(NOTE — Update at the End of the Column)
One of the things that changes you, when you become a parent, is the body of knowledge you acquire to protect your spouse and children including things like knowledge of infectious diseases in public schools. In my case that meant looking at the NY Times saying the following: “…the administration has begun to send the expected 240,000 migrants and 52,000 unaccompanied minors who have crossed the border illegally in recent months in the Rio Grande Valley to cities around the county.” And at headlines for the open border crisis like this by Todd Starnes titled “Immigration crisis: Tuberculosis spreading at camps” which caused me to immediately free associate them with a pair of “Tuberculosis in Public School”, headlines, one local to North Texas in 2011 and the other very recently in California. See this 2011 Consumer Health Daily article from Denton Texas “TB Outbreaks in Texas Schools Show Disease Still a Threat – At least 100 people have tested positive for the respiratory ailment” and this 1 July 2014 article from the Sacramento Bee “Four more students test positive for tuberculosis at Grant High.”
As a Texas parent, this idea of TB positive illegal alien children released to illegal immigrant parents scares the heck out of me from the point of view of epidemiology. In the 1920s TB was the eighth leading cause of death for children 1-to-4 years old. Since then American public health has been so effective in preventing it that the USA no longer has any “herd immunity” to TB.
This “catch and release” illegal alien policy is horrible from the infectious disease point of view in that phlegm or aerosolized sputum that are contaminated with Mycobacterium tuberculosis are active biohazards that have long latent infection periods. This makes “exposure” very easy. The clinical definition of TB Exposure — which I found in a University of Vanderbilt student medical file PDF — is the following:
“A person is considered to be exposed if there is shared breathing space with someone with infectious pulmonary or laryngeal tuberculosis at a time when the infectious person is not wearing a mask and the other person is not wearing an N95 respirator. Usually a person has to be in close contact with someone with infectious tuberculosis for a long period of time to become infected; however, some people do become infected after short periods, especially if the contact is in a closed or poorly ventilated space.”
The Federal Government Hazmat protocol for dealing with suspected active TB cases is as follows:
1. Administrative controls
• “Develop policies and protocols to ensure the rapid identification, isolation, diagnostic evaluation and treatment of persons likely to have TB.”
2. Engineering controls
• Isolation and
• Negative pressure room ventilation
3.Personal protective equipment controls
• N95 personal respirator protection
Questions people and reporters need to be asking their local, state and federal elected officials regards the so-called “unattended child immigration crisis” include:
1. How many Border Patrol Agents, health workers or other support staff at these immigration processing centers have worn N95 respirators in treating symptomatic TB sufferers?
2. How many TB sufferers were also wearing masks?
3. Have those Border Patrol Agents, health workers or other support staff followed a rigorous TB decontamination protocol?
Whether people ask those questions or not, we are going to find out the answers soon, and not just in Texas. Testable anti-bodies to TB infection appear in two to 12 weeks for skin and blood tests and the incubation period for full blown active TB is six months to two(+) years.
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