Steller: Tucson doctors push baseless migrant-disease hysteria

2014-07-12T22:00:00Z 2014-07-16T18:23:24Z Steller: Tucson doctors push baseless migrant-disease hysteriaTim Steller Arizona Daily Star Arizona Daily Star

The recent wave of illegal border crossings raises many issues — immigration laws, children’s rights, amnesty — but there are some that stretch common sense to the breaking point.

Like the threat of an Ebola-virus outbreak.

Two Tucson physicians are leading an effort to sound an alarm about the health risks they think are posed by the current wave of border-crossing migrants, most of whom are from Central America. The absurd outer edge of their arguments warns of the threat of, yes, Ebola in America.

“There is an uncontained outbreak of Ebola in West Africa, and many people from all areas of the world are coming to the country through Mexico,” Dr. Jane Orient told me Friday.

Hence, a wave of migration composed largely of Central Americans entering through Texas also may pose a risk of bringing America its first case of Ebola hemorrhagic fever — if an infected West African joins the pack. That’s the point of view of Orient and Dr. Elizabeth Lee Vliet, both of whom have been speaking out about the risks of diseases they think the migrants pose.

Among the possible threats they cite: lice, scabies, H1N1 (“swine”) flu, dengue fever, Chagas virus, tuberculosis and Ebola.

“There is a high risk of bringing deadly diseases, both familiar like measles and unfamiliar like dengue (‘bonebreak’) fever, to a vulnerable population,” Orient said in a news release for the Association of American Physicans and Surgeons, a fringe medical group she directs.

Is there really a high risk? Well, no — not according to actual epidemiologists, infectious disease specialists and others with expertise in public health, unlike Orient and Vliet. More to the point, their partisan alarm-sounding reflects a longstanding American tradition of labeling immigrants as disease-ridden and dangerous.

Dr. Francisco Garcia, director of the Pima County Health Department, noted that there are two main groups in question — the unaccompanied children who are being detained in places such as Nogales and sheltered in Tucson and elsewhere, and the mothers with children who are being released.

“For the children coming to the facilities in Nogales, I believe there is no public-health threat,” Garcia told me Friday. “All of these children are being screened thoroughly, all are being vaccinated, all are being given a TB test.”

However, the families with children who are being given summonses to appear in immigration court and released — they are not being thoroughly screened and could have infectious diseases, Garcia acknowledged.

On this group, he said in a Friday memo to the Pima County Board of Supervisors, “At this time, I have insufficient information to fully assess the extent of the potential public health threat posed by the families in transit; however, I believe the risk is low.”

Orient thinks they’re all a potential health threat because of the diseases present in the areas they come from and the conditions they’re in as they move north through Mexico.

“We have tens of thousands of them coming in a surge, and they’re coming in unsanitary, highly stressful conditions,” she said.

But that concern largely ignores a couple of key factors.

One is the interconnected reality of the United States, and the world, today. Houston and Dallas — the biggest airports in the state where the wave is arriving — both have flights coming in daily from Central American sites like Guatemala City and San Salvador. Nobody is checking those passengers to see if they’re carrying diseases. And neither is anyone checking the hundreds of thousands of people who legally walk, drive and fly between the United States and Mexico daily.

Also, this surge of illegal migrants, while concerning, is smaller than the wave experienced in Arizona during much of the last decade. Since most of those people were Mexican, Border Patrol agents could more easily process and return them to their home country, but those sent back were quickly replaced by new crossers.

Do you remember any epidemics they caused? It didn’t happen, though cable-TV newsman Lou Dobbs and others tried to raise hysteria about a non-existent leprosy outbreak, among other disease fears.

Another factor: Americans have become our own worst enemy when it comes to infectious diseases. The trend of not vaccinating children against diseases such as measles has led to outbreaks around the country. Tucson had a pertussis outbreak last year.

Some of the Central American countries have strong vaccination programs.

This isn’t to say the migrants pose no disease risk, just that it’s limited and shouldn’t be alarming to the general public. Certainly, Border Patrol agents and others who work in the detention facilities can justifiably worry about conditions there.

A union local of the National Border Patrol Council has advised agents to bring a second set of clothes to change into before going home from the detention center and to shower if possible before leaving. I have no problem with such precautions.

Some agents have come down with scabies, a couple have gotten flu, and they’ve been around numerous minors who tested positive for tuberculosis. In Nogales, one child had an active case of TB.

That sounds alarming, and Orient and Vliet are happy to perpetuate the fear. Multiple- drug-resistant tuberculosis is more common in Central America than here, Orient told me, so it would be bad if it spread here.

True enough, it would be bad. But an actual expert on tuberculosis, Dr. Shauna McIsaac, was not as concerned about the issue when I spoke with her Friday as Orient was. McIsaac, who runs Pima County’s tuberculosis clinic that treats about two dozen patients, noted a few crucial facts about TB.

Central Americans are much more likely to get a tuberculosis vaccine, she said, and children who have had the vaccine often test positive for tuberculosis. In other words, when officials at the detention centers get a positive TB test from a child, it may simply mean they’ve had a vaccine.

Even isolating and monitoring children who test positive “would be over-responding,” McIsaac said.

Also, crucially, children under 10 essentially cannot transmit tuberculosis, even if they’re showing symptoms such as a cough, McIsaac said. Latent cases, in which people test positive for tuberculosis but are not showing active symptoms, pose no risk.

So where is all this concern coming from? There’s a long tradition in the United States of viewing immigrants as disease-ridden Typhoid Marys. It happened with the Chinese in San Francisco, the Irish in New York and many other groups over our history. This is just the latest example.

Until evidence emerges of a real new risk posed by these migrants, joining the hysteria just means embracing this lamentable American tradition.

Contact columnist Tim Steller at tsteller@tucson.com or 807-7789. On Twitter: @senyorreporter

Copyright 2014 Arizona Daily Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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