The numbers of immigrants in custody with a contagious diseases has spiked in the past year. For the previous two years, the agency has not encountered a single case of mumps among its detainees.

“As of March 7, 2019, there was a total of 2,287 detainees cohorted for exposure to a detainee with a contagious condition,” said ICE spokesperson Brendan Raedy in a statement.

In the past 12 months, there have been health investigations at 51 ICE detention facilities for mumps, chickenpox and influenza, according to Raedy.

There have been 236 reported cases of mumps, with another 16 suspected cases during this time period.

Mumps is a contagious virus that is typically spread through saliva and mucus. Symptoms include fever, muscle aches, loss of appetite and puffiness around the cheeks and jaw from swollen salivary glands.

Last year, there were 423 people documented with influenza and 461 people with chickenpox in ICE custody, according to the agency.

But from January 2016 to February 2018, there were zero notifications of mumps, and only 73 of chickenpox and 34 of influenza.

“ICE takes very seriously the health, safety and welfare of those in our care. ICE is committed to ensuring the welfare of all those in the agency’s custody, including providing access to necessary and appropriate medical care,” Raedy said in a statement.

Last week, Texas officials announced that nearly 200 people at immigration detention facilities across the state had contracted mumps since October.

The 186 patients ranged from 13 to 66 years old, the Texas Department of State Health Services said Tuesday.

“They should be in isolation,” said Dr. David Persse, of Houston’s public health authority last week.

Persse urged ICE start isolating people who show mumps symptoms and quarantine people who may have been infected.

“To some degree, this is foreseeable, because you’re bringing a lot of people and housing them in tight spaces for long periods,” Persse said.

US officials have been warning of the perils of diseases for migrants arriving in the US, increasingly in large numbers of families and children.

“Migrants travel north from countries where poverty and disease are rampant, and their health can be aggravated by the physical toll of the journey. Many individuals we encounter may have never seen a doctor, received immunizations, or lived in sanitary conditions. Close quarters on trains and buses can hasten the spread of communicable diseases,” said US Customs and Border Protection Commissioner Kevin McAleenan during congressional testimony last week.

In December, CBP mandated secondary medical reviews of all in children, after two young Guatemalan children died after being in Border Protection custody.

CBP also requested additional medical support from the US Coast Guard and the US Public Health Service Commissioned Corps, as well as coordinating with the US Centers for Disease Control and Prevention to gather data on infectious diseases among migrants in custody.

Migrants who cross the border illegally are generally transferred from Border Protection custody to ICE custody for further processing or release.

ICE said that comprehensive medical care is provided to everyone in custody, including access to nurses, physicians, and to 24-hour emergency care.

It was unclear Monday, if ICE was taking additional steps to deal with issues of disease in its facilities.

Reuters first reported on the quarantine.

Source: https://fox5sandiego.com/2019/03/12/more-than-2000-people-in-ice-custody-quarantined-for-contagious-diseases/

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Jonathan Mermin, MD, MPH, Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), US Centers for Disease Control and Prevention, Atlanta, Georgia, shared a national perspective on this problem.

More than 600,000 Americans have died from opioid overdose since 2000, he said. Of particular concern, he added, is the interconnectedness between drug overdoses and reports of new cases of hepatitis C virus (HCV) infection.

The United States has seen a steady rise in the incidence of HCV cases since 2010, including doubling of the number of reports of pregnant women infected with the virus; this surge in HCV incidence is linked to IDU with sharing of needles, Dr. Mermin explained.

“We are also seeing an increase in the proportion of HIV infections,” he said. Progress made in recent decades with respect to declining HIV rates associated with IDU is now leveling off, and even reversing, because of the opioid crisis, he noted. In addition, hepatitis A outbreaks have also become a crisis for some states, especially among adults experiencing homelessness.

Cases of syphilis are also on the rise in the United States. This includes congenital cases, said Dr. Mermin, reports of which have increased 176% since 2012. He noted that 88,000 cases of syphilis were reported in the United States in 2016. Increasing numbers and proportions of cases of syphilis in heterosexual individuals are occurring among people who use drugs, said Dr. Mermin, including among those who inject drugs.

Jay Butler, MD, chief medical officer and director, Division of Public Health, Alaska Department of Health and Social Services, also shared his state-level perspective from working on the front-lines of the opioid crisis in Alaska.

In 2017, approximately 1 in 30 of all deaths in Alaska were associated with opioid overdoses, he said.

