Thread: Dangerous TB Patient Nabbed On U.S. Border .

March 1, 2013, 3:30 p.m. ET.

Dangerous TB Patient Nabbed On U.S. Border .

By BETSY MCKAY

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.

Related Video

Multi-drug-resistant tuberculosis has been a growing problem in India for years. Now an even more extreme strain of the deadly disease -- resistant to all of the drugs normally used to treat it -- is causing concern. WSJ's Natacha Butler reports from Mumbai.
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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.

In-Depth: A Killer Quietly Gains Strength
The Wall Street Journal is chronicling the world's imperfect response to the rise of drug-resistant tuberculosis, an ancient disease that modern medicine, until recently, could defeat.

A selection of reports:

Deadly unintended consequences: The global TB-fighting strategy helped allow the spread of new, all-but-untreatable strains . (11/23/12)
Exclusive numbers suggest more than 25% of patients at one Indian TB clinic don't respond to the primary treatment. (11/23/12)
One woman's case of nearly incurable tuberculosis echoes around the world. (9/8/12)
India's slow reaction appears to be nurturing an all-but-untreatable strain of TB, raising the prospect of a global health hazard. (6/20/12)
A top doctor in Mumbai reports finding 12 cases of tuberculosis that are all but untreatable by current methods. (1/19/12)
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Twelve Border Patrol agents were tested for the disease, but none contracted it from the patient, a Customs and Border Protection official said. Casual contact doesn't necessarily lead to infection, though it depends in part on how much time is spent in tight quarters with a patient, and how much the patient coughs, spreading bacteria into the air.

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. Detainees who are suspected of being ill are placed in cells by themselves.

Given how far and wide the patient ventured—he took a flight of more than eight hours to Brazil, and also traveled by car, boat and on foot—his case was reported to the World Health Organization as having potentially widespread public-health impact. Now, officials in the 13 countries the man visited along the way must try to track down thousands of people he likely came into contact with, to see if any were infected.

That will be a challenge. "We will try to investigate where he was," said Martin Castellanos, director of Mexico's national TB program. But reconstructing his precise route through Mexico, or any country, will be difficult and perhaps impossible, he said.

Dr. Castellanos says he was told the man spent time in a migrant community in Reynosa, across the border from Texas. But migrants typically linger there only "for a week, two weeks," he said, before moving on. "For sure, no one who was there in November is there now," he said.

The WHO's Stop TB Department said it is working with the CDC to inform affected countries about people who may have been exposed to the man. It is also trying to get more details on potentially infected people in those countries who have been reached by local authorities.

DHS and the CDC declined to discuss details of the man's case, citing patient privacy. The man declined an interview request from the Journal made through ICE. He also declined to sign a privacy waiver allowing officials to release details of his treatment and his immigration case, ICE said.

XDR-TB is a particularly dangerous form of the disease that is resistant not only to the two most potent TB drugs, but also a handful of second-line drugs. It is rare in the U.S.: Only six cases were reported in 2011, according to the CDC.

But it is a growing threat in countries including India and South Africa, where it has been found all over the country. The risk to the world is that the disease will migrate outward from these hot spots. Treatment options for XDR-TB are limited and can themselves be toxic.

ICE officials screen patients for TB—both regular and multidrug-resistant varieties—when they arrive at a detention facility. "We prepare for it and look for it," an ICE medical official said. They find one or two cases of multidrug-resistant TB a year, the official said.

How long the man will remain in care in the U.S. is unclear. Treatment can last for years, but TB patients aren't infectious for the entire course of treatment.

Detainee patients aren't normally kept until they are completely cured. However, infectious patients aren't deported on commercial flights or by any other means that "could be a danger to anyone," the official said.

One risk, of course, is that a patient won't have enough drugs or medical expertise to complete the treatment he or she needs once deported to another country. TB strains can become increasingly drug-resistant if a patient's treatment regimen is interrupted, even briefly. This is one way that drug-resistant TB has emerged over time.

The Migrant Clinicians Network, an Austin, Texas, nongovernmental organization, helps arrange for deported patients to continue their treatment in their home countries. U.S. officials also often send patients home with a supply of the TB drugs they need, particularly to countries where supplies are uneven.

Arranging care for drug-resistant patients is complicated, said Ed Zuroweste, the Migrant Clinicians Network's chief medical officer. "XDR is hugely difficult," he said. "You really have to have experts to treat someone like that."

Nepal is known for innovative health programs, including some to fight TB. But like many countries, it has struggled with drug-resistant forms. Nepal reported more than 35,000 TB cases in 2011, and 2.9% of new and 12% of previously-treated TB cases are multidrug-resistant, according to WHO data.

Dangerous TB Patient Nabbed On U.S. Border - WSJ.com

Added to Homepage with amended title:
http://www.alipac.us/content/dangero...s-border-1414/

Published: 5 hours ago
Jack Minor
World Net Daily

Once-defeated disease now surging, lethal for 60 percent of those infected

A member of Congress who for more than 30 years worked as a doctor says the baggage that illegal aliens are bringing into the United States now is killing people.

