Border States More Vulnerable To Transmission Of Infectious Disease

Jun 17, 2014

In 2011 more than 3.6 million passenger vehicles, 4.2 million pedestrians and 300,000 commercial vehicles crossed into Ciudad Juárez through one of El Paso's international bridges.
Credit Simon Thompson

Many in the US consider Tuberculosis as infectious disease of an age past. But that’s not the case in Mexico, where according to the World Bank people are five times more likely to contract the disease.  As Simon Thompson reports cross border trade and migration can make border states just as vulnerable to incidences and even outbreaks of deadly and contagious diseases.

Tuberculosis or TB is an infectious chronic cough that attacks the lung and gives sufferers fevers, chest pains and makes them cough up blood. It’s transmitted in the air person to person often through sneezing, singing and speech and according to the World Health Organization it is the second most deadly infectious disease in the world.  

Jose Velasco is the Executive director of the US Mexico Border Health commission. He says TB is largely preventable and treatable in the U-S, but an international border can complicate that.

“Those disease's they don’t respect border, they just cross the border without respecting any color of flags or cultures or countries” he says.

Illegal immigration is often blamed for cases in the U-S, but Velasco says it’s far more complicated. He says the transmission of the disease is happening in both directions from both sides of the border, particularly in cities with border economies like El Paso.

“This is a dynamic border, changing coming back some people live here, they work in Juarez, some people live in Juarez they come here they work here so there is a lot of changes it is like a unique community" he says.

In the U-S, when somebody contracts tuberculosis and becomes an immediate health threat they are quarantined and isolated from interactions with the general public.

But in Mexico, health protocols differ.

“When somebody here has Tuberculosis they have to receive the treatment or other wise we have to detain them. In Mexico they don’t so we have to negotiate with them, the government in Mexico to monitor that person without breaking their human rights” he says.

The main approach has been brokering cross border, bi-national partnerships and initiatives to allow for the sharing of information and best practices to tackle public health threats in both countries.

"Our job as a federal agency we provide those services to Mexico. Same thing they develop a vaccine initiative for the border for nationally hold on the border is different we need to develop and tailor that is a problem for these specific communities” he says.

In May 2014 US Senator Tom Udall announced legislation to provide grants and funding for cross border collaborations and public infrastructure for detecting and monitoring the spread of infectious disease.

As a Center for Disease Control Medical Officer in El Paso Miguel Escobedo is a collaborator in existing programs such a bill would complement and reinforce.  

He says the Centers for Disease Control quarantine stations are strategically located in San Diego and El Paso to manage infectious diseases– before they can be spread to other parts of the country through trade routes and migration.

“We have a set of tools that allows us to find people who may be coughing and have TB and could potentially spread the disease to others and a very important tools is being able to find those partners to detect and find those individuals and getting them too treatment" he says.

The CDC quarantine station is also focused on monitoring West Nile and Dengue fever. Escobedo says unmanaged, U-S ties with Mexico or any country with higher incidences of contagious infections is a problem.  He says diseases like TB can develop resistance to existing forms of medicine and treatment, risking a more widespread problem in the U-S.

“You have drug resistant germ and by bringing and sharing them across the border we are better able to identify and track the development of resistant criteria that we can develop appropriate anti-biotic and different strategies to deal with this drug resistant TB bacteria” he says.

But doing that effectively means monitoring and testing in areas outside the U-S.
Escobedo says that’s where collaboration between the Mexican government and organizations like the US-Mexico Border Health commission becomes essential.

Executive Director Jose Velasco works on specific policies to make it happen.  

“It is very difficult to cross the border so we need to negotiate to allow with immigration to cross with the samples to send it to CDC  to test it” Velasco says.

Still CDC Medical Assistant Miguel Escobedo says prevention is the main line of attack. He says work is being done on both sides of border to provide education and awareness of infectious diseases and how they can be contracted.

According to the World Health Organization 95% of Tuberculosis related deaths occur in low and middle-income countries.