BIRMINGHAM, Ala. -- Alabama's prison system, badly overcrowded and facing a lawsuit over medical treatment of inmates, is facing its worst outbreak of tuberculosis in five years, a health official said Thursday.

Pam Barrett, director of tuberculosis control for the Alabama Department of Public Health, said medical officials have diagnosed nine active cases of the infectious respiratory disease in state prisons so far this year.

While the number isn't huge, Alabama prisons averaged fewer than five TB cases annually each year since 2009 and didn't have any last year, Barrett said.


"This is a very serious outbreak," she said.

All but one of the cases this year occurred at the St. Clair Correctional Facility, which was designed for 984 men but held 1,292 prisoners at the end of May. Inmates are put on a six-month treatment plan once they are diagnosed.

To prevent the spread of the disease through a prison system packed with more than 25,000 inmates, or nearly twice the designed capacity, St. Clair isn't accepting new inmates or transferring prisoners to other lockups, Barrett said.

Health officials are optimistic that the worst is over because no new cases have been diagnosed in a few weeks, Barrett said.

"We think we're at the end of it," she said. "The Department of Corrections is a hotbed of TB because of the living arrangements."

Tuberculosis isn't a problem unique to Alabama prisons. The Centers for Disease Control and Prevent says the airborne disease is more common in prisons than in the general population.

A patient with tuberculosis can appear to have less-serious illnesses like pneumonia or bronchitis, and doctors typically don't suspect TB right away.

The Southern Poverty Law Center and the Alabama Disabilities Advocacy Center filed suit against Alabama prisons in June claiming the state failed to provide inmates with basic care for medical and mental health problems.

The department has denied the lawsuit's allegations that care is so poor is doesn't meet constitutional standards.