Twenty-One Refugees Diagnosed with Active TB in Nebraska

Twenty-one refugees resettled in Nebraska were diagnosed with active tuberculosis (TB) between 2011 and 2015, the Nebraska Department of Health and Human Services tells Breitbart News.

Two of those refugees were diagnosed with active TB within ninety days of arriving in Nebraska during an initial domestic medical screening. The remaining 19 refugees were diagnosed with active TB within five years of their arrival in Nebraska.

The estimated 10,000 refugees who live in Nebraska comprise less than one percent of the state’s 1.9 million population. Yet the 21 cases of active TB diagnosed among resettled refugees in Nebraska accounted for more than 15 percent of the 137 total cases of active TB diagnosed in the entire population of the state between 2011 and 2015.

Nebraska joins a number of other states in which Breitbart News has confirmed recently arrived refugees have been diagnosed with active TB. Twenty-seven cases of active TB were diagnosed in Wisconsin, 21 in Louisiana, 17 in Vermont, 16 in Colorado, 11 in Florida, 7 in Idaho, 4 in one county in North Dakota, 4 in Indiana, and 9 in one county in Kentucky.

In fact, every state that has provided data to Breitbart News about refugee health has confirmed that recently resettled refugees have been diagnosed with active TB in the state.

Many states Breitbart News contacted, like New York, Massachusetts, Connecticut, Pennsylvania, and Michigan, however, have so far either refused to provide refugee health data or simply not responded.

Among the states that have provided all or part of the refugee health data Breitbart News requested, some patterns are apparent. Idaho and Nebraska, for instance, have several similarities. The two states have the same population (1.9 million), the same percentage of foreign-born population (6 percent), and high per capita rates of refugee resettlement.

As Breitbart News reported, 82 percent of the 38 cases of active TB diagnosed in Nebraska in 2014 were foreign-born. During the three-year period between 2012 and 2014, 73 percent of the 37 cases of active TB diagnosed in Idaho were foreign-born.

Nebraska reported that two cases of active TB were diagnosed among refugees during their initial domestic medical screenings conducted within 90 days of their arrival during the years between 2011 and 2015. Idaho reported that seven cases of active TB were diagnosed among refugees during their initial domestic medical screenings conducted within 90 days of their arrival.

Nebraska, however, has been more forthcoming so far in its provision of refugee health data.

The state reported that, in addition to the two cases of active TB diagnosed among refugees upon arrival, an additional 19 cases were diagnosed during the first five years subsequent to their arrival.

Idaho has yet to answer Breitbart’s questions about the number of refugees who have been diagnosed with active TB during the first five years following their arrival.

High levels of latent TB infection (LTBI) among resettled refugees is another pattern apparent from the refugee health data Breitbart News has been able to obtain from cooperating states.

As Breitbart News reported, approximately 4 percent of the general population in the United States has LTBI, in contrast to 33 percent of the population throughout the world.

Though 10 percent of the general population that tests positive for LTBI develops active TB at some point in their life, that activation percentage seems to be significantly higher in the resettled refugee population in the United States, according to a number of recent medical studies.

Twenty-five percent of the 4,848 refugees who completed initial domestic medical screenings in Nebraska during this five-year period tested positive for latent TB infection (LTBI), the Nebraska Department of Health and Human Services tells Breitbart News.

Several other states, including Vermont (35 percent) and Tennessee (27 percent), report higher rates of LTBI among refugees than Nebraska reported. Other states, such as Texas (15 percent) and Arizona (18 percent), report lower rates.

Another pattern that emerges is that successful treatment rates of refugees diagnosed with LTBI vary by state.

In some states, the treatment rate is low, around 60 percent, while in other states, like Minnesota, it is high, around 85 percent.

The LTBI treatment rate matters because of the apparent greater activation rate to active TB among the resettled refugee population.

But in Nebraska, this rate is not tracked. “We do not have data on the number of people treated after testing positive for LTBI,” a spokesperson for the Nebraska Department of Health and Human Services tells Breitbart News. “Local physicians and clinics take the lead for treatment of positive LTBI patients,” the spokesperson says.

“If a refugee tests positive for LTBI, he/she is referred to a local healthcare provider/clinic. DHHS offers free medication to providers to encourage patients to return to complete their course of medicine. We do not have data on the number of people treated after testing positive for LTBI,” the spokesperson adds.

“Nebraska Department of Health and Human Services receives Refugee Medical Assistance dollars [from the federal government’s refugee resettlement program] and has contracts with CHI Florence Residency Clinic in Omaha and Lincoln Lancaster County Health Department in Lincoln” to perform the initial domestic medical screenings of arriving refugees, the spokesperson tells Breitbart News.

Elected leaders in Nebraska appear to be largely unaware of the significant public health risk posed to the general population of the state by the high rates of active TB and latent TB infection among the refugees resettled in the state by the federal refugee resettlement program.

Unlike Tennessee, Kentucky, Idaho, Kansas, New Jersey, and several other states, Nebraska has not withdrawn from the federal refugee resettlement program, though the state’s Republican governor, Pete Ricketts, has the authority to do so.

The Tennessee General Assembly recently announced that it intends to sue the federal government on Tenth Amendment grounds to stop the resettlement of refugees within the state.