TB anywhere is TB everywhere: the intersection of U.S. immigration enforcement policy and TB

Tuberculosis (TB) is a significant health issue to both the general public and the officers who enforce our nation's immigration laws. Current immigration enforcement policies increase the likelihood that immigration officers will encounter people with TB. Should the United States alter its immigration enforcement policies to address more directly the threat that tuberculosis poses to public health? This thesis reviews this question through the lens of the Advisory Council on Tuberculosis's recommendation that the priority is to identify and treat all cases of active TB. This thesis provides a policy options analysis examining the status quo and three options suggested in the literature on TB: cure TB before removal, increase international cooperation in treating TB, and increase TB testing. This policy analysis identifies gaps in the Department of Homeland Security's (DHS) ability to identify and treat active TB in the aliens encountered through the immigration enforcement process. Additionally, it recommends that the DHS require that all detained aliens be screened for active TB by use of a chest X-ray. It further recommends that the DHS completely cure all aliens found to have active TB, whether detained or released from detention, prior to their removal from the United States.http://archive.org/details/tbnywhereistbeve1094550583Detention and Deportation Officer, Alternatives to Detention Monitoring Officer, U.S. Immigration and Customs Enforcement, Dallas, TexasApproved for public release; distribution is unlimited