A student at Castle Heights Middle School in Rock Hill, South Carolina was diagnosed with active tuberculosis (TB) in December.

Officials with the South Carolina Department of Health and Environmental Control (DHEC) and Rock Hill Schools, part of the York County Public School System, are not disclosing the patient’s country of origin.

“We can’t provide any more information about the individual that was confirmed with the case of tuberculosis,” a spokesperson for the South Carolina DHEC tells Breitbart News.

“We are in the middle of our contact investigations,” the spokesperson adds.

“The South Carolina Department of Health and Environmental Control (DHEC) has confirmed a case of tuberculosis (TB) at your child’s/your school. This is the same suspect case you were notified of on December 23rd. The case has been confirmed by laboratory testing, and DHEC’s investigation is active and on-going,” the South Carolina DHEC told parents in a letter on December 29.

“[I]ndividuals who are identified as close contacts will receive the recommendation to be tested for TB first. As the contact investigation progresses, others may be recommended for testing. Only those recommended for testing will be tested by DHEC at each stage of the contact investigation,” the letter added.

There have been a number of recent press reports from around the country concerning middle school and high school students diagnosed with active TB.

In November, a student at a high school in Omaha, Nebraska, where 18 percent are refugees, was also diagnosed with active TB.

Nebraska and South Carolina are on opposite ends of the spectrum among the fifty states when it comes to foreign-born cases of TB. In 2014, for instance, 82 percent of all TB cases in Nebraska were foreign-born. That percentage declined slightly in 2015 to 75 percent.

In 2013, 17 percent of all TB cases in South Carolina, or 19 out of 112, were foreign-born. In 2014 that percentage increased slightly to 21 percent, or 17 out of 79, and increased again in 2015 to 24 percent, or 25 out of 104.

Of these 25, only two had an initial immigration status of “refugee.” Two of the foreign-born cases of TB arrived on immigration visas, five were classified as “other” — which includes but is not limited to “undocumented” migrants (illegal aliens) — and 15 were classified in the “unknown or missing” immigration status upon first arrival.

Mexico was the country of origin for 32 percent of these foreign-born cases of TB, or eight out of 25. In 2015, 19 percent of the country’s foreign-born cases of TB, or 1,254 out of 6,350, listed Mexico as their country of origin.

Across the country, 66 percent of all TB cases diagnosed in 2015, or 6,350 out of 9,563, were foreign-born.

The foreign-born population of South Carolina was 4.8 percent during the four-year period ending in 2013. During that same period, Nebraska’s foreign-born population was 6.3 percent. The country’s foreign-born population was 12.9 percent during that period.

While Nebraska has experienced a high rate of refugee resettlement per capita in recent years, South Carolina has one of the lowest per capita rates of refugee resettlement in the country.

As Breitbart News reported previously, Nebraska had the highest per capita rate of refugee resettlement in the country during the first three months of FY 2017, with 26.3 refugees resettled for every 100,000 residents.

South Carolina had one of the lowest per capita rates of refugee resettlement, 2.1 refugees resettled for every 100,000 residents, well below the national average of 8.0.

Between FY 2013 and FY 2016, a total of 4,714 refugees were resettled in Nebraska, which has a population of 1.9 million, according to the Department of State’s interactive website. During the same four years, 845 refugees were resettled in South Carolina, which has a population of 4.9 million.

South Carolina’s foreign-born population comes primarily through immigration, both legal and illegal, from Latin American countries rather than through the federal refugee resettlement program.

According to the Pew Research Center, South Carolina is “the state with the second-fastest growing Latino population in the country, behind Alabama.”

“Latinos come mainly to work in the agriculture and poultry industries,” the Arizona Republic reports.

One measure of the impact of foreign-born residents on a community is the number of public school students who participate in taxpayer funded English as a Second Language (ESL) or English for Speakers of Other Language (ESOL) programs and are described as English Language Learners (ELLs).

Communities across the country with high percentages of refugees, legal migrants, and illegal migrants in their population also have high percentages of ELL/ESL/ESOL participation in their school systems.

According to the 2015-2016 District English Language Learner/Refugee Report for the Omaha Public Schools, the number of “K-12 students currently participating in the ESL Program includes 7,285 ELLs or 14.8 percent” of total enrolled students.

“We have 19 ESL/ESOL teachers working with 1,030 ESL/ESOL students,” Mychal Frost, director of communications for Rock Hill Schools, tells Breitbart News.

The Rock Hill Schools system enrolls “nearly 18,000 students” in the current academic year, which means six percent of enrolled students are ESL/ESL students, slightly less than half the percentage in Omaha.

Demand for ESL/ESOL instruction in Rock Hill Schools appears to be increasing. In 2009, for instance, the local newspaper reported that the school district had 13 ESL/ESOL teachers, six fewer than it currently has.

“Since 2005, the number of students with limited English proficiency in Rock Hill schools has ballooned 70 percent, to 755 students. They hail from 33 countries and speak 27 different languages. Most of them — 85 percent — are Latino,” the Herald Online reported at the time.

Fifty-four percent of the students in Rock Hills Schools are Caucasian, 35 percent are African-American, six percent are Hispanic, 1.5 percent are Asian, 1.5 percent are Native American, and two percent are “other,” according to the school district’s website.

Forty-four percent of students in the district receive a free lunch.

“Your reporting on Breitbart.com implies that you will attempt to use this data to indicate the confirmed case of TB is from a foreign-born student connected in some way to the influx of refugees into the United States over the past few years,” Rock Hills Schools spokesperson Frost adds.

“The identity of the student is and will remain private as we are bound by federal law (FERPA) to not release medical or educational information about students. As such, we cannot confirm or provide the birth location of the student involved in this case,” he notes.

“Citing medical privacy law (HIPPA), it is highly unlikely SC DHEC will release any additional information specific to this case. Their media relations team is, however, able to talk generally about active and latent TB cases, characteristics of the germ, etc.” Frost concludes.

South Carolina’s treatment of TB cases in the recent past has come under criticism.

In 2013, the Wall Street Journal reported, “South Carolina health officials are under fire for a delayed response to a tuberculosis outbreak at a rural elementary school in which hundreds of people were exposed to the contagious airborne disease, including 465 children who weren’t tested until nearly three months after local nurses discovered the outbreak.”

Some 53 of those children were infected with TB, including 10 who were diagnosed with an active form of the disease, meaning they had symptoms of TB that require lengthy drug treatment to cure. A person who is infected but doesn’t have an active form of the disease still requires some treatment, usually just one drug. All told, 1,526 adults and children have been tested, 106 were infected, and 12 developed active TB, according to state officials.

As the percentage of foreign-born cases of TB continues to increase, public health officials around the country are likely to face the same question local officials in South Carolina and Nebraska have been asked about the patient’s country of origin when students in their local school districts are diagnosed with TB.

Currently, public officials almost uniformly claim that releasing that information would violate the patient’s privacy rights. Country of origin information, however, would not specifically identify the patient in either the Omaha Public Schools or Rock Hill Public Schools cases, but would instead identify the patient as part of a fairly large group.

Those asserted privacy rights, however, need to be balanced against public health of the general population. Country of origin information is relevant to the type of immigration and public health practices that will control the spread of TB.

As Breitbart News reported previously, 2015 saw the first increase in the number of TB cases diagnosed in the United States in 23 years, a phenomenon many experts attribute to the rise of foreign-born cases of TB in the country from 22 percent in 1986 to 66 percent in 2015.