Immigration Detention Center in Arizona Failed to Contain Measles Outbreak

http://www.nytimes.com/2016/07/13/us/measles-immigration-detention-center-arizona.html

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Health officials in Arizona are pressing federal officials for better cooperation after an outbreak of measles at an immigration detention center was prolonged because some employees were slow to be vaccinated.

The outbreak started in late May in the detention center in Eloy, Ariz., and has grown to 22 cases, currently the largest episode in the country of the disease, which was once eradicated in the United States. The cases include nine employees of the facility, which is overseen by Immigration and Customs Enforcement, a federal agency.

“What was surprising was the failure by the organizations that run the facility to make sure their staff was vaccinated,” said Thomas Schryer, the director of public health for Pinal County, home of the center. “The lingering issue has been the staff passing the illness among each other and going out into the community.”

The facility, 65 miles southeast of Phoenix, holds about 1,250 immigrants from many countries, both men and women, who are awaiting court proceedings or deportation. They include migrants who have come in recent months from three violence-torn countries in Central America. The center is supervised by the federal agency but operated by a private prison company, Corrections Corporation of America, or CCA, which has more than 300 employees.

The first measles case was identified on May 25. Arizona health officials said they had not yet been able to identify the first person to become ill so they cannot confirm whether it was an immigrant.

“It is very difficult to say where this came from,” said Dr. Cara Christ, the director of the Arizona Department of Health Services. All the immigrants in the center were vaccinated if they needed it in the first days after the outbreak, officials from the prison company said.

When the outbreak was not contained and spread to staff members, county and state health officials asked the company and federal officials to provide information showing their employees were being vaccinated or had proof of earlier vaccinations.

The prison company moved quickly to comply, Arizona health officials said.

“It was something we took really seriously and we have been pleased with the cooperation from our employees,” a CCA spokesman, Jonathan Burns, said.

But some employees of the immigration agency, which is known as ICE, did not come forward with proof of vaccinations, and the agency said it could not legally require them to do it. The immigration agency employs about 100 people at the center.

Last week, state and county officials asked the agency for a list of its employees to contact them directly, Mr. Schryer said. They have not received a response.

But Dr. Christ said federal officials had been more helpful since her office clarified that it had the authority to request employees’ vaccination information. She said doctors from her agency had offered free vaccines at the detention center as well as information sessions for employees who had questions.

“We try to answer questions and be compassionate and make it easy to get the shots,” Dr. Christ said. “We don’t want people to take this disease home to their families.”

Jennifer Elzea, a spokeswoman for ICE, said the agency was closely monitoring the facility. “ICE instituted numerous initial and ongoing measures to prevent further spread of the disease,” she said.

No one has died in the outbreak, but one staff member spent four days in the hospital, Mr. Schryer said. One person who came down with the illness was an immigrant recently released from the facility, health officials said. The last case to be confirmed was on July 2; measles has an incubation period of 21 days.

The flow of migrants crossing the border illegally has been an issue in Arizona for years, with some residents warning that migrants could import diseases to the United States. But health officials said a larger problem was the declining vaccination rate in Arizona.

The state had seven cases of measles that spread from an outbreak at Disneyland in California in 2014. Health officials said many of the nearly 150 people infected in the United States in that episode had declined vaccinations.

“We have created our own susceptibility because we opt out,” Mr. Schryer said. “We have had the luxury of vaccination in this country for so long. But this disease is not something to play around with.”