Paul Auwaerter, MD, MBA, President IDSA
Melanie Thompson, MD, Chair HIVMA
Paul Spearman, MD, FPIDS, President PIDS
Keith Kaye, MD, MPH, FSHEA   

The consequences to individual and public health of continuing “zero-tolerance” border policies and of large scale detention of thousands of weakened and vulnerable individuals will be longstanding and far-reaching. The separation of immigrant families at our borders has run counter to principles of promoting wellbeing and preventing disease, as well as of prioritizing compassion, empathy and the best interests of children that must be part of any healthy society. That separation has challenged the first step in the most basic health services of collecting medical histories, including of immunizations. While Department of Health and Human Services and U.S. Centers for Disease Control and Prevention policies provide immunizations and basic health exams for unaccompanied minors, immigrants and refugees, whether these policies are being followed remains unclear at best.      

Basic practices of hygiene and infection prevention have already been demonstrated to be lacking, with reported outbreaks of chicken pox as well as scabies and other infections among those detained, indicating just some of the potential for widespread transmission of illnesses the policy has created. The possibilities for the spread of tuberculosis and other airborne diseases, including measles, as well as vector-borne illnesses, including ones resistant to antibiotics, continues to concern us. 

As organizations of more than 12,000 infectious diseases, pediatric infectious diseases and HIV physicians, as well as healthcare epidemiologists, the Infectious Diseases Society of America, the HIV Medicine Association, the Pediatric Infectious Diseases Society and the Society for Healthcare Epidemiology of America call for speedy reunification of children with their families.  We remain deeply concerned that the policy of detaining large numbers of people, including entire families is leading to conditions that can fuel the spread of infections, and call for a thorough evaluation of the conditions and the consequences of their detention and of the public health ramifications.