Friday, June 01, 2007

The Invisible Enemy Within

The media is in full feeding-frenzy "mode" over the case of that Atlanta lawyer who learned he had drug-resistant tuberculosis, yet traveled overseas and somehow managed to re-enter the United States, despite being placed on a Homeland Security "hot list."

In a scramble to land a dubious "exclusive," Diane Sawyer of ABC actually flew to Denver, where the attorney--31-year-old Andrew Speaker--is in the isolation ward of a hospital that specializes in TB treatment. The sight of Sawyer interviewing Mr. Speaker, clad in a surgical mask, was both silly and disturbing. Apparently, the risk of infection isn't high enough to require the ABC anchor to wear protective gear, but Speaker's mask was a reminder of the seriousness of his condition--and the fact that he may have exposed other people--on two continents--to a deadly disease.

Mr. Speaker has already offered the perfunctory apology "for any grief or pain that I have caused anyone." He also told ABC that he has tape recordings of a meeting with health officials that would confirm his view that it was OK to travel in his condition. However, doctors and public health officials paint a different picture. Physicians said they told Speaker not to travel. The Atlanta-based Centers for Disease Control (CDC) was aware of his condition, and also advised him not to travel. But Speaker claims that the tape will show that he was never told he couldn't travel, and elected to go through with his honeymoon to Greece and Italy, with stops in France and Canada along the way.

While the media focus their attention on a TB-infected trial lawyer and his beautiful bride, they are (predictably) missing the real story. There is a growing tuberculosis epidemic in this country, but it isn't being spread by a selfish attorney who ignored doctors' warnings and went jet-setting to Europe on a lavish honeymoon. Instead, the real TB problem can be found in our immigrant communities, where infection rates dwarf those of the native-born population. Consider the prescient observations from National Review's James Edwards, published six years ago this month. Hat tip:

"Immigration law makes being infected with certain diseases grounds for exclusion on the basis of threatening public health. However, the screening process in the home country and at points of entry is not foolproof, and illegal migration across a land border makes it easier for a disease carrier to bypass health inspection. And it doesn't help any that some diseases, such as TB, may be carried in the body for years before becoming highly contagious."

TB may again rise in the United States, and this will stem directly from mass immigration. Worldwide, this disease has made a comeback, accompanied by vaccine-resistant strains. From 1985 to 1991, TB cases rose 20 percent globally. For the first time, the World Health Organization in 1995 declared tuberculosis to be a worldwide emergency. This lung disease is ravaging Africa, Southeast Asia, and Eastern Europe. TB deaths are rising worldwide for the first time in about 40 years."


In the United States, the incidence of TB is prevalent among immigrants. About 41 percent of the 18,361 known tuberculosis cases in 1998 were immigrants; in 1986, 22 percent of new U.S. TB cases were immigrants. The foreign-born incidence of TB in the United States approaches six times that of the native-born. CDC figures show that during the period from 1993 through 1998, the native-born had 5.8 cases of TB per 100,000, while the foreign-born rate was 32.9.

TB is especially prevalent in Mexicans, Filipinos, Vietnamese, Indians, Chinese, Haitians, and Koreans. Mexican immigrants have an infection rate of 35.5 cases per 100,000, far above the native-born rate. Yet, Vietnamese have an infection rate of 137.7; Haitians, 118.5; and Filipinos, 95.9. Immigrants from many Third World countries carry TB, including those from the Dominican Republic and Ecuador, and even Puerto Rico.


To make things worse, many U.S. public-health officials put political correctness before common sense. A Maryland public-health officer told the Washington Post, "My greatest fear is that there will be this terrible xenophobic response to anyone who is a quote-unquote refugee or immigrant." One official told the New York Times, "It may make absolute sense to screen certain subpopulations because you have evidence of rates of TB way out of proportion to what we see elsewhere. But how you do that without contributing to additional stigma is a challenge we're all confronted with."

