Seven Refugees With Active TB Sent to Idaho

tuberculosis - TB
AP Photo/Lefteris Pitarakis

Seven refugees with active tuberculosis (TB) were diagnosed shortly after their resettlement in Idaho between 2011 and 2015, according to the Idaho Department of Health and Welfare.

This makes Idaho the seventh state to confirm to Breitbart News that recently arrived refugees have been diagnosed with active TB.

The other states in which recently arrived refugees have been diagnosed with active TB include: Louisiana (twenty-one), Florida (eleven), Colorado, (ten), Indiana (four), Kentucky (where nine were diagnosed in one county), and North Dakota (where four refugees who resided in the United States for less than five years were diagnosed in one county).

Idaho is one of fourteen states that have withdrawn from the federal refugee resettlement program where the federal government has hired a voluntary agency (VOLAG) to resettle refugees under the statutorily questionable Wilson Fish alternative program.

In Idaho, the federal government has contracted the Idaho Office for Refugees (IOR), a division of the large non-profit known as Janus, to run the program. Janus is one of the largest organizations within the lucrative and politically connected refugee resettlement industry, which is paid more than $1 billion per year by the federal government.

Jan Reeves, the man who runs IOR, was honored by the Obama administration at the White House in 2013 as a “champion of change.”

“The White House honors ten leaders with the Welcoming America organization — helping immigrants integrate civicilly, linguistically and socially into the fabric of their neighborhoods – and our nation,” the announcement read.

“During the last 5 years, Mr. Reeves, in partnership with the City of Boise Mayor’s Office, has led the effort to more fully integrate refugees into the community and create a more welcoming environment for all newcomers. Through the successful engagement of dozens of community partners, this effort has led to the development and implementation of Boise’s first Refugee Community Plan,” the White House said of Reeves.

The refugee program in Idaho has been in the news recently after it was reported that two young refugees from Sudan and one young refugee from Iraq were arrested and charged with sexual assault of a five year old girl at an apartment complex in Twin Falls, Idaho.

“Police Chief Craig Kingsbury of Twin Falls, Idaho, confirmed Monday that three Sudanese and Iraqi boys allegedly sexually assaulted a five-year-old girl, and that two of them have been sent to a detention center after allegedly brutalizing the American child,” Breitbart News reported of the incident that allegedly took place in early June.

Breitbart News asked IOR’s Reeves if he could confirm or deny that the suspects arrested in that case had been resettled in Idaho as part of the refugee resettlement program, but received no response.

The U.S. Attorney for the District of Idaho, Wendy Olson, however, has not been reticent in offering her comments on the alleged sexual assault.

“President Barack Obama’s top legal appointee in Idaho is threatening to prosecute Americans who criticize the federal immigration policies which enabled Sudanese and Iraqi Muslim migrants to perpetrate a vile sexual attack against a five-year-old girl in Twin Falls, Idaho,” Breitbart News reported last week.

4,650 refugees were resettled in Idaho between 2011 and 2015. Of these, 17 percent, or 785 were from Iraq, 15 percent, or 708, were from the Democratic Republic of the Congo, 12 percent, or 554, were from Bhutan, and 11 percent, or 500, were from Burma.

The Congo, Burma, and Bhutan are countries with high rates of active TB and latent TB infection (LTBI).

90 percent of the 4,650 refugees resettled in Idaho between 2011 and 2015, or 4202, were medically screened within the first three months of their arrival, according to the Idaho Department of Health and Welfare.

Of those screened, 21 percent (896) tested positive for LTBI.

Only four percent of the general population in the United States tests positive for LTBI.

A recent UC San Diego study concluded that high rates of LTBI among resettled refugees “increase risk of active TB in refugee resettlement communities.”

The rate of LTBI among refugees resettled in other states ranges from 35 percent to 12 percent in these states: Vermont (35 percent), Tennessee (27 percent), Indiana (26 percent), Minnesota (22 percent), Texas (15 percent), and California (12 percent). In addition, one county in North Dakota reports a 29 percent rate of LTBI infection among recently arrived refugees.

The Idaho Department of Health and Welfare also provided Breitbart News with a breakdown of B1, B2, and B3 tuberculosis health risk notifications it received from the Centers for Disease Control (CDC) through its Electronic Disease Notification system between 2011 and 2015 at the time of refugee arrivals.

274 B1 notifications were received, 160 B2 notifications were received, and 8 B3 notifications were received.

“The CDC sends all B notifications simultaneously to both the local public health districts and state public health. Upon each notification, the state works very closely with the local public health district to ensure treatment is offered and monitored. With these direct notifications from the CDC, neither the state nor counties require identical notifications from Janus,” a spokesperson for the Idaho Department of Health and Welfare tells Breitbart News.

“Approximately 44% of TB B notifications are for non-refugee visa types,” the spokesperson adds.

B1 tuberculosis health risk notices are for what the CDC calls “active non-infectious” cases of TB where radiographs indicate the presence of the disease but sputum spears and cultures are negative.

B2 tuberculosis health risk notices indicate positive tests for LTBI

B3 tuberculosis health risk notices indicate the individual has been in contact with someone who has been diagnosed with active TB.

The Idaho Department of Health and Welfare also provided some data on the treatment of refugees who tested positive for LTBI.

“Idaho has two refugee clinic sites, one in Boise and the other in Twin Falls,” the Idaho Department of Health and Welfare tells Breitbart News.

When asked the number of refugees who completed domestic medical screening and tested positive for latent tuberculosis infection (LTBI) at the time of that screening who successfully completed LTBI treatment within one year, a spokesperson for the Idaho Department of Health and Welfare tells Breitbart News, “This data is not readily available from our Twin Falls clinic,” but referred Breitbart News to a study by several doctors who work at the Boise screening clinic.

“LTBI treatment completion rates commonly reported in the literature are low (69% INH, 80.5% RIF),” several doctors who work at the Family Medicine Residency of Idaho [the Boise Clinic] wrote in a 2015 paper, “Achieving high levels of treatment completion for latent TB (LTBI) in a low incidence state with relatively large numbers of resettled refugees.”

“The Family Medicine Residency of Idaho (FMRI), which operates the local health district TB Clinic in Boise, Idaho, has implemented steps to achieve higher completion rates (76‐94%). Over 40% of the Clinic’s patients are recently resettled refugees who speak more than fifteen different languages,” the study reported.

These higher rates were achieved using “cultural insight and sensitivity”:

 Outreach and educational materials are provided in the patient’s language.

 Supplementary pictorial materials are used for patients with low literacy.

 Qualified medical interpreters are consistently provided in person whenever possible but also by phone when necessary.

 Related household members are seen in small group appointments when appropriate.

 A welcoming and positive TB Clinic environment is cultivated.

The Idaho Department of Health and Welfare provided one of the more complete responses to refugee tuberculosis health questions posed by Breitbart News to any state to date, a welcome relief from the veil of secrecy and stonewalling prevalent among the public health establishment and refugee resettlement agencies in several other states.

Several questions, however, remain unanswered in Idaho with regards to the treatment of refugees who arrived with B1, B2, and B3 notifications, and the Idaho Department of Health and Welfare assures Breitbart News it is working to provide those answers.

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