Children have died from illnesses such as influenza with an associated bacterial infection, pneumonia, sepsis, and a misdiagnosed sinus infection, wrote Mark Travassos, MD, of the University of Maryland School of Medicine in Baltimore, in Clinical Infectious Diseases.
Lack of adequate healthcare for migrant children at the border has been widely reported. In a statement, heads of the Infectious Diseases Society of America (IDSA), the HIV Medicine Association, the Society for Healthcare Epidemiology of America, and the Pediatric Infectious Diseases Society (PIDS) expressed concern about the practice of care for migrants, including withholding medical immunizations and other critical and routine health services.
Indeed, IDSA Past President Cynthia Sears, MD, recently penned an editorial for MedPage Today, where she characterized withholding flu shots and other routine healthcare from migrants at the border as a "stark violation of law, ethics, and public trust, and a frightening violation of public healthcare principles."
An accompanying CID editorial by Betsy Herold, MD, and Kristina Bryant, MD, both of PIDS, provided a snapshot of the quarantines at detention centers: 5,200 adult immigrants quarantined due to vaccine-preventable diseases, nearly 900 confirmed and probable mumps cases reported by the CDC among adults and an additional 33 cases among facility staff from September 2018 to August 2019. They also noted 423 confirmed cases of influenza and 461 confirmed cases of chicken pox.
Indeed, Travassos discussed the detained children who died from infection-related causes, noting that "before September 2018, no child had died in United States Border Patrol Custody in a decade." The story of Felipe Gomez, who died of influenza in December 2018, is the most well-known.
"Transmission of infectious diseases such as influenza in these facilities suggests a lack of effective infection control procedures in place, perhaps even inadequate basic sanitation," Travassos wrote.
He detailed Gomez's autopsy report, indicating that the boy not only tested positive for influenza, but contracted sepsis from Staphylococcus aureus, a complication of the flu. Furthermore, Travassos stated that Carlos Hernandez Vásquez, age 16, died of influenza due to complications from pneumonia and sepsis, and Jakelin Caal Maquin, age 7, also died of sepsis.
In addition, 16-year-old Juan de Leon Gutierrez died from Pott's puffy tumor, an infection of the frontal portion of the skull, which Travassos said is "typically due to misdiagnosis or inappropriate treatment of a sinus infection." He added that these deaths "[raised] concerns about the ability of Border Patrol employees to recognize children in need of urgent medical attention."
"Overcrowding is known to contribute to disease outbreaks [and] military guidance emphasizes the importance of immunization in the prevention of respiratory disease outbreaks," the editorialists wrote.
Travassos also urged organizations like IDSA and the American Academy of Pediatrics to be included in "formulating effective policies for pediatric care and infection control policies ... [and] building on policies in place for child care centers and hospitals, including the training of workers to identify and manage illness in children."
"There is an urgent need for advocacy by clinicians and professional societies to resolve this crisis," he wrote