The number of active TB cases in the eight county Idaho public health district that includes Twin Falls jumped 500 percent between 2011 and 2012.
One case of active TB was diagnosed in the South Central Public Health District that includes Twin Falls in 2011, and six active TB cases were diagnosed there in 2012, the year Chobani opened the world’s largest yogurt factory in the small southern Idaho city with the help of $54 million in federal, state, and local financial assistance.
That same year, 2012, the percentage of active TB cases in Idaho that were foreign-born spiked to 80 percent, or 12 out of 15, up from 50 percent in 2011, or 6 out of 12. As Breitbart News reported previously, the percentage of active TB cases in the country that are foreign-born is 66 percent.
The city of Twin Falls, located within the county of the same name, is the site of a sexual assault case of a 5 -year-old American-born girl involving three Muslim refugee boys that has drawn national attention.
The population of state of Idaho is 1.6 million. The South Central Public Health District of Idaho consists of eight counties that have a population of 187,000. Twin Falls County is the largest county in the district, with a population of 78,000.
In 2012, the South Central Public Health District accounted for 40 percent of the active TB cases diagnosed in the state of Idaho, even though it has only 12 percent of the state’s population.
During the three year period between 2012 and 2014, the percentage of active TB cases in Idaho that were foreign-born was 73 percent, or 27 out of 37.
TB Cases by Idaho Public Health District Number of cases by year, a publication of the Idaho Department of Health, provides a detailed break down of the active TB cases in Idaho during the five years between 2011 and 2015:
State Total by Year: 2011 – 2012 – 2013 – 2014 – 2015 5 Year Total
Public Health District
South Central (Twin Falls): 1 – 6 – 2 – 4 – 1 — 14
Central (Boise): 4 – 4 – 4 – 6 – 8 — 26
All 5 Other Districts: 7 – 5 – 5 – 1 – 2 — 20
State Total: 12 – 15 – 11 – 11 – 11 — 60
Foreign-Born: 6 – 12 – 7 – 8 – NA — 33/49
Percentage Foreign Born: 50 – 80 – 63 – 72 – NA — 67
Refugees Upon Arrival: 1 – 2 – 1 – 2 – 1 — 7
Refugees in First 5 Years NA – NA – NA – NA – NA — NA
(Source: Idaho Department of Health and Welfare)
(See American Lung Association: Trends in Tuberculosis and Morbidity for 2011 foreign-born data)
(See page 66 of this 2012 CDC report for 2012 foreign-born data)
(See CDC 2013 Profile of Idaho for 2013 foreign-born data)
(See TBFacts.org for 2014 foreign-born data)
(Refugees Upon Arrival data provided by Idaho Department of Health and Welfare, as reported by Breitbart News)
During these five years, Idaho as a whole consistently ranked as one of the states with the lowest rates of active TB in the country, ranging between 0.67 cases per thousand to 0.76 per 100,000 in every year except 2012, when the statewide rate jumped slightly to 0.94 per 100,000, thanks to the spike in the Twin Falls public health district.
It was a different story in the South Central Public Health District in which Twin Falls is located, however, where the district’s 2011 rate of 0.53 per 100,000 spiked dramatically up in 2012 to 3.2 per 100,000. The rate remained well above the rest of the state in 2013, at 1.07 per 100,000, and 2014, at 2.1 per 100,000. By 2015, however, it had returned to a lower 0.52 per 100,000 rate.
What neither the South Central Public Health District nor the Idaho Department of Health and Welfare have yet disclosed, however, is the break down of the active TB cases by county within the South Central Public Health District.
That information matters a great deal, since the aggregation of the public health data among all eight counties could conceal or mask a significant outbreak if all the cases were diagnosed in only one of those eight counties.
For example, in a hypothetical scenario in which all six cases of active TB reported by the South Central Public Health District in 2012 were actually diagnosed in Twin Falls County, the 3.2 cases of TB per 100,000 reported at the district level that year would be misleading. In seven of the district’s counties, the true rate that year would be 0.0 per 100,000, while the rate in Twin Falls County would be an alarming 7.7 per 100,000, more than double the national rate. In 2015 the U.S. average was 3.0 cases of active TB per 100,000.
This is one reason why most other states report all diagnosed cases of TB at the county level.
Additional information that neither the South Central Public Health District nor the Idaho Department of Health and Welfare have yet disclosed is the countries of origin of the 33 foreign-born cases of active TB diagnosed in the state between 2011 and 2014, and how many of the state’s 11 cases of active TB in 2015 were foreign-born.
In Nebraska, another largely rural state, where six percent of the population is foreign born, 82 percent of active TB cases diagnosed in 2014 were foreign-born. Those 2014 cases in Nebraska represented an 80 percent spike in active TB cases statewide compared to 2013. All of the increase driven came from foreign-born cases of TB. The Nebraska Department of Health and Human Services said the countries of origin included Mexico, the Sudan, Somalia, Burma, and Nepal (Bhutan), among others.
Like Nebraska, Idaho has seen an increase in its foreign-born population recently, from legal and illegal Mexican immigrants, and refugees brought in to the state under the federal refugee resettlement program.
In 2013, Bob Naerebout, executive director of the Idaho Dairymen’s Association, told the McClatchy News Service that “between 75 and 80 percent” of Idaho’s estimated 8,300 dairy industry workers were illegal immigrants.
Many of those workers are from Mexico, a high TB burden country.
An estimated seven percent of the state’s dairy industry workers live in the eight counties that comprise the South Central Public Health District.
