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Originally published July 16, 2014 at 6:27 PM | Page modified July 17, 2014 at 1:22 PM

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Basic care, not disease, biggest medical issue for immigrant children

State health officials have reported three cases of tuberculosis, 23 cases of chickenpox and three cases of flu among children housed in detention centers after crossing the Texas-Mexico border.


The Dallas Morning News

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DALLAS — Despite concerns about the potential public-health crisis posed by immigrant children crossing the Texas-Mexico border, medical experts say the likelihood of their spreading disease is low.

Still, experts in emergency preparedness are urging health-care providers and Texas to get ready for many children who may need basic medical care.

“Four, five or a dozen children may not strain the system, but we’re now talking about thousands and thousands of children” who have unique physiological and psychological needs, said Michael Anderson, a Cleveland, Ohio, pediatrician and expert in pediatric disaster response.

More than 57,000 children have traveled alone from Central American countries and have been detained by U.S. immigration authorities at South Texas holding facilities this year. That number could reach 90,000 by year’s end.

Many are being transferred to other immigration centers, and 2,000 are expected to be housed in Dallas later this summer.

As of late last week, state health officials have reported three cases of tuberculosis, 23 cases of chickenpox and three cases of flu among children housed in detention centers in South Texas, said Carrie Williams, a spokeswoman for the Texas Department of State Health Services.

“We’ve had no reports of measles,” she said. “Generally, the potential for a wider public-health issue is there. But the biggest risk we are seeing for the people in the detention centers is because of the lack of hand-washing facilities.”

Immigrant children typically pose little threat to public health, says the state’s top pediatrician.

“The general public doesn’t need to be concerned that there are going to be outbreaks of illness due to these immigrant children,” says Dr. Mark Ward, president of the Texas Pediatric Society, which represents 2,800 pediatricians. “Most of these children will not have an illness that puts others at risk.”

Recently, Gov. Rick Perry weighed in with his concerns about unsanitary conditions at the Texas facilities where the children are being housed.

Every immigrant child undergoes a medical screening by a paramedic or emergency medical technician, looking for rashes, fevers and coughing, said Jessica Maxwell, spokeswoman for the Department of Homeland Security’s health-affairs office.

Such symptoms would send a child for a second screening by a doctor, nurse or physician assistant working for federal Health and Human Services.

“Any child who needs medical treatment is sent to a local emergency room, and if they are suspected to have a communicable disease, such as chickenpox or tuberculosis, they are quarantined, vaccinated and treated,” she said. “It’s a very small amount of children, compared to the general population.”

The most common medical complaint among these new arrivals, Maxwell said, “relates to their journey: dehydration, exhaustion, foot and ankle injuries.”

Many of the children remain in overcrowded conditions, sleeping side by side on the floor.

“Scabies and lice is primarily what we’re seeing,” said Shawn Moran, spokesman for the National Border Patrol Council, which represents 16,500 border agents. His group is calling for a more comprehensive medical response.

“You’ve got people in such close quarters,” Moran said. “I’m hearing there’s trouble getting cleaning supplies to kill off the infestations we’re seeing.”

Scabies is a contagious skin infection caused by mites, which usually results in a rash and relentless itching. Head lice, another parasite, infest the hair and neck and also cause itching. Both are easily treated.

Moran, who is based in San Diego, said most of the young immigrants appeared to be teenagers, although he declined to provide an exact percentage. He estimated that about 100 to 150 of them were under a year old, although the babies were accompanied by a relative, usually a teen.

Federal officials have been reluctant to discuss the children and their medical needs. They have not provided demographic information, including breakdown by age and gender.

“Some of them are illiterate,” Moran said of the immigrants. “They are unable to tell us what town they are from, much less know their vaccination history.”

Dr. Martin Garza, a volunteer pediatrician at the Sacred Heart relief shelter in McAllen, sees the same health conditions in immigrant children as in his private patients at his Edinburg clinic.

“We haven’t seen kids who have been significantly ill,” he said. “In fact, we’re seeing the opposite. I’m seeing kids that have been well taken care of in their country, that have vaccination records with them, that are not the poorest of the poor but a middle-class-type person from their country.”

The children who are being released from detention centers have common ailments — “everything from upper respiratory tract infections to abdominal pain from constipation or diarrhea,” said Garza. “We’re seeing some skin rashes, a few have been scabies but not very many. There’s no rash epidemic or anything like that.”

Dallas County Judge Clay Jenkins, who has led the effort to bring the children to Dallas, said he was not worried about them transporting serious diseases with them.

“The community need not be concerned about a mysterious disease,” he said after a July 9 meeting with Obama. He also conferred with Dr. Kyle Janek, executive commissioner of the Texas Health and Human Services Commission, about TB testing for the children.

If any diseases should appear as a result of their transfer to Dallas, Jenkins said, “we have protocols in place that are exhaustive to quarantine children that are contagious.”

Jenkins added that immigrant children had similar health profiles and higher vaccination rates than most American children.

“The diseases that the children may carry are, for the most part, diseases that go through every elementary school in (Dallas Independent School District) every year. And the more serious diseases are the diseases that we treat at Parkland every day.”



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