Over the past few months, reports from Arizona, California, and Texas have indicated immigrants are spreading conditions like scabies and dengue fever inside border facilities - some even calling the outbreaks full-on "epidemics." That may seem like a bit of hyperbole, but the details are as hazy as they are conflicting: some say a flood of people has so severely overwhelmed the federal government's ability to manage the situation that holding facilities are overrun with sick individuals. Others say there is no real threat coming from the nearly 82,000 Central American migrants who are being screened to enter the United States. 

One thing's for sure: some diseases have entered the country. Cases of H1N1 swine flu, fever and gastrointestinal issues have been logged at several facilities in Texas and Arizona, and particularly among young children. This may be largely due to their living conditions inside these temporary holding areas, where thousands of kids are forced to live in close quarters, giving ailments room to spread with relative ease. Although officials have insisted any illness is being contained inside facility walls, Americans are increasingly fearing that something truly life-threatening may already be at their doorsteps. 

According to director of the NYU Division of Medical Ethics Arthur Caplan, however, cases of sickness at the border have been entirely overblown. In fact, on-site ailments haven't proven any more serious than at other refugee camps and border holding areas worldwide. Caplan also said the Center for Disease Control hasn't released any official reports concerning a serious outbreak - something they are legally bound to do anytime the situation arises.

"There have been no reports of these diseases. Nothing," Caplan says, referring in particular to dengue fever, a mosquito-borne virus that rumors say has hit facilities on multiple occasions. "If they had those diseases, we'd know. There is a health issue, but it's kids who are dehydrated, sick, women who are pregnant - [generic] health issues that need attention."

Caplan states the exaggerated stories of deadly sicknesses are part of what he calls "fear mongering" - a way to demonize South American immigrants. 

"I think it's people using fear to stir up resistance to immigrants," he says. "You know, 'They're dirty, infectious, they'll harm us.'" 

According to Caplan, the bulk of immigrants who arrive at the holding facilities have bruises, broken bones, and are usually sick with gastrointestinal issues stemming from the trip to the United States - a journey that comes with the serious risks of theft, injury, rape and even death. Typically traveling by bus from Honduras, El Salvador, and Guatemala primarily, immigrants move through Mexico, many of them apparently fleeing violence back home. The Guardian reported in July that gang-related violence from crews like the Calle 18 and Mara Salvatrucha has torn entire communities apart. Shrewd politicking and a coup in Honduras have also contributed to what Fox News refers to as an "endless wave" of immigrants flocking to the United States in the recent past. But even this has been refuted, blurring the haze of what's really going on at the border even further - a recent Washington Times article stated immigrants have come for "permisos," or free passes, into the United States. According to an internal Border Patrol intelligence memo obtained by the Times, family members told others in Central America to hurry toward the border before the end of June, when the "notices to appear" would no longer be distributed.

For board certified otolaryngologist Dr. Elaina George, the issue has graduated beyond human concerns. She characterizes the situation as a medical emergency that could seriously affect all persons, regardless of citizenship. Moreover, she is concerned the root of the problem is being overshadowed by "cries of racism, selfishness, and lack of compassion." 

"This is not a denigration of immigrants," she states. "My own father was an immigrant. This isn't a racial thing. It doesn't make you racist when you question a person who has come over with, possibly, swine flu, TB, scabies, lice, or dengue fever."

George says the scene at the border is messy at best, with authorities scrambling to assemble a lineup of border officials to help perform primary screenings. But due to the high volume of people entering the United States and a shortage of hands on deck, some make it through without thorough examination. 

The notion that immigrants will only infect one another inside holding facilities is simply not true, George adds. She said border agents are susceptible to these sicknesses, and could bring them into the United States civilian population. An example of this may have already occurred. The National Review Online stated that an unidentified border patrol agent caught bacterial pneumonia, and could have symptoms of chronic asthma for life.

"It's a very traumatic experience for [the agent] and [the agent's] family," vice president of NBPC 2455 Agent Jarrad Seely told the Review Online. "Our agents have been getting sick more often than before with flus and congestion and a whole bunch of respiratory illnesses. The processing room was severely overcrowded, and that just made [it] perfect breeding ground for these diseases."

According to a Department of Defense memo, two children who arrived at a facility in Nogales, Arizona by themselves were later placed on a flight to California. They both exhibited signs of extreme flu symptoms, and each had 101-degree fevers. They were eventually hospitalized.

"Whatever immune systems [migrants] had before the journey are depleted," George says. "Then they're crowded in tiny holding areas. They're at the mercy of whoever's taking care of them. There's only yellow crime tape separating the sick from those who are well."

The first course of action is to vaccinate, claims chairman of the Department of Preventive Medicine at Vanderbilt University William Schaffner. He states attention to hygiene, surveillance of sickness and early treatment are necessary steps to keep all parties in good health. 

"We are going to find medical problems that have not been addressed, with children and people who could be under-vaccinated," Schaffner explains. "They can be taken care of in due course if resources are available. They must be examined, along with a record of their health background." 

Although Schaffner says an adequate number of officials have been deployed to the facilities, others insist more must join in to help. Meanwhile, the steady stream of immigrants entering the United States continues to flow. 

"Do these children have unmet medical issues? Absolutely. Just as their anxiety can be eased with counseling, just as their malnutrition can be reversed with good food, and just as their diarrheal illness can be dealt with, there is surely a way to address this situation," Schaffner concludes. "This isn't an alarmist issue, but it certainly is a humanitarian issue."