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Refugee Diseases Pose New Public Health Threat

Mounting evidence indicates the nation’s nearly two-year-long battle against COVID-19 has been diverting attention and resources from other contagious diseases brought here by waves of Afghan refugees and by migrants pouring across the southern border.

An official Health Advisory issued by the Centers for Disease Control and Prevention (CDC) on September 20 alerted clinicians nationwide the approximately 124,000 evacuees from Afghanistan, including 6,000 U.S. citizens, could include people carrying measles, mumps, leishmaniasis, malaria, and even polio.

“Many of the evacuees are from areas with limited access to healthcare and vaccinations and have been living in close quarters for long periods of time during the evacuation process, thereby raising the risk of disease spread,” the CDC stated in its “Guidance for Clinicians Caring for Individuals Recently Evacuated from Afghanistan.”

Eight military bases around the U.S. are serving as temporary homes to the thousands of people airlifted from Afghanistan during August’s chaotic evacuation from Kabul. Those bases are 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.

The CDC is primarily concerned about the spread of three diseases:  measles, malaria, and polio.


CDC officials are so concerned about the spread of measles that, at the agency’s request, evacuation flights from “safe havens” in other countries have been halted until people waiting for departure have received the measles, mumps, and rubella (MMR) vaccine and quarantined for 21 days.

The agency acknowledged some refugees left their quarters before they could be vaccinated, and still others, among the first to arrive, were settled in the United States in locations other than military bases.

As of September 20, the CDC had been notified of 16 confirmed cases of measles and 4 cases of mumps among those evacuated from Afghanistan. “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 with the measles virus,” the CDC noted.

Afghanistan ranks seventh in the world in measles cases, the CDC points out.  Measles has not been endemic in the United States since 2000 but can be brought into the country by travelers.  With the influx of tens of thousands of Afghan refugees, public health officials are advised to be on the lookout. “Measles outbreaks in refugee camps and other congregate settings lead to high morbidity and mortality (as high as 34%),” the CDC warns.

“One to three out of 1,000 people with measles will die, even with the best care,” states the CDC.


Malaria disappeared in the United States in the early 1950s. However, the insect that transmits the disease, the Anopheles mosquito, is present across the country. Travelers continue to carry malaria, and the number of U.S. infections has risen since the 1970s, to about 2,000 per year today. The last confirmed local outbreak of malaria in the United States occurred in 2003.

The CDC responded to the influx of Afghan refugees by urging clinicians to contact local and state health authorities as soon as a case of malaria has been confirmed.

“Malaria is endemic to Afghanistan, and transmission occurs April through December in nearly half the country where altitudes are below 2,000 to 2,500 meters,” the CDC stated.


“Afghanistan is one of only two countries in the world where the wild poliovirus is still endemic,” the CDC notes.

Since 1979, there have been no cases of polio originating in the U.S., though a few have been brought into the country by travelers.

“While the risk is low, CDC advises clinicians to maintain vigilance for cases of polio in patients recently arriving from Afghanistan or in people who have had close contact with recent arrivals from Afghanistan and whose vaccination status is unknown,” the CDC says.

Reversing Mission Creep

The CDC’s report on Afghan evacuees marks a return—for how long is not yet clear—to the agency’s original mission of preventing the spread of communicable diseases.

Writing in the spring of 2020, when the nation was in the early stages of COVID-19, Hillsdale College President Larry Arnn noted the CDC was squandering resources on peripheral subjects such as gun violence and how parents should raise their children.

“It has widened its work to include chronic diseases and addictions, nutrition, school health, injuries—and in a telltale sign of ideological corruption and mission creep—racial and ethnic approaches to community health,” Arnn wrote. “It is a logical fact that if you favor some people, you disfavor others.”

Although the CDC posted a public health alert regarding newly arriving Afghan refugees, it has yet to issue a similar document for the far-greater number of migrants illegally entering the United States along the Mexican border.

Most migrants are not being turned back and, according to media reports, are being dispersed around the country. Others evade apprehension at the border and make their way to destinations farther inland. With the Biden administration effectively pursuing an open-border policy with Mexico, the number of migrants flooding into the country is expected to grow. What communicable diseases these people might be bringing with them is largely unknown, and the CDC has declined to issue any warnings.

Disparity of Mandates

Meanwhile, the U.S. will lift border restrictions for fully vaccinated international travelers beginning on November 8. The policy covers people entering the U.S. legally via land borders and air travel but makes no mention of the vaccine status of those entering the country illegally.

Jane Orient, M.D., the president of the American Association of Physicians and Surgeons, is struck by the administration’s policy of mandating vaccines for U.S. citizens but not for illegal immigrants.

“This policy is obviously schizophrenic,” Orient tells Health Care News. “American citizens are subject to far more restrictions than either group. We may track and trace and quarantine Americans who might have passed within six feet of a COVID-positive person, but do we know where illegal immigrants are?”

Public health officials are basing decisions on ideology instead of epidemiology, says Marilyn Singleton, MD., J.D., a California-based anesthesiologist.

“Thousands of BLM protesters mingled shoulder-to-shoulder without criticism from federal infectious disease gurus, because they deemed it a worthy cause,” said Singleton. “At the same time, church services were prohibited and a large outdoor gathering of motorcycle enthusiasts was criticized as a potential ‘super-spreader’ event.

“Such disparate treatment was based on politics, not science,” said Singleton. “A reminder to policymakers: a virus has no political agenda and will spread where it can thrive.”

Bonner R. Cohen, Ph.D., (bcohen@nationalcenter.org) is a senior fellow at the National Center for Public Policy Research.


Bonner R Cohen
Bonner R Cohen
Bonner R. Cohen is a senior fellow with the National Center for Public Policy Research, a position he has held since 2002.


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