TUBERCULOSIS: The Fight to control tuberculosis in El Paso Mexican border

December 23rd, 2010
The daily crossings by both Texan and Mexican citizens to visit family, shop, and work open great risks in the transmission of infectious tuberculosis (TB). These crossings greatly affect the Texas-Mexico border, and in 2009, a total of 1,501 cases of TB were reported to the Texas Department of State Health Services.
A CDC public health advisor known as Bruce Health reported a case of drug resistant TB on a foreign national that crossed the border numerous times while in an infectious state. A “be on the lookout,” alert was issued by the El Paso Quarantine Station in April 16, 2007, for a Mexican national who had a very resistant strain of tuberculosis.
The patient was first diagnosed with TB in 2001 by Mexican health officials and treated with the drug, Rifater. The patient disappeared from the health system, and since the drug Rifater can be purchased over the counter in Mexico, he only took the drug when symptoms reappeared. The patient was not seen again until January 2007 when he visited the Mexican health department, and was again symptomatic.
The Juarez program started the patient on a 4 drug therapy in January 2007, and also placed the patient in a Directly Observed Therapy (DOT) program, which they never did before. The patient became multi-drug resistant (MDR).
A communication door was opened between the patient, Juntos program which provides support to the Juarez program by processing cultures, the medical director of the El Paso Quarantine Station, and the chief of the Juarez Health department, to advice the patient against crossing the U.S. border, traveling by air, and to gather information to conduct an investigation. He did not follow instructions and continued to cross the border.
The patient was then placed on a “Do not board “ list after much discussion with representatives from the Texas TB program, the Department of Homeland Security, Customs and Border Protection, the U.S. Department of State, and the Centers for disease Control. He voluntarily handed his visa to the U.S. Department of State.
An understanding between the patient and the U.S. Department of State was undertaken in which the patient would not legally travel to the United States, and his visa would not be revoked.
http://www.examiner.com/infectious-disease-in-el-paso/the-fight-to-control-tuberculosis-el-paso-mexican-border