The opioid epidemic in Alaska is a very dynamic one, he noted. Although the state had made progress with respect to reducing the numbers of death associated with prescription painkillers and heroin, Dr. Butler noted that these gains have now been wiped out due to the emergence of illicit fentanyl in recent years. This epidemic is different, he said. “We’re now seeing clusters of deaths. And, many users do not even realize they are taking fentanyl—they think it’s heroin.”

The rise in infectious disease cases is an increasing challenge, too, said Dr. Butler. For example, Alaska has seen an increase in the rate of HCV diagnoses among individuals younger than 30 years since 2015. Self-injection drug use is a major driver behind the HCV epidemic, he explained.

Alaska was the second state to issue a disaster declaration on the opioid epidemic, said Dr. Butler. And statewide efforts are now underway to address the opioid crisis, he added. These center on a 3-pronged approach to managing addictions and substance-use disorders that targets: harm reduction to prevent life-threatening adverse outcomes (for example, by increasing access to naloxone and to syringe/needle exchange programs); diagnosis and treatment (including removing the associated stigma, and understanding addiction as a chronic disease of the brain); and prevention (for example, by encouraging judicious opioid prescribing and holding drug take-back events).

At the national level, CDC has taken a 5-point strategy to prevent opioid overdoses and harms, said Dr. Mermin. These focus on: conducting surveillance and research; improving state, local, and tribal efforts to prevent overdoses and harms; supporting health care provider and health systems; raising awareness about opioid use disorder and the severity of the epidemic, to empower people to make safe choices; and improving collaborations between public health officials and public safety officials.

He emphasized the importance of introducing comprehensive syringe service programs (SSPs) at the community level. These cost-saving programs prevent infections, he said, and do not increase drug use or crime in communities. Indeed, people who use SSPs are 3- to 5-times more likely to stop injecting drugs.

“Large-scale public health action and targeted, comprehensive, community-wide programs can prevent infections, reduce drug use, save lives, and save money,” Dr. Mermin concluded.

Dr. Parry graduated from the University of Liverpool, England in 1997 and is a board-certified veterinary pathologist. After 13 years working in academia, she founded Midwest Veterinary Pathology, LLC where she now works as a private consultant. She is passionate about veterinary education and serves on the Indiana Veterinary Medical Association’s Continuing Education Committee. She regularly writes continuing education articles for veterinary organizations and journals and has also served on the American College of Veterinary Pathologists’ Examination Committee and Education Committee.

Source: https://www.contagionlive.com/news/infectious-diseases-on-the-rise-amid-the-opioid-epidemic

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European health officials are on high alert as the number of clinically-confirmed measles cases across the continent passed 23,500 in the first six months of the year.

That’s a staggering increase over last year, in which about 6,000 cases were confirmed across across the full 12 months. The real number is likely higher, say health officials, who estimate more than 41,000 cases have already occurred this year.

Most measles infections last about 10 days, and while many people recover from the complications, sickness can cause serious health problems. Infections have led to brain swelling, meningitis, pneumonia, and liver infections. The highly contagious virus has been the underlying cause of 37 deaths in 2018 in Europe, according to public health officials.

So why the high rates? Officials in Europe and America are pointing, in part, to the populations of parents who are actively choosing to not vaccinate their children.

“This partial setback demonstrates that every person who is not immune remains vulnerable no matter where they live, and every country must keep pushing to increase coverage and close immunity gaps, even after achieving interrupted or eliminated status,” said World Health Organization official Nedret Emiroglu in a statement.

The number of cases in America is also on the rise, albeit less staggering so than in Europe. So far in 2018, the US Centers for Disease Control and Prevention says 107 infections have been reported. That means the US is poised to surpass last year’s 12-month total of 118 cases.

The increased prevalence of measles is noteworthy because, at least in America, the virus was virtually stomped out after a vaccine became available in the 1960s. Europe hit a record low number of cases in 2016, when the continent reported just over 5,000 infections. But increases in cases have corresponded with the rise of a social movement that spurns the idea of vaccinating children to protect against the virus. Some of the leeriness toward vaccinations has bubbled up from now-discredited research from two decades ago, which incorrectly linked vaccines to autism.

Since 2009, the number of “philosophical-belief” decisions to not vaccinate has risen in 12 of 18 US states that allow opt-outs, according to research published in June in the journal PLOS Medicine. In Texas alone, the number of grade-school aged children who’ve not been vaccinated (pdf) has increased 20-fold since 2003, when the state gave people the ability to choose to opt out of a vaccination.

“Our findings indicate that new foci of anti-vaccine activities are being established in major metropolitan areas, rendering select cities vulnerable for vaccination-preventable diseases,” the PLOS Medicine study states.

Source: https://qz.com/1364973/mankind-almost-beat-measles-but-the-virus-is-storming-back-in-europe/

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