Health officials fear disease in surge of illegal immigrants

Dengue fever, drug-resistant tuberculosis, scabies, and Chinkungunya fever, are among the illnesses being brought into the U.S.

Fears that the recent surge in the numbers of illegal immigrants crossing into the United States are carrying highly contagious diseases are causing alarm among public health officials, not only in border states, but elsewhere.  The risk of contagion is increased since some of the illegal immigrants are being released on their own recognizance to states beyond Texas and Arizona, for example, in order to be reunited with family members in the interior of the country. Some states appear to be preparing to receive illegal immigrants. For example, in Michigan there have been reports that a facility is being prepared in a rural area north of Detroit to receive as many as 200 unaccompanied minors.
 
Currently, illegal immigrants are not prescreened in any way, and many carry disease. So far in 2014, the Rio Grande Valley Sector of the Border Patrol has detained 150,000 illegal immigrants. Also this year, federal authorities expect 80,000 minors are expected to enter the country illegally. They risk rape and death at the hands of smugglers, known as ‘coyotes’, while others have simply died of heat exhaustion and thirst while lost in the border region. The Border Patrol and the Department of Health and Human Services (HHS) have set up temporary holding centers in southern Texas and Arizona. Visiting media and Members of Congress have ascertained that the conditions are cramped and unsanitary, while Border Patrol officers are overwhelmed with the scale of the humanitarian crisis. The Border Patrol, DHS, local churches and philanthropic organizations are struggling to cope with the demands for food, clothing, diapers, and medical care. Besides, anywhere from 10% to 25% of the immigrants in the Texas and Arizona sector are suffering from scabies, a highly contagious intensely itchy rash caused by insect mites. Fleas are also a problem.
 
Some health officials and experts have concluded that the United States is facing a public health crisis on a grand scale, and have urged that the Centers for Disease Control should become directly involved. It is feared that when these immigrants leave the camps and travel elsewhere, they spread disease to other states.  Federal law makes immigrants inadmissible should they be carrying certain diseases. Among them are: leprosy, active tuberculosis, cholera, plague, five distinct sexually transmitted diseases, and influenza caused by strains with the potential to cause a pandemic. In addition, foreigners not vaccinated against measles, mumps, rubella, and several other diseases are also barred.
 
(Border Patrol officers prepare a mine-resistant vehicle)
 
It is known that drug-resistant tuberculosis is spreading in Texas. Several counties in the Lone Star State have twice the state average number of cases. Dengue fever, a viral illness spread by mosquitoes that causes fatigue and  excruciating bone and muscle pain affecting over 100 million people per year, is now spreading from the illegal immigrants into Texas and Arizona as infected mosquitoes begin to breed in the areas near the camps. A vaccine for Dengue is being developed, but is not yet available. A major health disaster is in the offing, said Dr. Marc Siegel of FOX News, should Dengue fever take hold in the U.S. Measles and chicken pox are also emerging among the unvaccinated immigrants, putting those who are unvaccinated in surrounding areas at risk, since these viruses are highly contagious. Yet another tropical disease, Chagas, is also spreading in Texas.
 
(Composite risk map for Chagas in Texas)
 
Swine flu (H1N1) has also appeared among the current surge of illegal immigrants. According to Health and Human Services, a child being held at Joint Base San Antonio-Lackland has been diagnosed and hospitalized for the virus. This form of influenza, which reached pandemic proportions in 2009, has been especially problematic for children and pregnant women, can also spread quickly in close quarters such as the detention camps.  The federal government is sending vaccine to the base. In addition, measles and chicken pox have also appeared among the immigrants.
 
Besides these threats, yet another one could be on its way to the U.S. Public health officials in El Salvador, the Central American republic from which hail many of the illegal immigrants in the current surge, have noted a rise in the number of cases of Chikungunya disease. Of African origin, the mosquito-borne disease is sometimes fatal. It is widespread on the African continent, as well as India. In recent years, the disease has appeared in several Latin American and Caribbean nations. The World Health Organization says the name comes from the Kimakonde language spoken along the Mozambique-Tanzania border. Meaning “to become contorted,” the name describes the stooped-over sufferers wracked in pain by Chikungunya.
 
(Aedes egypti - malaria mosquito)
 
According to VOA News, Dr. Scott Weaver of the University of Texas Institute for Human Infections and Immunity said, “It’s a mosquito-borne virus. It originated in Africa and still circulates there now. Its original transmission cycle involves mosquitoes in forest habitats and non-human primates. That’s the main vertebrae hosts. But periodically it emerges from that cycle into an urban cycle involving people and different kinds of mosquitoes.”
 
 “It’s not normally life threatening. There are a few fatal cases. The case fatality rates recently have been estimated at about one in 1,000 people. But even though it’s not normally fatal, it’s a very painful and debilitating disease that can incapacitate people for weeks to months or even pain can persist for years.”
 
According to El Salvador’s Ministry of Health, there are currently 1,512 suspected cases of Chikungunya in the country. Most of the victims live in and around San Salvador, the capital city. In San Vicente, another Salvadoran province, there are 118 cases of the virus, and 88 in the municipality of San Ildefonso.  Most of those affected range in age from 10 to 19 years. Besides Chinkungunya, El Salvador is also plagued with Dengue fever: the Ministry of Health has reported a total of 16,937 suspected cases and 5,698 confirmed cases of Dengue. This number reflects an increase of 101% over the figures for 2013. Salvadoran officials are calling on the public to cooperate in its anti-mosquito campaign.
 
Dr. Weaver of the University of Texas predicts that Chingunkunya will make an appearance in the southern states.  “I think that we will see some cases in the southern U.S. We can predict, I think fairly well, what will happen with Chikungunya because it’s a very similar disease and transmission cycle to Dengue virus and we have a lot of experience with Dengue. Typically, with dengue, we see cases along the Mexico border and south Texas. And then we see outbreaks of focal transmission from imported, infected travelers in Florida,” he said.

(Chikungunya sufferers in India)
 
There are two different strains of Chikungunya. The strain from eastern Africa in 2004 is able to easily mutate and increase its ability to infect the Asian tiger mosquito. The bloodsucker is found on every continent except Antarctica. Another African strain that emerged in the 1950s, now found in the Caribbean, is less able to adapt and infect the Asian tiger mosquito. The primary vector for the disease is the so-called yellow fever mosquito. There is no treatment available. The University of Texas is currently working to initiate human trials of a prospective vaccine, but delivery is many years away.
 
This history of disease contagion in federally managed facilities goes back at least to the Civil War era. During the mid-1860s, African-American slaves who had left behind the plantations where they had been forced to work were considered "contraband" by the federal authorities and U.S. Army and seized as enemy property. In Natchez, MIssissippi, thousands of slaves are said to have been held in a mosquito-infested area along the Mississippi River now known as 'the Devil's Punch Bowl.' They were not allowed to leave. A smallpox epidemic and inadequate attention killed an untold number of the former slaves held in the federal camp there. There is no marker to note the tragedy.


Spero News editor Martin Barillas is a former US diplomat, who also worked as a democracy advocate and election observer in Latin America. He is also a freelance translator.

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