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Monday, July 21, 2014

No, in fact, refugee children do NOT pose a health threat, says health expert

Posted By on Mon, Jul 21, 2014 at 4:25 PM

Yesterday's Post-Gazette brought us the disheartening news that some residents of Emsworth are upset that refugee children fleeing hardship in Central America may be cared for by a Catholic charity there. It's a painful read, with Emsworth residents worrying aloud that the children may bring diseases with them, or be working as mules for drug cartels. One business owner suggested that bringing kids here would be like "putting one bullet in a gun and putting it to your head."

"We can't look at that age group the same way that we look at kids in a more civilized country," he added.

It would be easy to hate on that kind of attitude -- too easy. (Though City Paper reserves the right to do so in a future column/blog post.) No doubt many Emsworth residents are horrified by the sentiments expressed in that story. And no doubt you can find similar ideas expressed well outside of Emsworth, starting with anyplace that a Fox News camera happens to be pointing. Years ago, I did a story about a controversy surrounding the use of immigrant labor at a South Side construction project, and the threat of disease-carrying immigrants was one of the concerns raised by workers on a picket line outside.

And in fact Gov. Tom Corbett has begun raising fears of importing disease-ridden children in an interview with KDKA's John Shumway. Corbett opined that before any kids got sent to Pennsylvania, the federal government should "make sure ... that they've had all their immunizations and so forth because we have a strong concern about that."

"Measles is one [disease] that comes to mind very quickly" as a concern, Corbett added.

Where to begin? First, the World Health Organization reports that in most Central and South American countries, immunization rates against measles and other childhood communicable diseases are actually on par with, or even better than immunization rates in the United States. Mexico and Nicaragua, for example, have immunization rates of 99 percent -- well above the 92 percent rate in the U.S. Honduras, Guatemala, El Salvador, Belize, Colombia, Peru -- all do at least as well as the US at inoculating their children against measles.

In fact, when you realize that Texas does a worse job of inoculating kids than, say, Guatemala, you have to wonder who the real "civilized country" is.

Indeed, some internet wag has already speculated that if Corbett is really worried about spreading disease, he might want to clamp down on Texas-based firms drilling for natural gas in the Marcellus Shale. And the funny part is that measles -- the one disease Corbett mentioned by name -- is among those we probably need to worry the least about.

"There hasn't been an endemic infection of measles anywhere in the Americas since 2002," says Amesh Adalja, an infectious-disease physician at UPMC who also works on biosecurity and emerging infectious disease problems. Measles and other communicable childhood diseases are problems in some parts of the world -- namely in portions of Africa and Asia. When measles has cropped up in Western Hemisphere during the past decade-plus, it's come from those places, rather than south of the border.

Worrying about this stuff is what Adalja does for a living: When I spoke to him this afternoon, he was down at Baltimore's Center for Biosecurity, a think tank which works on bioterrorism, pandemics, and "any kind of catastrophic health event." But disease outbreaks from undocumented workers, or refugee children, are not threats that keep him up at night.

"I don't believe that children from South or Central America pose any undue burden of disease to individuals living here," Adalja says. "We do get disease importation, but they aren't coming from undocumented immigrants. It's because we travel all over the world, and people come here –- legally -– and bring the pathogens with them."

Adalja says "there's a natural tendency for people to fear diseases coming into their country." But if you're looking for something to be afraid of, it ain't a bunch of kids trying to make a better life for themselves. The people you should reallybe keeping at bay are those unseasonably tanned relatives who just got back from a cruise -- and not just because they're threatening to show you their vacation movies.

While the scenario of some preadolescent Honduran kid carrying a killer virus unknown to modern science is largely the stuff of science-fiction, the disease vector Adalja is talking about is happening right now. Chikungunya, a mosquito-born disease that causes debilitating pain, was reportedly brought to the United States by people vacationing in the Caribbean. The disease spreads when mosquitoes back home feast on the blood of people who were infected elsewhere. Other headline-grabbing infectious diseases, like SARS, have spread the same way.

In fact, says Adalja, "When I look for exotic diseases, where do I find the highest yield? It's from a tourist going spelunking in a cave in Africa. It's a businessman who goes on safari and butchers animals."

"The number of undocumented immigrants here is going to be dwarfed by the number of people coming through airports every day," says Adalja. And while measles cases have been rising here in the United States, Adalja and others ascribe the increase to a misinformed campaign, waged by some high-profile celebrities, trumpeting a completely false and totally disproven link between vaccines and autism. "We have less to fear from measles from Central and South American immigrants," says Adalja, "than we do from Jenny McCarthy."

So if Corbett is looking for an election-year scapegoat, maybe he could try her next time?

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