Influenza, Varicella, and Mumps Outbreaks in US Migrant Detention Centers

Abstract

In 2019, the US Immigration and Customs Enforcement (ICE) agency detained 510 854 migrants. 1 Detention centers have poor living standards and environmental crowding that may facilitate infectious disease transmission. 2 ,3 We documented outbreaks of influenza, varicella, and mumps among involuntarily detained migrants.

The United States detention system for migrants: Patterns of negligence and inconsistency

“…Prior to the COVID-19 pandemic, CBP and ICE shared an extensive history of refusing to provide vaccines that would mitigate the spread of communicable diseases like the seasonal flu, mumps, measles, or the chickenpox in detention facilities ( Foppiano Palacios et al., 2020 ; US House Committee on Oversight and Reform and Subcommittee on Civil Rights and Civil Liberties, 2020 ; Lo et al., 2020 ). The pre-pandemic observations and concerns of KIs are mirrored by more recent congressional and whistleblower reports that have shone a spotlight on the failure of detention facilities across the country to limit the spread of COVID-19 and provide proper care and treatment for those who are sick ( Government Accountability Project, 2020 ; Project South.…”

Adult hospitalizations from immigration detention in Louisiana and Texas, 2015–2018

“…More data are needed to better understand the higher-than-expected ICU admission rate, lower-than-expected hospitalization rates, and large number of certain procedures, and it is possible that immigrants are arriving to immigration detention facilities at advanced stages of illness after travel across the Southern US Border or due to lack of healthcare access outside of detention facilities. Another possibility however is that immigration detention facilities may not be properly managing conditions prior to hospitalization or, potentially, they are delaying care until the patient worsens enough to warrant hospitalization, as has been suggested by multiple governmental reports [6][7][8][9].…”

“…These accounts were confirmed by a US House of Representatives oversight investigation that concluded "immigrants in detention centers operated by for-profit contractors are facing negative health outcomes and even death because of inadequate medical care, poor conditions, understaffing, and delayed emergency care." [8] CBP and ICE's failure to maintain a sanitary environment, adequately immunize detainees, and properly monitor and manage infectious diseases has led to several infectious disease outbreaks [9].…”

Repeated introductions and intensive community transmission fueled a mumps virus outbreak in Washington State

“…We suspect that more diffuse contact patterns may help explain this. Mumps has historically caused outbreaks in communities with strong, interconnected contact patterns (Barskey et al, 2012;Fields et al, 2019;Nelson et al, 2013), and in dense housing environments (Snijders et al, 2012), highlighted most recently by outbreaks in US detention centers (Lo et al, 2021). In 2016, most outbreaks in the US were associated with university settings (Albertson et al, 2016;Bonwitt et al, 2017;Donahue et al, 2017;Golwalkar et al, 2018;Shah et al, 2018;Wohl et al, 2020), including a separate, smaller outbreak in Washington State associated with Greek housing (Bonwitt et al, 2017).…”