County ‘Not Being Informed Which Refugees Completed Their Initial Domestic Screening’ at Nebraska School With Active TB Diagnosis

The Douglas County Public Health Department is not being informed which refugees completed their “initial domestic screening,” a required health assessment that includes a test to determine whether the arriving migrant has latent tuberculosis (TB) infection.

Eighteen percent of the students attending that high school, where a student was diagnosed with active TB last month, or 237 out of 1,273, are foreign-born refugees.

“That information may be gathered by the Nebraska Health and Human Services Health refugee program,” a spokesperson for the Douglas County Public Health Department (DCPHD) tells Breitbart News.

The Nebraska Department of Health and Human Services has not responded to a Breitbart News request for the number of Benson Magnet High School students who arrived in the country as refugees and completed an initial domestic medical screening, tested positive for latent TB infection (LTBI), and successfully completed medical treatment for that condition.

Twenty-five percent of the 4,848 refugees who arrived in Nebraska between 2011 and 2015 and completed initial domestic medical screenings tested positive for LTBI, a rate that compares unfavorably to the American-born population in the country, where an estimated four percent of the population has LTBI.

A 2013 study by the University of California at San Diego concluded that high rates of LTBI among arriving refugees pose a health risk to the general population of the communities in which they are resettled, in part due to a much higher percentage of refugees with LTBI who develop active infectious TB.

Resettlement agencies and government health departments are required by statute and regulation to treat refugees who test positive for LTBI upon their arrival in the country with a drug regimen that lessens the likelihood they will develop active TB.

According to the Nebraska Refugee Health Screening Procedures issued by the Nebraska Department of Health and Human Services, “refugee health screening providers must . . . [p]rescribe, refer, or supply appropriate medications for infectious diseases and other conditions identified during the health screening.” (emphasis added.)

But neither the Nebraska Department of Health and Human Services nor the DCPHD appear to be monitoring whether any of the refugees who test positive for LTBI upon their arrival in the state receive the proper medical treatment for the condition.

When asked how many of these 237 refugees attending Benson Magnet High School who completed initial domestic medical screenings tested positive for latent TB at that time, the spokesperson said “Again, DCHD does not have that information.”

“In general, latent TB cases are referred to a healthcare provider who evaluates the individual and if necessary prescribes treatment,” the spokesperson tells Breitbart News.

“These cases are not followed by the governmental agency but are the responsibility of the refugee, parent or guardian and private physician. Resources only allow us to monitor active infectious TB cases,” the spokesperson adds.

“DCHD makes sure that every person with active infectious TB completes treatment – 100 %,” the spokesperson notes.

Breitbart News reported earlier this week that seven out of the 172 students, faculty, and staff who were exposed to the student diagnosed with active TB and were given blood tests tested positive for TB.

Of the seven individuals who tested positive for TB in blood tests, “So far, at least four of the individuals have already had a negative chest x-ray,” the DCHD spokesperson adds.

“DCHD will continue to be in contact with the physicians of those who tested positive,” the spokesperson adds.

When asked how DCHD Health Director Dr. Adi Pour can be certain that the 19 out of 191 at the school who were exposed to TB but did not submit to blood tests pose no risk of exposing others to TB, the spokesperson responded that “DCHD is continuing to work with the school to contact parents and guardians of those individuals that were not tested,” adding:

Some of these parents have decided to take their children to their own doctors (3 so far). Those who were not at school that week or missed the opportunity to be tested are being offered free testing at DCHD (4 so far). The hope is to capture all students who were potentially exposed. Information about this testing has been provided in various ways, such as robo calls, phone calls, parent meetings, letters, etc. and we hope that parents also see it as a personal responsibility to have their children tested.

Forty two out of 47 cases of active TB diagnosed in Douglas County, Nebraska between January 1, 2014 and December 10, 2016, or 89 percent, were foreign-born. In 2014, 82 percent of the cases of active TB diagnosed in Nebraska, or 31 out of 38, were foreign-born.

The state of Nebraska, and Douglas County in particular, compare unfavorably to the country as a whole, where 66 percent of the 9,563 cases of active TB diagnosed in 2015 were foreign-born.