Santa Barbara, CA: TB outbreak among Mexican ethnic group called “tip of the iceberg”

Although the ethnic group members harboring an outbreak of active TB in scenic Santa Barbara are not refugees, but largely illegal aliens, this is still an important story especially coming at the same time as the case in Illinois we reported last week.

We have, over the years, been following TB outbreaks largely coming from the foreign-born because we think it is one of the most under-reported problems (due to political correctness!) with our willy-nilly immigration system.  See our ‘Health issues’ category, here.

Another RRW geography lesson: The state of Oaxaca in Mexico.

From the Santa Barbara Independent last week (Hat tip: ‘pungentpeppers’):

Santa Barbara health officials have been quietly working for months to contain a tuberculosis (TB) outbreak, and are now ramping up suppression efforts after publicly announcing that a Santa Maria High School student has been diagnosed with the infectious disease.

While the single diagnosis is a cause for concern, prompting both a community meeting on Friday and mass screenings at the school next Monday, the County of Santa Barbara Public Health Department’s grander ground plan has been actively kept under the radar for the past six months due to fears of alienating an already marginalized population and concerns about political backlash.

In 2013, 26 Santa Barbara residents were diagnosed with TB; 16 are North County residents, and nine are of Oaxacan descent. Figures for 2014 are not yet available, said Public Health Department spokesperson Susan Klein-Rothschild. At least one person died in 2013 from the disease (which typically attacks the lungs and has a 50 percent mortality rate if left untreated) and many had let it progress to advance stages before receiving treatment (which makes it much more contagious). Three children younger than 10 years old were diagnosed last year, and one was left severely and permanently disabled.

The disease has taken a real hold in the Oaxacan community!

Five of the Oaxacan cases “have epidemiologic links and the same genetic pattern on their TB isolate,” meaning they are all part of the same transmission chain. The Center for Disease Control declares an “outbreak” when three of more cases display that genetic link, and this week’s high school student case has been connected to the chain……the disease appears to have taken a real hold in the Oaxacan community.

Challenging job partly because they speak neither English or Spanish (diversity is strength, right!)

Thoman explained during an interview this Wednesday that Public Health nurses have been combing North County communities “day and night” in recent weeks, searching for signs of the disease. It’s a challenging assignment, she went on, as some of the Oaxacan individuals may be undocumented and harbor a distrust of government workers. Plus, many of them only speak Mixteco.

Only ten percent of California TB cases will become active!  Do the math!  Yikes! Isn’t ten percent of 3 million, 300,000?

While an estimated three million California residents carry the bacteria that causes the disease, only about 10 percent of them will come down with active TB, which can be cured with medication.  [if they get it in time, and if the foreign-born person completes the prescribed drug treatment regime—ed]

Why isn’t this story all over the national news?  For the same reason Santa Barbara health officials kept it quiet for so long—political correctness!

If fears of terrorism or crime don’t wake up Americans regarding our present out-of-control immigration, then surely the fear of ones kids getting TB in school will do it.  Or, how about Mom bringing the disease home because she is a public health nurse, a social service worker, or simply a volunteer for refugee and immigrant groups?

Asylum seeker from Nepal gets across US border with drug-resistant TB

Terrorists can come across the Southern Border and hardly anyone bats an eyelash, but will people pay some attention to the OTMs (Other than Mexicans) also coming across infected with deadly transmittable (and untreatable!) diseases?

The rate of active TB cases in the US is rising with the refugee/asylum seeker population.  I first heard of the TB problem with refugees when Allen County (Ft. Wayne) Indiana was having a problem with all the cases among the Burmese.   Here is one post I wrote in 2009 about active TB rates rising in Minnesota, and here is my post on a shocking video only watched by a few hundred people about refugees with active TB being readied to come to the US.

But, it’s cases like this Nepalese asylum seeker getting across the border into Texas (after traveling the whole globe) with the worst possible case of drug-resistant TB that gets the media’s attention.  Imagine health officials trying to track all those he came in contact with!

The Wall Street Journal thanks to Drudge (emphasis mine):

Drug resistant TB clinic in the Philippines. Photo: Leah Mae Damazo/IRIN

In medical isolation in South Texas, 100 miles or so from Mexico’s border, is a man who embodies one of U.S. health officials’ greatest worries: He is the first person to cross and be held in detention while infected with one of the most severe types of drug-resistant tuberculosis known today.

His three-month odyssey through 13 countries—from his homeland of Nepal through South Asia, Brazil, Mexico, and finally into Texas—shows the way in which dangerous new strains of the disease can migrate across the world unchecked.

Tuberculosis, an ancient, fatal airborne disease, has been treatable for decades with a cocktail of drugs. However, shoddy medical practices world-wide have enabled the bacteria to mutate and, in some cases, become all but untreatable. In recent months The Wall Street Journal has exposed widening TB drug resistance in hot spots like India, and shown that the U.S. is surprisingly unprepared for the growing global problem. Most U.S. cases of drug-resistant TB occur in people who were born abroad, according to the Centers for Disease Control and Prevention.

The Nepalese man detained at the U.S. border carries a particularly deadly strain—XDR, “extensively drug-resistant” TB. His TB is resistant to at least eight of the 15 or so standard drugs, according to a U.S. government description of the case reviewed by the Journal. His XDR strain has been seen only once before in the U.S., in another patient of Nepalese origin, according to the government description.

The Nepalese patient was taken into custody by the U.S. Border Patrol in late November as he tried to cross the border illegally near McAllen, Texas, according to Department of Homeland Security officials. The government declined to name him.

He was transferred five days later to an Immigration and Customs Enforcement detention facility in Los Fresnos, Texas, and put into “medical isolation” with suspected tuberculosis, according to ICE. He has since been moved to another ICE detention facility, in Pearsall, Texas, with more medical staff, ICE said. He is the first XDR-case in ICE custody.

[…..]

It remains unclear whether other people in custody with the Nepalese detainee might have been infected. By the time the Border Patrol learned of his infection, other people detained with him would have been transferred elsewhere, the CBP official said.

There is more, read it all!

WSJ reporter Betsy McCay has other articles on the topic.  At one point a month or so ago I thought the WSJ had a really great map of TB hotspots around the world.  I recall South Africa was one of the hottest countries for the disease.  But, I couldn’t find it just now so maybe it was at another publication.

For more information on TB, HIV, mental illness and other health problems related to refugees and immigrants generally, see our health issues category, here, where we have 144 previous posts archived.