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January 4, 2000
TB Among Immigrants Causes Concern
J M Shenoy
Recent reports about the continuing rise of tuberculosis among immigrants has prompted immigration authorities in America to install several chest X-ray machines near the Mexican border with Texas and California. There are plans to have more machines at other entry points, immigration authorities say.
Those illegal immigrants who are detected with TB are treated at border points for a few weeks and sent back with medication which they are expected to take for at least six months.
Mexicans lead with the highest number of TB cases among the immigrants, followed by Filipinos, Vietnamese, Indians, Chinese, Haitians and Koreans. In recent weeks, tuberculosis has been detected in many Tibetan monks in Minnesota and New York.
"Despite the overall good news, we see a number of warning signals that need to be addressed," Dr Marisa Moore, an epidemiologist with the Centers for Disease Control and Prevention, has said.
In Canada, too, TB has been staging a comeback. Toronto reported about 500 cases of TB last year with an incidence rate three times the provincial and Canadian average. About 70 per cent of TB victims were foreign-born. Groups that have been demanding a severe restriction on immigrants and tighter border control have been using TB statistics to bolster their arguments and demands.
In America, the five-year overall drop came after a dramatic surge in TB cases from the mid-1980s through 1992.
The CDC said 19,855 TB cases were reported in the United States in 1997, a seven per cent decrease from 1996 and a 26 per cent drop from 1992.
In 1998, out of the 18,361 cases reported across America, immigrants accounted for nearly 42 per cent cases, although they represented just over 10 percent of the total population. The increase of TB among immigrants has been going up in the last seven years.
Most immigrants were infected while living outside the United States, and the disease became active after they moved here, the CDC said.
TB is more common in less industrialized countries where people live closely together and there is less screening and treatment.
Officials from CDC and elsewhere have been suggested for over two years that there should be more screening for the people most at risk for TB. They are urging for large scale TB screening in cities in California, Texas, New York, Illinois and Florida which have large number of immigrants.
Tuberculosis is a bigger killer than malaria and AIDS combined in many countries. Every year, about 2.5 million people die of TB worldwide. These include 100,000 children, according to the World Health Organization.
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