A recent news story reports that Idaho has resettled seven refugees with active tuberculosis (TB) between 2011 and 2015. While that is accurate, it’s important to note that those refugees were not infectious and could not spread the tuberculosis infection to other people.
They all had abnormal chest X-rays, which is typically how they are screened for TB in other countries, but they tested negative for contagious disease in three separate sputum cultures after they arrived in Idaho. Even so, they all received immediate treatment and were monitored by public health officials to make sure any TB would be killed that their lungs might harbor.
Refugees are not allowed to leave their country if they are contagious from active tuberculosis. After a refugee arrives in Idaho, they go through an assessment process that covers immunizations, health screenings including TB screening, and referrals to medical providers for any conditions that need treatment. They are monitored very closely through the Division of Public Health’s Refugee Health Screening Program to protect public health. More than 4,500 refugees arrived in the state during the last five years.
“Refugees receive multiple medical screenings both before and after they arrive for their own health as well as for the health of the general public,” said Dr. Christine Hahn, M.D., state public health medical director and TB physician. “We don’t take TB infection lightly, and neither do the refugees. They are eager and extremely cooperative about getting treatment for any health condition that needs to be addressed. Public health officials monitor their treatment daily and follow up with them to make sure it is completed.”
Tuberculosis infection can happen in other parts of the body, including the brain, kidney, and spine. But the infection can’t be spread through normal contact when it is not in the lungs or throat. TB is typically spread through coughing or sneezing, in very close proximity. A person cannot get TB from sharing drinks, toys or personal items.
Idaho public health officials are extremely cautious even with refugees with latent tuberculosis infection and offer treatment to be sure the infection doesn’t become active. People with latent TB infection have TB germs in their bodies, but they are not sick because the germs are not active. These people do not have symptoms of TB disease, and they cannot spread the germs to others. However, they may develop TB disease in the future, which is why they are often prescribed treatment to prevent them from developing TB disease.
Idaho typically reports about 10 cases of active TB each year to the Centers for Disease Control and Prevention, with one or two from the refugee community. There are five cases being treated in the state today, but none are refugees. The last outbreak of TB in the state happened in 2008 in the Treasure Valley’s homeless population.
Learn more about tuberculosis symptoms and treatment in this fact sheet.