Vermont Health Department begins releasing stats on refugees with active TB

This article by Bruce Parker originally published July 8, 2016, on

The Vermont Department of Health has begun releasing statistics on active tuberculosis among refugees following Watchdog’s reporting on the issue.

This week, Health Department officials gave two prominent news outlets statistics on active TB disease cases found among Vermont’s refugees.

On Thursday, Breitbart reported that the Health Department diagnosed three refugees with contagious, symptomatic TB over the past seven months. Vermont Public Radio reportedthat 15 active TB cases have been diagnosed among refugees between 2003 and 2015, also according to department officials. Adding this year’s cases brings the total to 17.

The statistics come more than a month after Watchdog first requested the information and reported that more than one-third of refugees resettled in Vermont test positive for latent tuberculosis.

Data that Watchdog initially requested but was denied through repeated stonewallingby Health Department officials shows how many refugees have been diagnosed with active TB disease. Unlike latent tuberculosis, active TB disease is contagious, symptomatic and potentially deadly.

The limited data release follows revelations that multiple refugees are undergoing treatment for active TB disease in Vermont. Public records Watchdog published online show that TB control teams associated with University of Vermont Medical Center are treating three new cases of active TB.

Information not disclosed by the Health Department includes how many contact investigations are underway to identify the disease’s potential spread among the general public. Also not disclosed was how many people will need to undergo testing due to contact with the active TB patients.

In January 2015, state epidemiologist Patsy Kelso and Health Commissioner Harry Chen led a well-publicized TB control effort to isolate a single teacher at Charlotte Central School diagnosed with active TB disease. That effort, covered by VPR and WCAX, ultimately tested 500 students and co-workers exposed to the teacher, and identified 19 children and two adults to whom the tuberculosis had spread, according to Stateline.

Kelso, speaking Thursday on VPR’s Vermont Edition, offered a much different response regarding TB disease among refugees.

“It’s not a concern of mine,” Kelso said.

“We will continue to see refugees with latent TB infection and we will continue to see, in rare cases, active TB illness in refugees — like we do all the time in U.S.-born Vermonters.”

Kelso’s lack of concern was summed up in VPR’s headline: “Tuberculosis In Refugee Population ‘Not A Concern,’ Says State Epidemiologist.”

During the interview, Kelso shared data that show refugee populations are exhibiting a considerably higher rate of TB disease compared to native born Vermonters. “Looking at 2003 to 2015, we’ve seen 77 cases of (active) TB in people in Vermont, and 26 of those were in U.S.-born people and 15 of them were in refugees,” she said. Kelso added that the other 36 cases involved immigrants living in Vermont.

As Breitbart reporter Michael Patrick Leahy noted Thursday, Vermont’s refugee population of about 6,300 people is smaller than Vermont’s population of 625,000 residents, meaning the rate of incidence is higher for refugees. Health Department officials told Breitbart that all contagious cases this year have been among refugees. No native-born Vermonters are known to have active TB.

While Kelso’s response may have been aimed at allaying public fears about the disease’s spread, the epidemiologist noted that up to 10 percent of latent TB cases advance to active TB disease. That means Vermont’s infectious disease teams can expect to diagnose many more active TB cases as a result of the Vermont Refugee Resettlement Program.

Of 900 refugees settled by the program since 2013, about 318, or 35.4 percent, test positive for latent tuberculosis. As those latent cases advance to active, Vermont’s infectious disease experts will likely diagnose 31 active TB cases coming from only four years of refugee resettlement.

The Health Department, in response to Watchdog’s reporting, published new information online about tuberculosis and refugee health in Vermont. “People with active TB disease usually have symptoms and may (with some exceptions) spread TB germs to others,” the July 6 update states.

The department’s tuberculosis fact sheet offers tips to help the public recognize symptoms and understand testing for tuberculosis. Symptoms include chest pain, cough — sometimes with blood — weight loss and fever, according to the fact sheet.

Vermonters concerned they might have been infected with tuberculosis can seek more information by calling the Vermont Department of Health Tuberculosis Program at 802-863-7240.

A “TB survivors” YouTube videofeaturing the Charlotte Central School Spanish teacher who survived active TB last year is also helpful for raising awareness.

Image courtesy of Public domain