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Immigration-related Health Hazard – Infectious Multidrug-resistant Tuberculosis (MDR-TB): U.S.A.

2017/01/06

Tuberculosis (TB) is a contagious and often severe airborne disease caused by infection with Mycobacterium tuberculosis (Mtb) bacteria. TB typically affects the lungs, but it also can affect any other organ of the body.  It is usually treated with a regimen of drugs taken for six months to two years depending on whether the infecting organisms are drug resistant. (Mtb) bacteria is listed as a Category C pathogen/Bioterrorism Agent.

1,565 Refugees Diagnosed with Active TB Since 2012, Three Times More Than Previously Reported

Between 2012 and 2015, 1,565 refugees were diagnosed with active tuberculosis (TB) in the United States, according to annual reports published by the Centers for Disease Control (CDC).

The CDC data, which has been public but obscure until now, shows that the number of refugees diagnosed with active TB in recent years is more than three times greater than previously reported by any media outlet.

The number of refugees diagnosed with TB in the United States has increased every year since 2012, the first year the CDC began publishing data on foreign-borne cases of the disease by category, when 358 were diagnosed. In 2013, 396 refugees were diagnosed with TB. The following year, 2014, 402 refugees were diagnosed with TB, and in 2015, the number of refugees diagnosed with TB rose again to 409. Data for 2016 has not yet been reported.

IMAGE_1_RefugeesTB

In October, Breitbart News reported that 476 cases of active TB among refugees have been reported in the fifteen states that made that data available. Thirty-five states did not make the data available, even though they had apparently reported it to the CDC:

At least eight cases of active TB were diagnosed among refugees upon their arrival in Minnesota in 2015, bringing the total number of cases of active TB among refugees in Minnesota over the past six years to at least 304. That also increases the number of active TB cases diagnosed among refugees over the past six years in the fifteen states in which Breitbart News has been able to obtain data to 476, broken down as follows:

Minnesota (304), Wisconsin (27)Nebraska (21)Louisiana (21), Michigan (19)Vermont (17)Colorado (16), Florida (11), Ohio (11 in one county)Idaho (7), Kentucky (9 in one county)North Dakota (4 in one county),  Indiana (4), California (3), and Tennessee, where two refugees have been diagnosed with the very dangerous, multi-drug resistant (MDR) TB.

Until Breitbart News discovered the public, but effectively hidden, CDC reports, the scale of the TB problem among refugees was under-reported by more than 1,000 cases over recent years – off by a factor of more than three.

The number of refugees resettled annually in the United States increased from 58,238 in FY 2012 to 69,933 in FY 2015, according to the Office of Refugee Resettlement.

The number of refugees resettled in FY 2016 increased to 84,995, according to the Department of State’s interactive website. During the first three months of FY 2017, the number of refugees resettled in the country increased to 25,671, almost double the 13,791 resettled during the first three months of FY 2016.

The increase in the number of refugees diagnosed with active TB from 358 in 2012 to 409 in 2015 was partially responsible for the increase in the total number of foreign-born cases of active TB increased from 6,274 to 6,350 during those four years.

Other categories of foreign-born cases of TB that increased included those who arrived under regular immigrant visas, which increased from 1,437 in 2012 to 1,670 in 2015,  those who arrived in the “other” category, which includes illegal immigrants (called “undocumented immigrants” in the CDC reports), which increased from 1,312 in 2012 to 1,408 in 2015, and those who arrived under student visas, which increased from 158 in 2012 to 191 in 2015.

Foreign-born TB cases as a percentage of all TB cases diagnosed in the United States increased from 63.1 percent in 2012 to 66.4 percent in 2015.

The total number of TB cases diagnosed in the United States declined from 9,945 in 2012 to 9,421 in 2014. In 2015, however, for the first time in 23 years, the number of TB cases diagnosed in the United States increased, instead of declined, to 9,557.

Two other important findings arise from the CDC data:

(1) Several of the 35 states for which no data was previously available about the number of active TB cases among refugees have a significant, and previously unreported, public health problem associated with unusually high rates of active TB among refugees.

(2) The number of cases of active TB among refugees in several of the 15 states for which complete or partial data was reported by those states significantly and inaccurately under reported the true incidence of active TB among refugees

Georgia, for instance, is the most surprising untold story. During the four years between 2012 and 2015, 96 cases of active TB were diagnosed among refugees in the Peach State. On a per capita basis, Georgia has one of the highest instances of refugee TB of any state in the country. Yet nowhere has this important story been reported.

Texas is known to have one of the highest rates of foreign-born TB in the country. What was not previously reported, however, is the significant role refugees have played in that phenomenon. During the four years between 2012 and 2015, 186 cases of active TB were diagnosed among refugees in the Lone Star State.

Similarly, it has been widely reported that TB is a public health issue in California.

Breitbart News was unable to obtain the full story from the California Department of Public Health about the number of refugees diagnosed with active TB in California until discovering the CDC annual reports. We had only been able to document three cases of active TB among refugees in California based upon publicly available data from the state.

The CDC data, however, makes clear that California has a significant problem with active TB among refugees. During the four years between 2012 and 2015, 251 cases of active TB were diagnosed among refugees, which is 248 more than the three cases previously reported.

Breitbart News will provide a number of additional reports based on the data contained in these annual CDC reports in the coming weeks.

[Byline Michael Patrick Leahy]

02 January 2017
Breitbart News  – Big Government

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See Also

Possible Airborne Person-to-Person Transmission of Mycobacterium bovis — Nebraska 2014–2015

US immigrant TB detection

Tuberculosis infects 27 at Kansas City area high school

The effect of migration within the European Union/European Economic Area on the distribution of tuberculosis, 2007 to 2013


According to the U.S. National Library of Medicine a bioterrorism attack is the deliberate release of viruses, bacteria, toxins or other harmful agents used to cause illness or death in people, animals, or plants.

Category C pathogens are the third highest priority and include emerging pathogens that could be engineered for mass dissemination in the future because of their availability, ease of production and dissemination, and potential for high morbidity and mortality rates and major health impact. NIAID Category A, B, and C Priority Pathogens


Related

Tuberculosis (TB) Research Articles and Reports

Paradoxical reaction associated with cervical lymph node tuberculosis: predictive factors and therapeutic management
Houda Chahed, Hela Hachicha, Aida Berriche, Rim Abdelmalek, Azza Mediouni, Badreddine Kilani, Mohamed Ben Amor, Hanene Tiouiri Benaissa, Ghazi Besbes
International Journal of Infectious Diseases, Volume 54, January 2017, Pages 4-7
DOI: http://dx.doi.org/10.1016/j.ijid.2016.10.025

Factors influencing treatment default among tuberculosis patients in a high burden province of South Africa
G. Kigozi, C. Heunis, P. Chikobvu, S. Botha, D. van Rensburg
International Journal of Infectious Diseases, Volume 54, January 2017, Pages 95-102
DOI: http://dx.doi.org/10.1016/j.ijid.2016.11.407

Paradoxical results of two automated real-time PCR assays in the diagnosis of pleural tuberculosis
Soraya E. Morales-López, Jayr A. Yepes, Irina Anzola, Hernán Aponte, Claudia R. Llerena-Polo
International Journal of Infectious Diseases, Volume 54, January 2017, Pages 36-38
DOI: http://dx.doi.org/10.1016/j.ijid.2016.11.011

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