Tine test

A four-pronged instrument used to administer the Tuberculin Tine Test. In this test, the tuberculosis antigen, which is located on the tines (spikes), is introduced just under the skin, usually the forearm.

Wikimedia Commons

BOISE — Seven refugees with active tuberculosis were resettled in Idaho between 2011 and 2015, but none of them were contagious, the state Department of Health and Welfare said Tuesday.

“While that is accurate (that they had TB), it’s important to note that those refugees were not infectious and could not spread the tuberculosis infection to other people,” DHW officials wrote on the department’s blog. “They all had abnormal chest X-rays, which is typically how they are screened for TB in other countries, but they tested negative for contagious disease in three separate sputum cultures after they arrived in Idaho. Even so, they all received immediate treatment and were monitored by public health officials to make sure any TB would be killed that their lungs might harbor.”

Refugees who are contagious from tuberculosis, the DHW said, are not allowed to leave their country, and after refugees arrive in Idaho they go through “an assessment process that covers immunizations, health screenings including TB screening, and referrals to medical providers for any conditions that need treatment.”

Of those seven cases, three were in Health District 5, which includes Twin Falls, and four in Health District 4, which includes Boise, said DHW spokeswoman Niki Forbing-Orr. Twin Falls and Boise are the two refugee resettlement sites in Idaho.

The DHW wrote that blog entry in response to a piece on the conservative news website Breitbart, which has been chronicling tuberculosis cases in refugees across the country. Breitbart also reported that about 21 percent of refugees who came to Idaho between 2011 and 2015 had latent tuberculosis infection, which is when the germs are in your body but inactive — out of 4,650 refugees who came in that time, 4,202 were medically screened within three months and 896 tested positive. DHW wrote in the blog entry that refugees with latent tuberculosis are often treated when they get here to make sure it doesn’t become active.

“For the most part the refugees are very cooperative,” Forbing-Orr said. “They want to be healthy and they want to assimilate.”

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The United States has one of the lowest tuberculosis rates in the world — it is estimated about 4 percent of the U.S. population has latent TB, compared to about a third of the world’s population, according to the Centers for Disease Control and Prevention. The countries with the highest TB rates are mostly in sub-Saharan Africa, according to the World Health Organization. Two-thirds of reported TB cases in the U.S. in 2014 occurred in foreign-born people, according to the CDC.

Idaho typically reports about 10 cases of active TB each year to the CDC, the state health department said, of which one or two are usually from the refugee community.

Five TB cases are being treated in Idaho today, the department said, but none are refugees. The last TB outbreak in the state was in 2008 in the Treasure Valley’s homeless population.

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