Rep. Michael Burgess, R-Texas, told WND that it’s not suitcases, clothes or the like – it’s the highly infectious cases of drug-resistant and lethal tuberculosis that are walking across the Mexican border.

“It is something I am aware of and it is definitely a factor to consider in the immigration debate,” Burgess said.

Tuberculosis is a bacterial infection that generally attacks the lungs, although it can attack any part of the body. The disease is easily spread when an infected individual coughs, sneezes or even talks in the presence of another person. If not properly treated the disease can be fatal.

The disease has been around since ancient times and tuberculosis was once the leading cause of death in America. Among the disease’s victims was the legendary Doc Holiday, who died in a tuberculosis ward in Colorado Springs.

While the 20th century development of antibiotics resulted in the disease being virtually eradicated in America by the 1960s, in recent years TB has been making a comeback with new strains that are resistant to most antibiotics.

Get the real explanation for the convolutions in Obamacare, in “Doctor in the House,” by Dr. Michael Burgess.

Last week it was reported that a persistent strain of tuberculosis had developed in some Los Angeles neighborhoods. Officials said as many as 4,500 people may have been exposed to the disease.

The Los Angeles Times reported the strain appeared to be unique to the region and concentrated among the homeless. Because TB is highly contagious, there is a potential for a widespread outbreak as homeless individuals often move around from place to place.

Last week officials advised police to wear protective surgical masks while dealing with suspects or members of the public who may have been exposed to the disease.

Los Angeles is not the only major city to have problems with the disease. Since 2008, Jacksonville, Fla., has suffered from a TB outbreak that officials with the Center for Disease Control said was among the worst seen in 20 years.

Despite the outbreak’s severity, the public was not informed of the danger until months after the CDC began tracking it. The reason given was the authorities felt they had the disease contained in 2008, despite cases being reported in other parts of the state.

Besides California and Florida, the states with the greatest number of multi-drug-resistant TB are Texas and New York, all having large numbers of illegal aliens within their borders. Florida was recently ranked as having the third largest illegal alien population by the Department of Homeland Security. Many illegals in Florida come from the Caribbean and other countries in the Southern Hemisphere, some of which have widespread problems with tuberculosis.

Last month, My San Antonio reported U.S. Customs and Immigration Enforcement agents had captured an illegal alien from Asia who was captured while trying to cross the Mexican border Nov. 27. The man was diagnosed with extensively drug-resistant tuberculosis, the least treatable form of the disease.

See a video on the issue:
Please go to source link to view

In the past, WND has reported on the dangers caused to the U.S. medical system by illegal aliens with drug-resistant strains of diseases including tuberculosis. A report in the Spring 2005 issue of the Journal of American Physicians and Surgeons warned how the influx of illegal aliens threatened to destroy the American medical system.

“By default, we grant health passes to illegal aliens,” wrote Madeleine Peiner Cosman, author of the report. “Yet many illegal aliens harbor fatal diseases that American medicine fought and vanquished long ago, such as drug-resistant tuberculosis, malaria, leprosy, plague, polio, dengue, and Chagas disease.”

“Many illegals who cross our borders have tuberculosis. That disease had largely disappeared from America, thanks to excellent hygiene and powerful modern drugs such as isoniazid and rifampin. TB’s swift, deadly return now is lethal for about 60 percent of those infected because of new Multi-Drug-Resistant Tuberculosis (MDR- TB). Until recently MDR-TB was endemic to Mexico.”

Burgess pledges that he will take steps to make sure the issue of illegal aliens introducing drug-resistant strains of these diseases is addressed as the House considers any immigration bills.

“This is something I am going to push for us to look at in the Oversight Committee on Energy and Commerce,” Burgess told WND. “The issue came up a couple of years ago in late 2010. We had some hearings a couple of years ago but it is time to ask some questions again.”

WND columnist Barbara Simpson wrote about the issue recently.

“Who’s in charge of this stupidity?” she wrote. “No immigrant should be allowed in this country without a complete health check.”

Illegals bringing drug-resistant TB to U.S.

March 3, 2013 By Daniel Greenfield
frontpagemag.com

They have a dream. And it just might kill you.

A member of Congress who for more than 30 years worked as a doctor says the baggage that illegal aliens are bringing into the United States now is killing people.

Last week it was reported that a persistent strain of tuberculosis had developed in some Los Angeles neighborhoods. Officials said as many as 4,500 people may have been exposed to the disease.

Besides California and Florida, the states with the greatest number of multi-drug-resistant TB are Texas and New York, all having large numbers of illegal aliens within their borders. Florida was recently ranked as having the third largest illegal alien population by the Department of Homeland Security. Many illegals in Florida come from the Caribbean and other countries in the Southern Hemisphere, some of which have widespread problems with tuberculosis.

Diversity is bringing a diverse variety of plagues to the United States allowing Americans to benefit from exposure to new and exotic strains of diseases.

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.

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. Detainees who are suspected of being ill are placed in cells by themselves.
Here’s an interesting question.

Of the thousands of illegal aliens freed by Obama as part of his sequester threat, how many were carriers?

Illegal Aliens Bringing 60 Percent Lethal Drug-Resistant TB to the United States