The Realities of Mass Migration and Central America Diseases

Andrew D. Fisher, MPAS, APA-C

 Andrew D. Fisher is stationed at Fort Benning, GA and at the time this article was written, was a Physician Assistant in the U.S. Army. He has no financial interest in any products mentioned, nor has any conflict of interested to disclose. These opinions are his own and are not endorsed by the U.S. Army or the Department of Defense.  This article first appeared in The Havok Journal on 31 July 2014.

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There has been much consternation lately over the potential for the spread of communicable diseases with the mass migration from Central America to the United States. Central American diseases can be dangerous and some have high mortality rates. Regardless of the political views a person may have, this is an issue that should be addressed.

Humans have inhabited Central America for thousands of years. Until the late 1400s and early 1500s, the Aztec and Mayans were the main inhabitants. With Christopher Columbus came a large Spanish influence that still dominates the culture today. Central America enjoys a tropical climate year round, with little fluctuations in temperature—a prime incubator for communicable diseases. There are only two seasons, rainy and humid.

Most healthcare issues stem from a lack of adequate family practice care and basic sanitation. Both governmental and Non-governmental Organizations (NGOs) offer humanitarian and medical assistance. They have both major success and failures.

There are several diseases to be concerned about when it comes to uncontrolled mass migration. Probably the most worrisome is mycobacterium tuberculosis (TB), because this disease does not require a certain environment to do its damage. TB mostly infects the lungs of humans, where it lives in the macrophages that protect the lungs. It is estimated that 2 billion people around the world have TB.

It is spread through droplets, and people in crowded cramped living quarters are more susceptible. Although it is treatable, the lack of preventative and primary care in Central America causes it to flourish. In the U.S. and other countries, Directly Observed Therapy (DOT) is used to treat TB. DOT uses healthcare workers to actually observe patients take the needed medication throughout treatment. It is highly successful in the U.S.

Pertussis is a respiratory disease caused by the bacteria bordatella, and bordatella pertussis is known to the general public by its common name Whooping Cough. As harmless as the name sounds, it actually has a relatively high mortality rate among unvaccinated children. The symptoms of pertussis include a paroxysmal cough, the whooping sound (caused by air passing by partially closed vocal cords), and vomiting after coughing fits. Unlike other bacteria, pertussis is not effectively treated with antibiotics. Most infected people do not experience any change in their own symptoms with the treatment of antibiotics, but treatment can help decrease the spread to others.

The last of respiratory diseases of concern, diphtheria, is highly contagious and has a high mortality rate. Diphtheria is very dangerous and is not uncommon to see in developed countries. In addition to antibiotics, if you are diagnosed with diphtheria you will receive antitoxin. According to the World Health Organization, there is no data about diphtheria in Central America; therefore it is not known the number of cases in that area of the world.

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