State health officials don’t collect information about the immigration status of people with reportable infectious diseases, raising doubts about Gov. Paul LePage’s repeated assertions that asylum seekers are bringing diseases to Maine.

Doctors who report infectious diseases to state officials submit limited information about the patient – including name, address, occupation, race and ethnicity – but they do not provide information on the patient’s immigration status, according to the Maine Center for Disease Control and Prevention’s notifiable disease reporting form. The patient’s country of birth is collected for certain diseases, according to state health officials.

Records published online of infectious disease rates in Maine do not include any personal or immigration status information about patients with diseases such as hepatitis, tuberculosis and HIV.

The head of an advocacy group that works with asylum seekers across the state says she is not aware of any widespread medical issue or large increases in infectious diseases among immigrants in Maine.

LePage last week repeated his claim that asylum seekers are bringing infectious diseases to the state. During a town hall meeting in Augusta on Wednesday, he said that HIPAA – the federal law that protects the confidentiality of personal medical information – prevents him from disclosing more information.

“We have them by data, but we don’t have them by name because we can’t,” LePage said Wednesday in response to a remark by an audience member about the governor’s stance on asylum seekers.

‘COMMENTS ARE REALLY TROUBLING’

Samantha Edwards, spokeswoman for the Department of Health and Human Services, said Friday that data on communicable diseases collected by the CDC do not include the immigration status of the patient. State officials did not respond to a question about what information is shared with the governor or what data he is using to support his statements.

Though Edwards said the state does obtain the country of birth for patients with certain reportable diseases – she was not able to identify the diseases – a person’s immigration status is not determined by his or her country of birth.

LePage has said several times since 2014 that immigrants are responsible for increases in certain infectious diseases. During his 2015 State of the State address, he suggested that illegal immigrants and asylum seekers should be required to undergo medical examinations to avoid the spread of infectious diseases in Maine.

Those types of negative comments make asylum seekers who come to Maine feel unwelcome and are frustrating because they are not based in fact, said Sue Roche, executive director of the Portland-based Immigrant Legal Advocacy Project.

“The comments are really troubling to us. They don’t appear to have any reported data or evidence backing them,” Roche said. “They’re really inflammatory and trying to place asylum seekers and immigrants into a negative place. There’s no evidence we’ve seen to show any of the comments the governor is making are accurate.”

Roche said she is not aware of any public health data that would show a patient’s immigration status in connection with his or her medical information.

“We aren’t aware of any widespread medical issues within the immigrant community,” she said.

TIGHT CONTROLS ON PATIENT DATA

Medical providers, medical laboratories, health care facilities and veterinarians are required to report to the CDC cases of more than 70 different diseases, including contagious diseases such as tuberculosis, hepatitis C and influenza.

Disease reports sent to state health officials must include the patient’s name, date of birth, address, phone number, occupation, race and ethnicity, according to a document outlining the procedure published by the CDC in September 2015. The CDC’s notifiable disease reporting form does not ask for the patient’s immigration status or country of origin.

Patients’ names and related information reported to the CDC remain confidential and can be released only to other public health and school officials for public health purposes, according to new CDC rules for the control of notifiable positions from September 2015. If the CDC director declares there is an actual or threatened epidemic, outbreak or public health threat or emergency, the information may be released to private health care providers and health and human services agencies “for the purpose of carrying out public health responsibilities for the department,” the CDC rules say.

Data released to the public – including the media – cannot contain any potentially identifying information.

The CDC publishes monthly online reports that show the number of cases of infectious diseases. The most recent data show varying increases in reported cases of tuberculosis, and hepatitis B and C. For example, there were seven cases of tuberculosis in the first quarter of 2016, compared with a median number of five cases for the same period during the previous five years. There were 12 cases of acute hepatitis B and 11 cases of acute hepatitis C in the quarter, compared with a median of four cases each in the same quarter the previous five years.

Nineteen cases of HIV have been reported in the first quarter this year; the five-year median is 15.

DRUG USE LINKED TO RISE IN HEPATITIS B

In a public health update released Thursday, the Maine CDC noted a “sharp increase” in the number of acute hepatitis B cases reported in 2016. There had been 15 confirmed cases this year as of May 16. No cases were reported during that period last year, while the five-year median for January through April is four cases.

The update went on to say that the primary risk factor for new cases of hepatitis B in Maine is injection drug use, which has escalated sharply in Maine. The update did not mention immigrants.

Many public health experts have attributed the increase in hepatitis to the epidemic of heroin abuse, with more addicts using the drug and sharing needles. Studies indicate that the greatest increases in hepatitis C are among young white people in suburban neighborhoods east of the Mississippi River who had abused prescription opioids in the past and had a recent history of intravenous drug use.

Tuberculosis cases in the United States are on the decline, according to the federal Centers for Disease Control and Prevention. A total of 9,421 cases were reported in 2014, a 1.5 percent decrease from the previous year.

While the total number of tuberculosis cases is decreasing, the percentage of cases among foreign-born individuals has risen steadily since 1993, according to the federal CDC. The most common countries of origin for people with tuberculosis are Mexico, the Philippines, India, Vietnam and China.

 


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