By Linda Carroll

(Reuters Health) – Doctors on Long Island say two migrant children showed up at their hospital in seriously ill condition at least in part because their asthma medication had been taken away by immigration authorities at the southern border.

The families of the children “indicated that they had albuterol in their possession that was confiscated and replacements were not supplied,” said Dr. Noy Halevy-Mizrahi of Stony Brook University, coauthor of the report in Pediatrics. “We wanted to bring awareness to this topic. Our main message is one of advocacy. We wanted to make sure to alert other physicians who might be caring for these patients.”

The first patient was a school-aged-girl with a history of mild intermittent asthma who had immigrated from Central America two months before she showed up in a Long Island emergency room with severe breathing problems due to unremitting asthma attacks. When examined, the girl was also found to have viral pneumonia, Halevy-Mizrahi said.

The second child, a 7-year-old boy, showed up in the ER also with severe unrelenting asthma attacks. The boy, who had a history of moderate persistent asthma, also had the flu. He, too, had his albuterol inhaler confiscated by the border patrol and was not given a replacement.

Because they were so sick, the two children were admitted to the intensive care unit.

While the blame for the children’s illnesses can’t be placed entirely on their lack of inhalers, “we do think this is an important factor contributing to the severity of their presentations,” Halevy-Mizrahi said. “The confiscation of albuterol, which is vital to the health maintenance of asthmatic patients, placed these children in vulnerable conditions.”

Not having an inhaler “contributed to the severity of their clinical presentation when they did ultimately seek treatment,” Halevy-Mizrahi said.

Halevy-Mizrahi and coauthor Ilana Harwayne-Gidansky suggest that when pediatricians are confronted with similar cases of migrants sickened because their medications were confiscated and not replaced, they should report these cases to U.S. Customs and Border Protection Information Center, the Department of Homeland Security (DHS) Office of Civil Rights and Civil Liberties, or the DHS Office of the Inspector General.

In addition, the authors write, “pediatricians should feel empowered to work with representatives in congress and their local districts.”

News reports have described border patrol agents confiscating other life-saving medications from migrant children, including insulin and epilepsy drugs, the authors note.

The new report is “depressing,” said Dr. Albert Wu, an internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. “The confiscating of an asthma inhaler or other essential medication from a child seems cruel, misguided and possibly criminal,” Wu said. “I think this represents a direct assault on the health of people – and they are people – crossing the border.”

“This kind of behavior should be condemned and the workers punished,” Wu added. “This is not who we are.”

SOURCE: Pediatrics, online December 3, 2019.