The Idaho Dairymen’s Association website states that “Today Magic Valley [Milk Producers] has 30 member farms located in Southern Idaho with nearly 3,000,000 lbs. of milk per day,” according to the Idaho Dairymen’s Association website.
Annualized, that amounts to approximately 1.1 billion pounds of milk a year, or about 7 percent of the state’s total output of 13.8 billion pounds of milk a year.
Breitbart News asked officials with the South Central Public Health District of Idaho to answer these and several other questions about these cases of active TB, but they referred our information request to the Idaho Department of Health and Welfare, which in turn asked us to submit a formal public records request for the information. Breitbart News has done that, and received this formal reply to that request:
On August 25, 2016, the Administrative Procedures Section (APS) received your request and it has been routed to the applicable division of the Department of Health and Welfare.
Pursuant to Section 74-103(1), Idaho Code, employees of the Department have determined that they will need more than three (3) working (business) days to retrieve or find the requested information.
Therefore, you are hereby notified that the Department will provide a response to your public records request within ten (10) working (business) days following the date of the receipt of your request. We anticipate a response will be sent by September 9, 2016.
Twin Falls has also been a center for refugee resettlement for over three decades. The College of Southern Idaho Refugee Program (CSRIBP), the local affiliate of one of the largest voluntary agencies (VOLAGs) in the country, the U.S. Committe for Refugees and Immigrants, has been the sole resettlement agency in the county during this entire period. About twenty-five percent of refugees resettled each year in Idaho go through CSIRP.
The remaining seventy-five percent of refugees are resettled in Idaho by the Idaho Office for Refugees, a division of another multi-state VOLAG, Janus. Most refugees resettled by this latter group are placed in the Boise area, which is included in the Central Public Health District.
Idaho has withdrawn from the federal refugee resettlement program and the program is operated in the state under the questionable statutory authority of the Wilson Fish alternative program.
Between 1990 and 2013, a total of 4,212 refugees were resettled by the CSIRP, according to its website.
Between 1993 and 2006 refugees to the area were Bosnian, Croat, Serbian, Iranian, Russian, Vietnamese, Burundi, and Mesketian Turks.
During the four years between 2009 and 2012, the number of refugees arriving in Twin Falls from high incidence TB countries increased dramatically as the countries of origin of refugees resettled in the area also changed.
Four hundred refugees from Burma, 453 from Bhutan, 122 from Eritrea, and 138 from Iraq resettled in Twin Falls County during these four years. Prior to 2007, no refugees from these four countries were resettled in the area.
Since 2012, refugees resettled in the Twin Falls area are primarily Afghani, Congolese, Sudanese, Iranian, Iraqi, Bhutanese, Burmese, and Eritreans. Many are Muslims.
Hamdi Ulukaya, the Kurdish entrepreneur, born in Turkey, who founded and is the majority owner of Chobani Yogurt, has publicly stated that 30 percent of his company’s 2,000 employees are refugees.
While it is not known how many of the more than one thousand refugees who have been resettled in Twin Falls by the CSIRP over the past decade have been hired to work at the local Chobani Yogurt plant, sources tell Breitbart News it is a significant number.
As the local Twin Falls Times-News reported back in July 2012, Chobani’s arrival generated a great deal of public enthusiasm at the time:
Like the others who stood in line with him, [Kirk] Woolman was one of the hundreds of job applicants who showed up at the Chobani job fair on Friday.
Due to the high amount of interest, the applicant line snaked its way throughout the College of Southern Idaho’s Herrett Center for Arts and Science and all of the way out the door.
By July 1, the Greek yogurt manufacturer must fill hundreds of jobs before opening its new production plant in Twin Falls. The majority of the top-level management positions have already been filled, but production and support staff positions still remain open.
Standing with Woolman were plenty of other seasonal and part-time employees who also sought better jobs. Some were older, dressed in suits and carrying several copies of freshly printed resumes. Others wore jeans and swapped tips on how to interview successfully.
After making it to the end of the line, Idaho Department of Labor representatives greeted the applicants at the entrance of the interview room. After standing for more than an hour, applicants were allowed a chance to sit while waiting on an interview with a Chobani representative.
Chobani will eventually hire 400 employees to run the new plant, but won’t hire them all at once, said Eric Nielson, the company’s human resource manager.
“When we open in the summer, we won’t be running at full capacity,” he said. “We’ll begin operating in phases. It may take a few months before we need the full 400 jobs.”
For Woolman, the job fair was a chance to land a permanent job. After working a series of seasonal stints for the past few months, the Hagerman resident is looking for full-time work.
The promise of most of Chobani’s wages starting at $14 per hour was another incentive for his interest.
By the time the grand opening was held in December 2012, the local NPR affiliate offered this slightly less boosterish report:
In November 2011, the New York-based Greek yogurt maker Chobani announced plans to build a multimillion dollar manufacturing facility in Twin Falls, Idaho, with plans to hire 400 people.
Today, 13 months later, Chobani’s Twin Falls facility holds its grand opening. New numbers show the yogurt maker hired fewer people than expected, and collected more subsidies than first reported.
A press release for today’s event says Chobani is opening with “over 300″ employees.The New York Times reports the Twin Falls facility has 300 employees. That’s 100 fewer jobs than Chobani first announced, but Twin Falls City Manager Travis Rothweiler says there are more jobs to come. He anticipates Chobani will employ up to 500 people once the facility is running at full capacity.
Breitbart News has found no evidence that local media outlets in the area – the Twin Falls Times-News, KMVT television, or the Idaho Statesman – were aware of or reported on the significant increase in active TB cases diagnosed in the Twin Falls area between 2012 and 2014.