The American disease and death bowls
Border Patrol vaccine policy is seemingly crafted to spread the flu
It is a non-controversial fact of nature that respiratory-borne infectious diseases spread more easily in crowded conditions in which basic sanitary measures such as hand-washing are not practiced (or not able to be practiced).
Such conditions exist in a wide variety of settings that can range from college dormitories to airports. This should come as no surprise that migrant detention camps can also be a place for an outbreak to spread.
Many different viruses exploit this route, but by far the most prolific - the one responsible for the most hospitalizations, severe illnesses and death - is influenza. In addition to the ease of respiratory spread, influenza can be transmitted a day before symptoms appear making it extremely difficult to control.
During flu season there are a litany of messages about cough etiquette, hand-washing and staying home when sick to dampen the spread of the virus. However, the chief means that exists to protect humans from influenza is the influenza vaccine.
This vaccine, which is recommended to everyone above 6 months of age, is about 50-60 percent effective at preventing the flu, but is very effective at preventing pneumonia, hospitalization and death from influenza. Higher vaccination levels in a population also prevent it from spreading. In fact, most pediatric influenza deaths in the U.S. are in unvaccinated children.
Creating a tinderbox
This week, it was announced that the U.S. Customs and Border Patrol (CBP) which is in charge of migrant detention centers has no plans to vaccinate detainees against influenza. CBP has cited logistical and other reasons for this policy decision. Integrating the facts about influenza and the facts about detention centers, this policy defies logic and is a recipe for disaster that exclusively serves the "interests" of the virus.
The migrants in the detention centers may be dehydrated or malnourished and therefore more susceptible to influenza and its complications.
The affinity for influenza to these centers is already in evidence as there have already been deaths reported at these centers as well as outbreaks of influenza that have interfered with daily operations. Without vaccination and compromised ability to practice hygiene, an influenza tinderbox is being created.
The CBP policy is baffling as it seems almost crafted to spread influenza. Policymakers, cognizant of the influenza deaths and cases that have occurred in these centers, the crowded and unsanitary conditions that exist, and the health status of some of the migrants, are making the wrong decision.
This policy will worsen conditions at the centers by, in effect, making them even more hospitable to the virus. I predict that when detained individuals invariably contract influenza, the blame will not fall on the virus abetting CBP policy, but on the detainees that were served up in almost a deliberate fashion to the virus.
Infectious disease resiliency is part of national security and this decision by CBP cannot be viewed as anything other than the willful and unnecessary lowering of that security.
Dr. Amesh A. Adalja, board-certified in infectious disease, critical care medicine, emergency medicine and internal medicine, is a senior scholar at the Johns Hopkins Center for Health Security. Follow him on Twitter: @AmeshAA.