Posts mislead on migrants spreading tuberculosis in US

Tuberculosis (TB) cases in the United States have increased every year since 2020, but posts linking the uptick solely to illegal immigration are misleading. Changes to international travel and migration are among several contributing factors the Centers for Disease Control and Prevention (CDC) has identified, as well as rising TB worldwide and under-resourced prevention programs due to the Covid-19 pandemic.

"TUBERCULOSIS, once considered eradicated, has arrived thanks to Joe Biden's Illegal Aliens," claims an April 4, 2024 Facebook post.

Another post from the same day says: "It was completely eliminated from the United States until the invasion was orchestrated by the Deep State/WEF."

Other posts claiming TB is on the rise due to illegal immigration have spread across Facebook and X.

Some posts point to April 2024 cases in a migrant shelter in Chicago. Others reference a CDC announcement that TB cases increased 16 percent across the US between 2022 and 2023 (archived here).

But the agency told AFP that migration is just one factor behind the uptick.

"Continued recovery from pandemic-related health care disruptions, worldwide increases in TB, and changes in international travel and immigration are likely contributing to US TB increases," said Matt Josey, a spokesman for the CDC's National Center for HIV, Viral Hepatitis, STD and TB Prevention, in an April 5 email.

When taken into US Customs and Border Protection (CBP) custody, migrants participate in a health interview (archived here). The agency's Office of the Chief Medical Officer screens for TB, and short-term holding facilities include isolation areas for sick people.

"CBP officers and agents prioritize the health and safety of all those they encounter by providing appropriate medical care and humanitarian assistance," a spokesperson told AFP in an April 1 email.

What causes tuberculosis?

Tuberculosis is caused by a bacterium that usually attacks the lungs, according to the CDC (archived here).

About one quarter of the world's population is infected with TB bacteria, according to the World Health Organization (archived here). Only a small proportion will become sick, but it is present "in all countries and age groups," the agency says online (archived here).

TB bacteria spread through the air. People with the disease are most likely to infect individuals they spend time with every day, according to the CDC (archived here).

The Bacille Calmette-Guérin vaccine is available for TB, but it is not widely used in the US because of the low risk of infection (archived here). The CDC says a child who cannot be separated from an untreated adult would be a good candidate for vaccination.

TB cases rising

The US has one of the lowest TB rates globally, and cases had declined for 27 years before 2021. But the disease was never eradicated, as the social media posts claim (archived here).

The CDC said 9,615 TB cases were provisionally reported in 2023, compared with 8,320 in 2022. The agency traced 76 percent of those cases to people who were not born in the US (archived here).

However, not all of them are attributable to recent arrivals -- the CDC said the statistic also includes people who immigrated years ago.

The breakdown of cases in those born in the US and those who were not has also remained fairly consistent, according to Henry Boom, director of the tuberculosis research unit at Case Western Reserve University's School of Medicine (archived here). He called immigration a "false flag," saying it "doesn't explain" the uptick.

"Part of it is catching up from what we missed during the Covid era," he said April 12.

State and local public health programs largely handle the prevention and control of TB. During the Covid-19 pandemic, the CDC says such programs were "severely taxed with many staff members diverted to the Covid-19 response."

Latent TB

The CDC estimates up to 13 million people in the US have a latent TB infection (archived here).

"Ninety to 95 percent of people with this latent infection will go through life without any manifestations of tuberculosis ever," Boom said.

In 2023, the CDC found "approximately 85 percent of TB cases in the US are attributed to reactivation of latent TB infection (LTBI) rather than recent transmission" (archived here).

Boom said the infection is more likely to flare up if a person's immune system is suppressed. An HIV infection is a major risk factor for TB, while diabetes also slightly increases risk.

"There's infection and there is disease, and when you're infected, you're not going to spread it to anybody. You're just at risk for yourself if you become immune-compromised," Boom said. "But if you have disease, then you're able to transmit it to others."

TB is treatable, with low-cost medication that is available in the US. However, Boom said compliance with the six-month treatment course can be an issue.

He added that transmission remains low outside of crowded housing where people face prolonged exposure.

"We're doing very well in general, and this is just a small blip," Boom said. "It looks impressive when you do percentages. But the number of cases we have in the US compared to TB-endemic countries is just very, very small."

More of AFP's reporting on misinformation about migration is available here.

April 16, 2024 The spelling of Henry Boom's name was corrected throughout.