among them.

“Medically, I’m happy with the way things went,” Clark said. “I think we did the things that needed to be done under the circumstances.”

A spokesman for the federal Centers for Disease Control in Atlanta said the county’s quick and thorough efforts seemed appropriate given the situation. “It sounds to me like they took pretty intelligent and appropriate action,” said CDC spokesman Bob Howard.

Clark said the disease strikes seven to 10 county jail inmates a year in the United States, and that two other inmates at county jail facilities have died since 1986.

Howard said that at least 11,000 people nationwide contract meningitis every year and that as many as one in six die of the disease. He said jail inmates and others forced to exist in close, institutionalized quarters are among those most at risk of catching meningitis, which is marked by inflammation of the brain and spinal cord. During the winter flu season, he said, it is very hard to tell the difference between a flu or pneumonia or the much more serious meningitis at first, since they all start out with similar symptoms, such as intense headaches, high fever and nausea.

While some patients may fully recover, Howard said, others can develop permanent brain damage, hearing loss and even mental retardation.

By early Monday, things were back to normal at the jail and visitors once again were allowed to visit.

Meanwhile, county supervisors Michael Antonovich and Ed Edelman said they requested top officials from the Sheriff’s and Health Services departments to present a status report on the meningitis outbreak at the weekly board meeting Tuesday.

Antonovich, who represents the Castaic area and acts as the supervisors’ liaison to the Sheriff’s Department, said he was shocked to hear about the outbreak.