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72.0pt;}#yiv5972729390 div.yiv5972729390WordSection1 {}-->From: Sent: 21
December 2015 04:33
Subject: EXCLUSIVE – Syrian Refugees Bringing Flesh-Eating Disease into U.S.?
WHAT ABOUT AUSTRALIA???
EXCLUSIVE – Syrian Refugees Bringing Flesh-Eating Disease into U.S.?
by Aaron Klein20 Dec 2015
JERUSALEM – There is a risk that Middle Eastern refugees entering the U.S.
could be infected with a flesh-eating disease that is sweeping across Syria.
Health agencies confirmed that Syrian refugees have transported leishmaniasis
to Lebanon and Turkey, where it has been difficult to manage and treat.
Compounding the problem, patients can be infected with the parasitic disease
without showing symptoms for weeks, months, or even years, and an
asymptomatic patient most likely doesn’t know that he or she is a carrier.
This means the health screening process for refugees could miss the disease
entirely.
Breitbart Jerusalem spoke with healthcare experts, including an epidemiologist
from the Centers for Disease Control and Prevention, or CDC’s Immigrant,
Refugee, and Migrant Health Branch, which is responsible for guiding the
medical screening of the Syrian refugees seeking to enter the U.S.
Volcano-like ulcers
Leishmaniasis is a disease caused by protozoan parasites. It is spread almost
entirely by sandflies, including those present in the U.S.
There are three main types of the disease: cutaneous, mucocutaneous, and
visceral leishmaniasis.
Cutaneous is the most common form among Syrians. It manifests in skin sores
that typically develop within a few weeks or months of a sand fly bite. The
sores can initially appear as bumps or nodules and may evolve into volcano-like
ulcers.
Mucocutaneous leishmaniasis causes skin ulcers like the cutaneous form, as
well as mucosal ulcers that usually damage the nose and mouth.
Visceral leishmaniasis, which has also been found among Syrian refugees, is the
most serious form and can be fatal. It damages internal organs, usually the
spleen and liver, and also affects bone marrow.
Refugees transmit to Lebanon, Turkey; threat to Europe, U.S.
Last year, the CDC published a study of a September 2012 outbreak among
Syrian refugees. The investigation found:
Fifty-nine percent of patients had more than one of the following: disease
compromising the function of vital sensory organs (eye, ear, nose, and mouth)
(27%); lesions of greater than 5 cm in diameter (49%); disfiguring facial
lesions (37%); special forms, such as sporotrichoid or lymphangietic with
satellite lesions (9%); and lesions present for more than 12 months’ duration.
Earlier this month, the news media hyped a story that the Islamic State was
causing the spread of leishmaniasis, because – as the U.K.’s Mirror
newspaper put it - militants were “slaughtering innocent people and dumping
their bodies in the street.”
Leishmaniasis has been spreading like wildfire in Syria since the health
system collapsed in rebel-held territories in 2011. By 2012, there were already
52,982 documented cases of the disease in Syria
Also in 2012, the CDC documented that “migration patterns of refugees with
cutaneous leishmanias is were identified in Lebanon,” with the health agency
producing a helpful illustration showing the disease’s “movement from cities in
Syria to regions in Lebanon.”
The peer-reviewed medical journal Pathogens noted that Lebanon had no cases of
cutaneous leishmaniasis prior to 2008 and only “sporadic cases in the following
years.”
After the arrival of refugees, 1,033 cases were confirmed by 2012, “96.6%
(998) of which were among Syrian refugees.” Writing at AHC Media, a publication
for healthcare professionals, Dr. Philip R. Fischer, Professor of Pediatrics at
the Mayo Clinic, documented the spread to Turkey as well:
As Syrians leave their homeland, they sometimes carry their germs with
them. There have been dramatic increases in the number of cases of cutaneous
leishmaniasis in southeastern Turkey. In Turkey, 69% of cutaneous leishmaniasis
patients are Syrians living in tent cities.
Fischer also noted a significant risk of the disease spreading to Europe with
the arrival of Syrian refugees.
As recent news reports have shown, many Syrian refuges don’t stay in
Turkey and Lebanon. There is a significant risk that cutaneous leishmaniasis
will reemerge in southern Europe, where the natural vector of the L. tropica
parasitealready exists.
Leishmaniasis has been endemic to Syria for centuries. Fischer noted that in
1756 a British physician “referred to the illness as Aleppo boil and Aleppo
evil.” However, it was minimized over time due to the advent of insecticides.
Medical screening
Refugees who enter the U.S. must undergo medical screening according to
protocols established by the Centers for Disease Control and Prevention, or
CDC. Each refugee must submit to a physical examination, including a skin
test and possibly a chest x-ray to check for tuberculosis,as well as a blood
test for syphilis.
The blood tests do not currently look for leishmaniasis. Clearly, an
attending doctor could easily spot a patient with obvious skin ulcers.
However, leishmaniasis cannot be detected upon physical examination if the
patient is asymptomatic, as can be the case for years.
Dr. Heather Burke, an epidemiologist from the CDC’s Immigrant, Refugee, and
Migrant Health Branch, explained to Breitbart News that there is generally a
window of three to six months from the initial physical examination until a
refugee departs for the U.S.
She said a medical examination is valid for six months, and explained that
patients undergo a second examination just prior to departure - a quicker
“fitness to fly” screening. While she conceded that this final examination is
not thorough, she said it would pick up any visible skin lesions. Burke told
Breitbart Jerusalem that she is not aware of a single case of leishmaniasis
entering the U.S. via Syrian refugees.
Dr. Jane Orient, executive director of the Association of American Physicians
and Surgeons, warned that “most doctors in the U.S. know nothing about
leishmaniasis.”
“We’d all need to refer patients to tropical diseases specialists,” she told
Breitbart Jerusalem. “The treatments are toxic and expensive, and some are not
widely available.”
For Orient, the only sensible public health policy is “for all refugees to pass
through a quarantined place like Ellis Island.”
“Officials need to know where they’ve been and what diseases occur there. We
need sophisticated, reliable screening methods and excellent vector control in
any areas where refugees stay.”
With research by Brenda J. Elliott.
Aaron Klein is Breitbart’s Jerusalem bureau chief. He is a New York Times
bestselling author and hosts the popular weekend talk radio program, “Aaron
Klein Investigative Radio.” Follow him on Twitter @AaronKleinShow. Follow him
on Facebook.
