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Information About Liberian Refugees A. Background on Potential Health Issues for Liberian Refugees by the Office of Global Health Affairs (pdf file) B. Risk for TB Infection/Disease The following information about TB among the Liberian Refugees comes from the Center's for Disease Control and Prevention National Center for Infectious Diseases Division of Global Migration and Quarantine. Approximately 8,000 Liberian refugees from Cote d'Ivoire (Ivory Coast) are expected to resettle to the United States over the next eight months. The Liberian refugees are housed in 12 camps in and around Abidjan. The International Organization for Migration has completed medical screening for approximately 2,000 Liberian refugees. As part of the overseas health assessment, the refugees were evaluated for active tuberculosis. Chest X-ray (CXR) was performed for all refugees 15 years of age or older. Those younger than 15 years of age had a CXR if they had: 1) a history of tuberculosis (TB) disease, 2) close contact with someone with TB disease, or 3) signs or symptoms suggestive of TB disease. Sputum smears were performed for refugees with CXR findings suggestive of active TB, or for those with signs or symptoms of TB, regardless of CXR findings. For this group of Liberian refugees, cultures were performed if sputum smears were negative, and the refugee had pronounced signs or symptoms of TB disease or the CXR findings were highly suspicious for TB disease. These culture results are pending at this time. Among the refugees screened, 9 have infectious TB (smear positive, i.e., Class A TB), and 38 have clinically active, smear negative TB (Class B1 TB). Most of the TB cases are among adults 20-32 years of age. There are also cases of TB and HIV co-infection. All the Class A and symptomatic Class B1 TB cases are receiving a full course (at least 6 months) of TB medications under directly observed therapy. A notation of the health assessment and treatment received overseas will be entered on the U.S. Department of State medical examination forms (DS-2053, DS-3024, and DS-3026) that will accompany the refugees. Because of the relatively high rates of TB and HIV reported among these refugees, and the high risk of developing TB disease once infected, we recommend that the refugees be tested for latent TB infection (LTBI) as soon as possible upon arrival to the United States. Information about testing and treatment for LTBI may be obtained from the following: CDC's Division of TB Elimination websites: Targeted Testing and Treatment http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4906a1.htm Fact Sheet: Treatment of LTBI http://www.cdc.gov/nchstp/tb/pubs/tbfactsheets/250110.htm Revised Recommendations Against the Use of Rifampin and Pyrazinamide for Treatment of LTBI (2 web sites) http://www.cdc.gov/mmwr/PDF/wk/mm5231.pdf http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5231a4.htm Broader Guidance on Diagnosing and Treating TB http://www.cdc.gov/mmwr/PDF/rr/rr5211.pdf or http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm |
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Wednesday, January 3, 2007
• VA Department of Health • Office of Epidemiology • Division
of TB Control Newcomer Health Program • Madison Building, 1st Floor, 109 Governor Street, Richmond, VA 23218-2248 Telephone: 804-864-7910 • Fax: 804-864-7913 |