An epidemic of pneumococcal disease in an overcrowded, inadequately ventilated jail.

States that correctional facilities in the US can be susceptible to outbreaks of respiratory infections due to overpopulation. Risk factors for pneumococcal disease were assessed in a case-control and a cohort study. The jail studied had a capacity of 3500 inmates but housed 6700. Median living area was 34 ft2. Fewer cases of disease were identified among inmates with 80 ft2 per person or more. CO2 levels were over the acceptable level. Disease attack rate was highest among inmates in cells with the highest carbon dioxide levels and lowest volume of outside air from the ventilation system.