June 14, 2016

Updated: Contagious Tuberculosis Arriving With Increased Foreign Born Population

Posted June 9, 2016 8:54 PM Et; Last updated June 14, 2016 8:39 PM ET

[Updated June 14, 2016 8:39 PM]
[From article]
Ten of the approximately 8,000 refugees who were resettled in Colorado by the federal government between 2011 and 2015 were diagnosed with active tuberculosis shortly after their arrival, according to the Tuberculosis in Colorado: 2015 report published by the state’s Department of Public Health and Environment.
A number of other states have also reported refugees have arrived with active TB, as Breitbart News reported previously. Four refugees with active TB were resettled in Indiana in 2015, and eleven refugees with active TB were resettled in Florida in the three years from 2013 to 2015.
[. . .]
High latent TB infection (LTBI) rates among resettled refugees are well documented, in addition to these cases of active TB.
Over the five years between 2011 and 2015, the latent TB infection rate of the 1,500 out of 8,000 refugees resettled in Colorado who had been flagged for TB in overseas medical screenings ranged from 27 percent to 41 percent. The Colorado Department of Public Health and Environment tells Breitbart News that it may take another week to provide LTBI infection rates for all 8,000 of these resettled refugees.
At least eight other states, in compliance with the Refugee Act of 1980, have reported LTBI infection rates among newly arrived refugees: Vermont (35 percent), Indiana (26 percent), Minnesota (22 percent), Florida (20 percent for TST test, 6 percent for blood test ), Arizona (18 percent), Utah (18 percent), Texas (15 percent), and California (12 percent).


Ten Refugees Sent To Colorado with Active Tuberculosis Since 2011
13 Jun 2016

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[Posted June 9, 2016 8:54 PM ET]
[From article]
Two-thirds of contagious tuberculosis carriers in the United States during 2015 were born overseas, up from one-fifth in 1986.
The government’s increased inflow of tuberculosis-carrying migrants appears to have reversed a 23-year decline of contagious tuberculosis cases inside the United States.
[. . .]
American-born active TB cases have declined from an estimated 17,725 in 1986 to 3,201 in 2015. That is down 80 percent since 1986.
But federal immigration policy is pushing up the nation’s contagious TB cases. In 2015, for the first time in 23 years, the number of active TB cases in the United States increased rather than declined. It rose by 1.7 percent from the 9,421 cases diagnosed in 2014.
Over the same 29 year period, the foreign-born population as a percentage of the total U.S. population has increased from 7.5 percent in 1986 (18 million out of a total population of 240 million) to an estimated 13.7 percent in 2015. That is an increase from the 13.2 percent in 2014, the last year for which there is complete data (42.5 million out of a total population of 322 million).
[. . .]

The increase in foreign born cases of active TB is attributable to several factors. A small part of that is due to migrants arriving with active TB, and then transmitting it within their arrival communities.
The largest part of the increase, however, appears to be due to the dramatically higher rate of latent TB infection among foreign born residents (which can range from 20 percent to 43 percent, depending on country of origin) compared to the general population, which has a four percent LTBI infection rate, and the greater likelihood those living in refugee communities will see their latent TB activate.
[. . .]
Foreign-born residents of the United States have been identified as a high risk population by the CDC because a number of them arrive from crowded refugee camps, engage in high risk behavior such as smoking, and have cultural traditions not consistent with successful completion of treatment therapy.
Numerous medical studies have reported on the link between high latent TB infection rates and the risk of active TB in refugee resettlement communities and other centers of migrant population.
[. . .]
While it is true that the rate of active TB among foreign born residents in the United States has declined slightly since 1986, the sheer volume of new foreign born migrants with high latent TB infection rates and much higher active TB rates does not bode well for the future decline in the overall number of active TB cases in the US.
[. . .]

Public health policies, however, appear to be doing little to stop the trend of increases in the absolute number of foreign born TB cases in the US.
Despite the CDC’s urging to “increasing detection and treatment of preexisting latent TB infection among the U.S. populations most affected by TB,” resettlement agencies around the United States are not consistently testing and treating refugees for latent TB infections.


U.S. Tuberculosis Cases Rise as Foreign-Born Patients Triple 1986 Caseload Percentage
9 Jun 2016

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