Despite rhetoric, illness threat from migrants is minimal, experts say

The Trump administration says a group of migrants now making their way through Mexico is a national security...

Posted: Nov 2, 2018 12:26 PM
Updated: Nov 2, 2018 12:26 PM

The Trump administration says a group of migrants now making their way through Mexico is a national security threat, and some conservative commentators claim that they are a threat to Americans' health. But experts say the people whose health is most at risk are the migrants themselves.

A story in the right-wing magazine The New American this weekend was headlined Will Migrant Caravan Kill Your Child - With Disease? On Monday, "Fox& Friends" co-host Brian Kilmeade claimed that the refugees pose a threat because they carry "diseases" and shouldn't be let in.

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A commentator on Fox, former immigration agent David Ward, also claimed that the migrants carry disease "such as smallpox and leprosy and [tuberculosis] that are going to infect our people in the United States." Later, according to the Daily Beast, Fox's press office sent out a clip clarifying the issue that mentioned only TB and leprosy and added, "we have no way of independently confirming this."

These claims are unlikely, experts say.

The World Health Assembly declared the world free of smallpox in May 1980, considered the biggest achievement in international public health, according to the US Centers for Disease Control and Prevention.

Leprosy is extremely rare, and although the World Health Organization says there are some cases in the Americas, 94% of them were reported in Brazil a study of the region between 2003-2013 found. The migrants are mostly fleeing Honduras, El Salvador and Guatemala, and those countries had a tiny number of cases.

Tuberculosis is a problem around the world. The United States saw 9,105 cases in 2017, according to the CDC.

Pueblo Sin Fronteras, a nonprofit working with the migrants, says that some people in the group are in a "delicate condition" but that their health issues don't relate to diseases that would be a threat to others. Rather, there are threats to their own health that stem from their difficult circumstances.

The migrants have walked hundreds of miles, many wearing only flip-flops, rubber clogs and sneakers that are falling apart. They have limited food and water. They've had to cross rivers and battle grueling heat and torrential rains. They sleep outside, on sidewalks or on floors. Many are exhausted, but still they walk a daily marathon.

"I am feeling some chills. I have had a fever for a few days," Carlos Gomez told CNN on Sunday. An out-of-work farmhand from Honduras, he says he has no choice but to walk. He needs to find a way to earn a living and to feed his eight children. "There is no work anymore. The government took our lands," he said.

Federal and state health departments in Mexico are working closely with the caravan, as is the Cruz Roja Mexicana, or the Mexican Red Cross.

Isaac Oxenhault of Cruz Roja Mexicana, who worked with the migrants when they reached Tapachula, said his group has treated more than 2,000 people for health problems. Foot injuries from the long journey are most common, he said, estimating that the Red Cross has treated 1,300 to 1,400 people for these issues.

Cruz Roja Mexicana has also treated about 400 people for problems with dehydration, supplying water and in some cases using IVs. Some have been treated for stomach problems, but these cases have been minimal, Oxenhault said.

At least three women have gone into labor, the Red Cross said, though all gave birth in hospitals. The Red Cross transported one of them for care. As far as serious illnesses like cancer or HIV, Oxenhault said, it has no record of any of those problems.

"There are general health needs besides this crisis and they are vulnerable in different ways, because many don't get formal medical care. They have not had preventative or curative care before," said Dr. Ricardo Perez Cuevas with the Mexican Institute of Public Health. "In terms of the possibility to infect other people, very low possibility."

Cuevas hopes to work with the migrant population to get more information about their general health and to make sure they get the help they need like vaccinations and general care. "Health care is a human right. It should not just be about avoiding disease, it should be about getting proper care."

Rene Leyva who works with Cuevas on immigrant health issues said to remember that migrant caravans are not a new phenomenon and for at least 15 years this team, and the public health sector overall in Mexico, have learned how to provide good health to the migrants traveling from Central America. "These are not health problems that would cause an epidemic, not at all, but there are some urgent situations of poor health conditions that come from exposure to the sun and to mosquitoes, perhaps food-related illness like diarrhea, and the risk of being hurt from car accidents on the road, but our health system has the capacity to resolve those consequences. They are not going to transmit disease from these countries to Mexico or elsewhere"

Of the 5,000 to 6,000 people who remain in the group, many are children facing their own health challenges.

Dr. Julie Linton, a pediatrician who works with immigrants from the region in the United States, but has not worked with this particular group, said that the No. 1 concern for children in such circumstances is trauma.

"What often gets lost in the rhetoric is that these families that are leaving are fleeing violence. These parents are seeking safety for their children and their family, and when we talk about people making this kind of journey, they are doing this and everything they can do to protect health and safety," said Linton, co-chairwoman of the American Academy of Pediatrics' Immigrant Health Special Interest Group.

Trauma can interfere with sleep, lead to challenges with bed-wetting and create eating problems. Parents may also see a change in their child's behavior, Linton said.

Children who have experienced trauma can have exaggerated responses to situations and problems with peers. They can experience a deep fear of separation from their parents. Trauma can hurt memory, limit concentration and make organizing thoughts difficult.

The trauma facing migrants in these circumstances doesn't start with the act of migration.

"I've taken care of children and families who have experienced direct threats or experienced physical harm from gangs and others. That trauma is why they leave," Linton said.

Even if the journey itself is hard and the outcome is uncertain, the result could help their health.

"What we know about the social determinants of health that can impact through someone's lifespan is that children are best able to achieve their dreams and survive trauma when they have access to safety and support and have a loving adult in their life that can shepherd them through childhood," Linton said. "These families are undergoing this treacherous journey feeling that they have no choice but to seek safety for their families elsewhere."

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