TB cases rooted in other countries
Gary Emerling:
The immigration boom from Latin America and Asia that has significantly increased the population in Fairfax and Loudoun counties is also raising concerns about new tuberculosis cases in the region.
In Loudoun County, health department Director David Goodfriend said 86 percent of the 15 tuberculosis cases this year originated in foreign countries.
"Most are from Central and South America because most of the population we get is from there," Dr. Goodfriend said.
The situation is typical of a region with a large number of immigrants, he said.
Health officials said 60 percent to 65 percent of cases in Virginia originated outside the country.
Fairfax County health officials reported that foreign-born residents had 93 percent of the 95 tuberculosis cases last year. Asians accounted for 55 percent of the cases and Hispanics accounted for 26 percent.
Some area residents recently used the numbers to argue against the opening of a center for day laborers, including illegal aliens, looking for work in the town of Herndon, which borders the two counties.
Last week, the Town Council voted in favor of the construction of a day-labor hiring site to stop workers from loitering at a 7-Eleven store.
Robert Miller, a Herndon resident and member of the American Council for Immigration Reform, was among those concerned about illegal aliens coming to the area and spreading the disease.
"It's a definite health hazard," said Mr. Miller, 77. "In Herndon I think we've got some time bombs ticking disease-wise."
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posted by Adam Lawson @ 4:22 PM
5 comments
5 Comments:
"In Herndon I think we've got some time bombs ticking disease-wise."
Yes, indeedy.
It is safe to say that a substantial number of laborers using this center will be illegal immigrants who have entered the US without benefit of medical screening. A number of communities in Northern Virginia have seen a marked increase in communicable diseases, most likely as a result of the influx of unscreened immigrants. According to a recent report from the American Lung Association of Virginia, 87% of the cases of tuberculosis in Northern Virginia were patients born outside of the US. Since immigrants who enter the US legally are screened for contagious diseases, it is not difficult to surmise the origin of most cases of tuberculosis in Northern Virginia. The number of persons – both laborers and employers – who would use this center would both expand and change as laborers moved on to another area, new laborers arrived, and different employers appeared to make use of it. Each of these groups would also have a wide circle of contacts in the larger community – homes, schools, businesses, churches, and neighborhoods. These circumstances have the makings of a potentially serious medical crisis.
So, if such a medical crisis should materialize, who gets sued? Project Hope and Harmony which is administering the work site? It sounds like a perfectly fine community organization, but I doubt that it has deep pockets. The city of Herndon, which approved the project, and Fairfax County, which helped finance it? Quite possibly. If you pick up a day laborer in a public parking lot, you are more or less on your own. If you pick him up at a government sponsored day laborer site, the situation might be perceived differently. Both Herndon and Fairfax County should have given careful consideration to this aspect of the day laborer site prior to making themselves and their citizens liable for lawsuits involving potentially huge sums of money.
Adam,
This is an issue which is a little close to home right now.
On Friday of last week, my colleagues and I were told that another member of staff, who's on long-term sick leave, had developed TB. For reasons of medical confidentiality, we were not told their identity - indeed, it's been withheld from most management.
TB is a consequence of the mass migration of people. I suppose keeping wage inflation down is more of a priority for our political and business leaders than public health.
This is abbreviated from a newsletter:
"The death of a nurse at Chesapeake (Va.) General Hospital caused by tuberculosis has prompted county health officials to request that nearly 1,000 people be tested for the dangerous disease.
With hundreds still to be checked, more than a dozen people have already tested positive for a non-active form of tuberculosis. (The) nurse at Chesapeake General died of tuberculosis (TB) on June 12.
Of the 14 positive test results so far, four were employees of the hospital, three were family members and seven were either visitors or patients at the hospital. None of those who have tested positive are said to have the contagious, active form of the disease. They will, however, require comprehensive treatment to avoid any risk of the bacteria becoming active.
Among those asked to submit to testing are hospital employees, family and friends of the deceased nurse as well as former hospital patients and visitors dating as far back as October of 2003. Because TB can take up to 12 weeks to appear, some of those who have already been tested may have to be checked a second time.
Health officials are concerned because many of those contacted have not shown up to be tested and a considerable number did not return a second time to have their test results read.
According to the Centers of Disease Control, TB is a disease that is caused by a bacteria that spreads through the air from one person to another when a person with TB coughs or sneezes."
If a nurse can develop a case of TB so serious that it kills her and be working in a hospital, surrounded by a host of medical professionals, including doctors, who don't pick up on her illness until it has spread to others, then how likely is it that an employee/volunteer of the Herndon day laborer site would pick up on a case of TB? If a hospital, which keeps good records of staff, patients, etc can't get everybody that might have been exposed, how will this day laborer site even START to find anybody who might be exposed? Does anyone think that the "employers" are going to drop off their names, addresses, and phone numbers?
Recently at day care center in Roanoke, VA a volunteer tested positive for TB. The center apparently screens employees but not volunteers. Last I read, 3 others have tested positive as a result of this exposure. Since it is a health issue, we were not informed of how the volunteer was infected or who the 3 are, that is, employees, other volunteers, parents of the children, or the children themselves.
One day laborer with the drug resistant strain of TB + one person with a suppressed immune system (chemotherapy, for example) = a major disaster.
A bunch of good comments.
You gotta wonder what's going on this country...
Update on the Chesapeake General nurse (abbreviated from a Dec 2004 newspaper):
Tests that were returned this week to state health officials have confirmed that two local cases of active tuberculosis were contracted from a nurse who died of the disease during the summer.
(The Chesapeake Health Director) said Thursday that tests to establish if there was a link between the nurse and the two TB cases were conducted by the national Centers for Disease Control and Prevention. The results proved that the strand of tuberculosis the nurse had was the same form found in a Chesapeake General Hospital co-worker and patient.
The co-worker is doing fine. The tuberculosis was caught early and was not yet contagious.
The patient, an elderly woman, died during the spring. Her death was due to other health complications. But before she died, health practitioners discovered she had active TB.
They also learned that the elderly woman had been cared for last fall at Chesapeake General by the nurse who died. Health officials, citing privacy laws, have declined to identify any of the people who developed active TB.
(The Chesapeake Health Director) said the three active cases were remarkably few, given the potential for the disease’s spread.
“To have this limited number of active cases is phenomenal,” (she) said, crediting a massive testing effort for helping keep the disease in check. Officials screened about 2,500 people after (the nurse)died.
The nurse had worked at Chesapeake General from November 2000 to April 2004. Through interviews with family members, friends and co-workers, health officials were able to determine that (she) likely was working with the contagious form of TB from July 2003 to April (2004).
They also learned that her last TB test, given by hospital officials each year to medical practitioners, was negative.
In letters and phone calls, health officials urged patients who had stayed in an inpatient medical surgery unit from July 2003 to April (2004) at Chesapeake General to receive free TB testing in clinics set up in the city.
Health officials also screened visitors and hospital associates who had contact with the patients of the Chesapeake General 2 East surgical unit for extended periods of time.
Of the 2,500 people screened, 128 people were found to have the latent form of TB. Although that form is not contagious, it can develop into active and contagious TB if a person’s immune system weakens.
Health officials are still trying to find out how (the nurse)contracted tuberculosis.
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From mid-2004 to late-2004, we have moved from "nearly 1,000" to 2,500 tested and from 14 latent to 2 active and 128 latent. Also note that this "good" outcome is credited to the hospital's being able to find and screen so many contacts. As I said in my previous post, the potential for serious disaster is right there.......
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