CDC alert to medical professionals: Afghan refugees may spread infectious diseases

(AP Photo/David Goldman, File)

It seems like this warning from the CDC shouldn’t be necessary yet the agency issued an alert to medical professionals to be on the lookout for Afghan refugees with infectious disease symptoms. A few cases of infectious diseases for which most Americans are vaccinated have started popping up among the Afghan evacuees recently brought into the United States.

The CDC posted an announcement on its website warning medical professionals and staff of the possibility of Afghan refugees bringing infectious diseases like measles, mumps, and rubella into the country during their evacuation. Most Americans have been vaccinated against all those diseases. The number of cases referenced in the warning is relatively small in comparison to the total number of evacuees so far but it’s worth noting that the CDC is obviously trying to get out in front of the possibility of that the spread of, say, measles becomes a major story. The warning comes from the Emergency Preparedness and Response section of the CDC website.

The Centers for Disease Control and Prevention (CDC) recommends that clinicians be on alert for cases of measles that meet the case definition, as well as other infectious diseases, including mumps, leishmaniasis, and malaria, among evacuees (including both Afghan nationals and U.S. citizens) from Afghanistan. Clinicians should immediately notify their local or state health department of any suspected cases of measles. Clinicians should also recommend the measles, mumps, and rubella (MMR) vaccine for unvaccinated patients. Measles is an extremely contagious infectious disease; around 9 out of 10 people who are close contacts and who are not protected will become infected following exposure to measles virus. As of September 20, 2021, CDC has been notified of 16 confirmed cases of measles and 4 cases of mumps among Afghan nationals and U.S. citizens, recently arriving from Afghanistan and continued vigilance is needed. In addition to MMR vaccination, CDC recommends that evacuees are also up to date on vaccinations for varicella, polio, COVID-19, and seasonal influenza.

After the public relations disaster from which the CDC continues to experience over their performance during the coronavirus pandemic, who can blame anyone for no longer placing trust in the agency? A national outbreak of disease usually under control thanks to widespread vaccinations, like the diseases referenced in its alert, would be particularly disastrous for the CDC. It certainly deserves the criticism it gets. Let’s hope that the medical community hasn’t completely tuned out the CDC at this point like so many Americans have done. Not long after the CDC alert went out, Pentagon Press Secretary John F. Kirby issued a statement that Afghan evacuees are required to get the MMR vaccine and then quarantine for 21 days. Perhaps his statement was so quickly issued due to trying to keep calm the communities in which the refugees are being relocated.

“All arriving Afghans are currently required to be vaccinated for measles as a condition of their humanitarian parole. And critical immunizations like MMR are being administered for Afghans at safe havens on military bases in the United States,” Kirby said. MMR vaccines would also be administered overseas as well, he said.

In May 2019, for example, cases of measles made a strong comeback for the first time since it was declared eliminated in 2000. CDC reported a total of 971 cases of measles in the U.S. since the beginning of 2019, compared to 963 cases during the entirety of 1994. So, the CDC is sounding the alarm now to head off another surge in cases. Afghanistan ranks seventh in the world for measles cases.

As of Sept. 20, the CDC had been notified of 16 confirmed cases of measles and four cases of mumps among Afghan nationals and U.S. citizens who recently arrived from Afghanistan. Earlier this month, Afghans contracted the measles at Fort Bliss, Wisconsin.

So far, 124,000 people from Afghanistan, including roughly 6,000 American citizens, have been flown out of Afghanistan, the CDC reports. Many of them “are from areas with limited access to healthcare and vaccinations and have been living in close quarters for long periods during the evacuation process, thereby raising the risk of disease spread,” the CDC reports.

All of those who were confirmed to have had the measles were isolated and provided care, and those with whom they had contact were also quarantined. Contacts who were not immune were given the MMR vaccine or, if not vaccine-eligible, immunoglobulin.

Since vaccination coverage is only at about 60% in Afghanistan, the CDC acknowledges it likely cannot prevent outbreaks in America. Measles infections are expected to spread among evacuees. Other diseases may come into play, too. Heads up, military communities.

Vigilance should be particularly enhanced in communities near the military bases that are housing the evacuees: Marine Corps Base Quantico, Virginia; Fort Pickett, Virginia; Fort Lee, Virginia; Holloman Air Force Base, New Mexico; Fort McCoy, Wisconsin; Fort Bliss, Texas; Joint Base McGuire-Dix-Lakehurst, New Jersey; and Camp Atterbury, Indiana.

Evacuees are also at increased likelihood of gastrointestinal infections, including shigellosis, giardiasis, cryptosporidiosis, hepatitis A, rotavirus, and viral diarrheal diseases, the CDC states. The CDC says it is also aware of some cases of varicella, mumps, tuberculosis, malaria, leishmaniasis, hepatitis A, and COVID-19 among evacuees.

Add this to the growing list of Biden administration failures. If there had been an orderly evacuation of Kabul, if it was all properly planned out and the evacuees were properly prepared, most of this could have been avoided. Screening would have determined if an evacuee was vaccinated or not and provided the vaccinations to those in need. This would have eliminated the risk of exposure to Afghans as well as Americans. Who had a measles epidemic in America on their 2021 bingo card?