Almost 900 people have been exposed to mumps while being held in detention facilities across the US over the last year, a report from the Centers for Disease Control and Prevention (CDC) has found.
A total of 898 cases in adult immigrants across 19 states have been reported between September 1, 2018, and August 22 this year, with 33 staff members at detention facilities also being infected with the disease. The CDC said that almost 400 of the cases took place in detention facilities in Texas, after an outbreak that began in October and spread between two detention centers in the state.
Mumps is a contagious disease that used to be common in children before the introduction of the MMR vaccine. It causes painful swelling of the parotid glands (large salivary glands at the sides of the face) as well as headaches, joint pain, and fever. While not normally serious, it can lead to serious complications such as viral meningitis (where the virus moves into the outer layer of the brain).
Where there was data on complications resulting from mumps, the CDC found that 15 percent of male patients went on to develop orchitis (inflammation of the testicles which can go on to cause infertility), while at least 13 patients were hospitalized.
Outbreaks most commonly occur among groups of people who have prolonged, close contact with people who have mumps, the CDC write on their website, e.g. through sharing water bottles or living in confined conditions.
Of the 898 cases of mumps and probable mumps, 758 of the patients were exposed to the disease while in the custody of Immigration and Customs Enforcement (ICE) or another US agency, with only 5 percent of patients being exposed before being apprehended by the authorities.
“This has all the makings of a public health crisis,” Nashville immigration attorney R. Andrew Free, who has been tracking mumps outbreaks at the facilities, told the Associated Press. “ICE has demonstrated itself incapable of ensuring the health and safety of people inside these facilities.”
Cramped conditions combined with poor hygiene make the transfer of disease much easier. There have been concerns about conditions in the facilities for some time, with the Department of Homeland Security issuing a warning of "dangerous overcrowding" observed during unannounced inspections of Customs and Border Protection (CBP) holding and detention facilities.
"[During one inspection we] observed detainees standing on toilets in the cells to make room and gain breathing space, thus limiting access to the toilets," the Department of Homeland Security said of one inspection of the El Paso Del Norte Processing Center. "Border Patrol agents said detainees who were not ill were raising medical complaints to obtain temporary release from the cells, adding to the medical staff’s burden."
Other inspections have found "children... held for weeks in deplorable conditions, without access to soap, clean water, showers, clean clothing, toilets, toothbrushes, adequate nutrition or adequate sleep." The CDC recommends washing hands often with soap and water to avoid contracting the disease, and staying away from others if you're infected to minimize the risk of the disease spreading.
The outbreak is far from over.
"As of August 22, 2019, mumps outbreaks are ongoing in 15 facilities in seven states," the CDC conclude their report. "New introductions into detention facilities through detainees who are transferred or exposed before being taken into custody continue to occur."