Health Officials: Risk of Disease from Immigrant Children Low

Eugenio del Bosque

While fears of immigrant children carrying disease persist, public health experts on the front lines offer reasons for calm.

The Dallas Morning News reported over the weekend that “the likelihood of [these kids] spreading disease is low.” The story cited health officials who have documented just three cases of flu, three cases of tuberculosis, and 23 cases of chickenpox among the 57,000 children detained in Texas.

This report comes while Dallas County Judge Clay Jenkins—acting on his idea that “in Texas, we don’t turn our back on children”—prepares his county to receive 2,000 unaccompanied migrant kids.

The physicians and state health officials interviewed by the Morning News emphasized the same message that the Observer reported last week: The Central American kids streaming across the border pose very little threat to the health of Texans. They do need medical care—mostly for the fatigue, dehydration and twisted ankles that have resulted from their journey.

As the U.S. Department of Health and Human Services has repeatedly emphasized, each child receives a screening for infectious disease.

Texas Department of State Health Services spokesperson Carrie Williams told the Morning News that health risks in the detention facilities spring mostly from “the lack of hand-washing facilities.” The occasional cases of lice and scabies, which have excited the ire of a Border Patrol union, do not seem to impress the medical professionals much.

Astute readers will have noted that chickenpox (also known as varicella) is in fact a vaccine-preventable disease. In 1995, the U.S. became the first country to recommend universal vaccination against chickenpox, which is typically a mild disease. (I had it. You probably had it. Serious complications are rare enough that many American physicians questioned whether vaccinating against varicella was worth the trouble.)

Since the mid-’90s, only a handful of nations have adopted universal varicella vaccination. In developing countries that face more pressing health issues, it wouldn’t be cost-effective. Agencies like the World Health Organization and UNICEF don’t include rates of varicella vaccination in their worldwide reports, because it’s not a global health priority.

In tropical regions such as Central America, chickenpox tends to occur more in teenagers and adults, rather than exclusively in young kids. That’s another factor in these few cases at the border: Kids from a temperate region might’ve already had chickenpox; many kids from Central America are still “immunologically naive”—that is, they haven’t been exposed to the virus.

But please don’t flip out, Internet. Most Americans are immune to this pox, thanks to vaccination or prior infection. Here in Texas, 90 percent of kids are vaccinated against varicella by age 3, according to the Department of State Health Services.

Like lice and scabies, chickenpox spreads more quickly in crowded and unsanitary conditions. The refugee kids who get chickenpox are likely to be itchy and miserable—and quarantined—for a couple of weeks, until the virus subsides.

If we want to spare them that ordeal, adequate hand-washing facilities in the detention centers might be a good place to start. We could also offer the children prompt varicella vaccination, as a recently published article in the journal International Health recommends. We should also move kids quickly from detention centers into the safety of families.

I’ll be the first to admit that the Texas medical system has its problems. But if the biggest “health threats” these kids from Central America bring are head lice, some twisted ankles and 23 cases of chickenpox, well, Texas can handle that.

Rachel Pearson is an MD/PhD student at the Institute for the Medical Humanities and the University of Texas Medical Branch. Her book about training in public hospitals, free clinics and prisons, No Apparent Distress, is forthcoming from WW Norton.

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Published at 1:50 pm CST