And, a more recent story in WorldNetDaily confirms the link between drug-resistant TB and immigrant populations:

In the U.S., 128 people were found to have it in 2004, a 13 percent increase from the previous year.

The states with the highest numbers of multi-drug resistant cases in the last decade were New York, California, Texas and Florida, according to the CDC – states with the highest populations of new immigrants.

It's worth noting that much of our public health data on drug-resistant TB cases among immigrants is based on those who came here legally, or illegals who finally sought treatment at U.S. health facilities. As with other aspects of the illegal population, officials actually have no idea as to the number that might be infected with multi-drug resistant tuberculosis, or other contagious diseases. Yet the Bush immigration plan would provide legal status to all immigrants who entered the country illegally, including those that pose a potential public health risk. And, I haven't seen a single provision in the bill that would require a simple chest X-ray or other TB tests as part of the screening process.

Likewise, we haven't heard much from Homeland Security or the CDC about how they plan to monitor and track "legalized" immigrants who present a public health threat. The measures that were supposed to keep Mr. Speaker out of the country failed miserably, and we can only wonder about the numbers of other infected patients who've slipped in as well. And, when you couple those ineffective screening measures with political correctness in the public health sector (remember those concerns about immigrant-directed "xenophobia" and "stigmas"), and you've got the breeding ground for future epidemics, even pandemics.

It's one of the most serious consequences of the current immigration "chaos," and the Bush-Kennedy plan to "reform" it. Our present system has brought large numbers of immigrants--many of them illegals--to this country. As a group, their TB infection rates are many times those of native-born Americans. Making matters worse, our current "screening" system is ineffective at identifying immigrants who may pose a public health threat. And, instead of sending them home (a policy that has existed since the days of Ellis Island), the "reform plan" would provide them with legal status, and place treatment costs on you, the American taxpayer. According to some estimates, the cost of treating a single case of multiple drug-resistant TB can cost $250,000.

Andrew Speaker shouldn't be the focal point of the media's new-found interest in tuberculosis. He's nothing more than an arrogant personal injury attorney who put his own plans above the safety of others. There is a certain irony in that decision; Mr. Speaker could be sued by other airline passengers who might have been exposed to TB through his indifference. But in the arena of public health, the Speaker case is simply a sideshow; if the press is genuinely concerned about the "new" TB threat, they need to examine infection rates among immigrants--particularly illegal aliens--and our woeful inability to deal with this "invisible" enemy within.

1 comment:

litbrit said...

You raise some excellent points about TB screening. When my family and I came to the US in 1974, all-clear chest X-rays were part of the requirements one had to satsify in order to receive a green card and reside permanently in America. The rule applied equally to everyone: British immigrants (like us), Latin American, Asian, Caribbean, African, (etc.) families--anyone who wanted to live and work in the U.S.

I believe that draconian immigration laws cause millions of desperate people to take the easy way in, which is to say, to sneak across the border and live below the radar. Problem is, none of these people are accounted for, much less documented or X-rayed or tested for any other communicable diseases.

The current proposed plan completely ignores the health aspects of immigration, too--at least, no such language jumped out at me from the numerous excerpts I've read.

I'm one of those progressives who believe people who want to work and have a chance at a better life should be afforded that opportunity. But it's complete madness to think that we can make people who are already here, Stateside, step out of the shadows of their cash-paying jobs with construction conglomerates, hotel chains, and restaurant chains (to name just a few of the large corporate interests with large illegal labor forces) and willingly go back to Mexico for a "touch back" visit, pay a fine that is arguably more than any of them can afford, and re-apply to re-enter. Not when they can simply stay put and keep on keeping on.

If we're serious about helping immigrants, reforming immigration law, AND addressing the public health concerns that are, increasingly, going to keep knocking us in the head (or lungs, as it were), we need a much better, smarter, more humane, and more comprehensive immigration bill than the one that's currently being bandied about.