Abstract

The Advisory Council for the Elimination of Tuberculosis (ACET) recommends the post-detention completion of tuberculosis (TB) treatment for persons deported or released from the custody of the Immigration and Naturalization Service (INS). The completion of TB therapy prevents disease relapse, subsequent transmission, and the emergence of drug resistance. Integral to treatment completion are issues of security and law enforcement involving persons who under immigration law are ineligible for legal admission into the United States. The Health Resources and Services Administration's Division of Immigration Health Services (DIHS) estimates that approximately 150 TB cases are identified annually among INS detainees in the INS service processing centers (SPCs) and contract detention facilities. Before transfer or deportation, INS policies require that detainees with TB disease receive treatment until they become noncontagious, even if treatment is not completed. INS policies are consistent with federal law, which does not bar deportation of persons with TB disease before the completion of treatment. This report describes three cases that illustrate several issues associated with the deportation of patients with incomplete treatment of TB disease after detention. These cases highlight the need for interagency coordination to ensure completion of treatment for persons being evaluated or treated for TB.

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