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By Seema Yasmin and Sherry Jacobson, The Dallas Morning News

DALLAS — Despite concerns about the potential public health crisis posed by immigrant children crossing the Texas-Mexico border, medical experts say the likelihood of their spreading disease is low.

Still, experts in emergency preparedness are urging health care providers and Texas to get ready for many children who may need basic medical care.

“Four, five, or a dozen children may not strain the system, but we’re now talking about thousands and thousands of children” who have very unique physiological and psychological needs, said Michael Anderson, a Cleveland, Ohio, pediatrician and expert in pediatric disaster response.

More than 57,000 children have traveled alone from Central American countries and have been detained by U.S immigration authorities at South Texas holding facilities this year. That number could reach 90,000 by year’s end.

Many are being transferred to other immigration centers, and 2,000 are expected to be housed in Dallas later this summer.

As of late last week, state health officials have reported three cases of tuberculosis, 23 cases of chicken pox, and three cases of flu among children housed in detention centers in South Texas, said Carrie Williams, a spokeswoman for the Texas Department of State Health Services.

“We’ve had no reports of measles,” she said. “Generally, the potential for a wider public health issue is there. But the biggest risk we are seeing for the people in the detention centers is because of the lack of hand-washing facilities.”

Immigrant children typically pose little threat to public health, says the state’s top pediatrician.

“The general public doesn’t need to be concerned that there are going to be outbreaks of illness due to these immigrant children,” says Dr. Mark Ward, president of the Texas Pediatric Society, which represents 2,800 pediatricians. “Most of these children will not have an illness that puts others at risk.”

Recently, Gov. Rick Perry weighed in with his concerns about unsanitary conditions at the Texas facilities where the children are being housed. His June 20 letter to President Barack Obama asked for state inspections to ensure international and national sanitary standards are met.

“Officials who have visited such facilities indicate insufficient bathroom facilities, lack of adequate water supplies, and other conditions that could result in epidemics of pertussis, tuberculosis, and other diseases,” Perry’s letter said. Such diseases could threaten not only the children, but employees and communities where the detainees might end up, he warned.

Every immigrant child undergoes a medical screening by a paramedic or emergency medical technician, looking for rashes, fevers, and coughing, said Jessica Maxwell, spokeswoman for the Department of Homeland Security’s health affairs office.

Such symptoms would send a child for a second screening by a doctor, nurse, or physician’s assistant working for federal Health and Human Services.

“Any child who needs medical treatment is sent to a local emergency room, and if they are suspected to have a communicable disease, such as chicken pox or tuberculosis, they are quarantined, vaccinated, and treated,” she said. “It’s a very small amount of children, compared to the general population.”

The most common medical complaint among these new arrivals, Maxwell said, “relates to their journey: dehydration, exhaustion, foot and ankle injuries.”

Providing prompt medical screening and treatment for ailments will save money in the long run, Ward said. “It makes sense to treat things now while they’re minor instead of letting them become serious and more costly to treat,” he said.

But many of the children remain in overcrowded conditions, sleeping side by side on the floor.

“Scabies and lice is primarily what we’re seeing,” said Shawn Moran, spokesman for the National Border Patrol Council, which represents 16,500 border agents. His group is calling for a more comprehensive medical response.

“You’ve got people in such close quarters,” Moran said. “I’m hearing there’s trouble getting cleaning supplies to kill off the infestations we’re seeing.”

Scabies is a contagious skin infection caused by mites, which usually results in a rash and relentless itching. Head lice, another parasite, infest the hair and neck and also cause itching. Both are easily treated.

“This facility is not intended for long-term detention, 72 hours at the most,” said Moran, who is based in San Diego. He visited the overcrowded Rio Grande immigration facility in May.

Moran said most of the young immigrants appeared to be teenagers, although he declined to provide an exact percentage. He estimated that about 100 to 150 of them were under a year old, although the babies were accompanied by a relative, usually a teen.

Federal officials have been reluctant to discuss the children and their medical needs. They have not provided demographic information, including breakdown by age and gender.

“Some of them are illiterate,” Moran said of the immigrants. “They are unable to tell us what town they are from, much less know their vaccination history.”

Photo: Los Angeles Times/MCT/Michael Robinson Chavez

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