Records from the Minnesota Department of Health show that 296 refugees have been diagnosed with tuberculosis (TB) between 2010 and 2014. Of the 296 refugees, 71 refugees were diagnosed within just a year of their arrival to the United States.

The number of active TB cases among Minnesota’s refugee population is ten times higher than reported by any other state. Previously, Wisconsin topped the list by reporting 27 cases of active TB among refugees between in 2015. Minnesota taxpayers paid an estimated $5 million dollars in healthcare expenses to treat the 296 cases of active TB among refugees during this time period.

The total of refugees with active TB nationwide is likely to be much higher than reported. Currently, there are 468 known cases of refugees with active TB in the country, but 36 states have not submitted any data regarding the number of cases within their refugee populations. Additionally, the Minnesota Department of Health suggests that the state’s numbers are higher than others because, unlike many other states, Minnesota conducts additional health screening within 90-days of a refugee’s arrival.

Federal law prohibits refugee applicants with active infectious TB from entering the country. However, some refugees were able to enter the United States with the contagious disease by receiving a waiver by the U.S. Department of Homeland Security (DHS) for their admission. DHS has not made public the number of TB and other disease-related waivers it has issued in recent years.