CDC addresses the discriminatory nature of TB policy for internationally adopted children

 

To better understand the CDC's TB screening policy for immigrants and how it affects internationally adopted children and their families, a series of articles related to the topic have recently been featured on this page. While Harper Yue Ye Scruggs, the first child in China affected by this policy, will now be coming home, it is important to remember that the CDC's TB screening policy for immigrants is still in place and will continue to affect other internationally adopted children until further action is taken. Families like the Crombies, whose adoption from the Philippines has been delayed nearly nine months, are still experiencing difficulties related to this policy.

To that end,  the International Adoption Examiner recently requested an interview with Dr. Drew Posey, the author of the Centers for Disease Control and Prevention 2007 Technical Instructions for Tuberculosis Screening and Treatment for Panel Physicians. However, Dr. Posey was not available to communicate by cell phone or email, so a CDC PR representative arranged to have the questions answered via email by other experts. Follow-up questions, which are listed below, were issued in response to clarify their answers, but they have yet to even be acknowledged. This is the conclusion of this multi-part interview. 

.Q: Why are internationally adopted children of American citizens subjected to this policy when children born abroad to American citizens are not? Wouldn’t these "foreign born" children be equally contagious?

A: U.S. immigration law is set by Congress and includes international adoptees as immigrants. CDC does not have the authority to require different standards for evaluating and treating persons suspected of having TB disease based on the type of immigrant visa (adoptive child versus other foreign-born child).  Therefore, all immigrants, including adopted children coming to live in the U.S., must receive a medical examination and follow all regulations for TB diagnosis and treatment.

*Follow-up question issued by the International Adoption Examiner that has yet to be answered by CDC:

1. Do you then acknowledge that, if legally adopted children from these countries are going to be considered a risk, then natural born children of Americans born in those very same countries should be considered an equal risk? According to the medical information you have presented, would it not seem that the two groups of children would be equal and that Congress should amend laws to reflect that? 

Q: Why are there no policies in place to protect the public from the millions of people who enter the country on tourists visas who may be infected with TB? Why is the hyper vigilance directed mostly at this particular population without some latitude given to children who are not likely to be contagious and are guaranteed (though a required adoption home study) quality health care immediately upon arrival in the States?  

A: In accordance with U.S. immigration law, the requirements for medical screening apply not only to adoptees, but also to all other immigrant visa holders and refugees that enter the United States.  Immigration law is set by Congress and applied through policies and regulations that are enforced by the U.S. Departments of State and Homeland Security. CDC provides Technical Instructions for the medical examination of immigrants and refugees. However, CDC does not have the authority to set different standards for screening and treating those who may have TB based on immigrant visa type.
 
All immigrants (both adults and children) must show that they can access medical care upon arrival to the United States. However, TB is a serious disease and efforts need to be made overseas to properly diagnose and treat the disease before arrival in the United States. The TB Technical Instructions ensure that this screening is done in a medically sound manner.

In addition to policies for immigrant applicants and refugees, there are policies that apply to tourists. Tourists may not be routinely screened, but they may be prevented from entering the United States if we are aware of their illness or if they demonstrate signs of the disease.

*Follow-up questions issued by the International Adoption Examiner that have yet to be answered by CDC:

1. If they are not routinely screened, how do you become aware of their illness?
2. How do you prevent them from entering the country and for how long?
3. Are they required to go through the same level of testing and treatment as immigrants before they are allowed to finally enter the U.S.?
4. How many tourists with TB has the CDC successfully prevented from entering the US?

Read Part 1 of this interview: CDC answers interview questions regarding TB policy for internationally adopted children

Read Part 2 of this interview: CDC attempts to explain rationale of TB screening policy for internationally adopted children

*****PLEASE ALSO READ THIS ARTICLE FOR EXPERT INFORMATION ON PEDIATRIC TUBERCULOSIS: Interview with pediatric tuberculosis expert Dr. Jeffrey Starke******

  To take action against the CDC's TB policy for internationally adopted children:  

1. Sign the Build Families, Not Barriers Petition
2. contact members of congress to ask them to take action to exempt this population of adoptees from the policy.
   

*photo of Centers for Disease Control and Prevention Emergency Operations Center (EOC) - Wikipedia (Public Domain)

  **To read the latest updates on this topic and all topics related to International Adoption, click on the subscribe button above this article.**