Increasing childhood vaccination coverage of the refugee and migrant population in Greece through the European programme PHILOS, April 2017 to April 2018

Mellou, Kassiani; Silvestros, Chrysovalantis; Saranti-Papasaranti, Eirini; Koustenis, A; Pavlopoulou, Ioanna; Georgakopoulou, Theano; Botsi, Chryssoula; Terzidis, Agis

doi:10.2807/1560-7917.es.2019.24.27.1800326

Cited by 26 publications

(51 citation statements)

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“…The low number of measles cases in refugees/immigrants demonstrates the success of Greek refugee vaccination project that started before the propagation of the epidemic in Greece low (Programme PHILOS) [ 27 ]. However, as incoming immigrants are continually accepted in hosting centers, constant awareness is needed for rapid response.…”

Section: Discussionmentioning

confidence: 99%

Measles epidemic in pediatric population in Greece during 2017–2018: Epidemiological, clinical characteristics and outcomes

et al. 2021

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Background and aim A measles outbreak occurred in Greece during 2017–2018 affecting mainly pediatric population. The aim of the study was to describe the epidemiological and clinical characteristics of the cases diagnosed in the major pediatric tertiary hospital of Athens, where 26.5% of national pediatric measles cases were diagnosed and treated. Methods This is a retrospective study of children 0–16 years old, who presented at the emergency department and/or were hospitalized with clinical presentation compatible with measles and diagnosis was confirmed with molecular detection of the measles RNA in pharyngeal swabs. Epidemiological, clinical and laboratory characteristics were retrieved from medical records and analyzed. Results A total of 578 children with measles were identified during the study period. 322 (55.7%) were male with median age 36 months (range:1–193), while the largest number of documented cases (251; 43.4%) were children aged 1–5 years. Most children (429/578; 74.2%) belonged to the Roma minority and only 64 (11.1%) had Greek origin. 497 (91.5%) children were unvaccinated and 37 (6.8%) were partially vaccinated with measles vaccine. Hospitalization was required for 342 (59.2%) children, whereas one or more complications were reported in 230 (67.2%) of them. Most frequent complications were elevated transaminases (139; 40.6%), acute otitis media (72; 21%), dehydration (67; 19.6%) and pneumonia (58; 16.9%). 11 children (3.2%) required intensive care admission for altered mental status/status epilepticus (3), sepsis (2) and ARDS (6). 119/342 (34.8%) children were treated with antibiotics because of possible or confirmed bacterial coinfection. One death was reported, concerning an 11-month-old unvaccinated infant, with underlying dystrophy, who died of sepsis. Conclusion Measles is not an innocent viral infection, as it is still characterized by high morbidity and complications rates. Unvaccinated or partially vaccinated populations could trigger new outbreaks, resulting in significant cost in public health. To avoid future measles outbreaks, high vaccination coverage should be achieved, as well as closing immunity gaps in the population and ensuring high-quality measles surveillance.

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Section: Discussionmentioning

confidence: 99%

Measles epidemic in pediatric population in Greece during 2017–2018: Epidemiological, clinical characteristics and outcomes

et al. 2021

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“…This was partly explained by the large influx of refugees from Eastern Europe [ 28 ]. Currently, like many developed countries, measles vaccines are offered free of charge to all Thai children and children of migrants who are a beneficiary of the Migrant Health Insurance Scheme (MHIS) managed by the MOPH [ 29 , 30 ]. However, for migrant workers coming into Thailand to seek jobs, there is no policy to assess if they already have immunity to certain diseases (including measles) before obtaining a work permit [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Investigation of Measles Outbreak among Thai and Migrant Workers in Two Factories in Nakhon Pathom, Thailand, 2019

Wongsanuphat

Thitichai

Jaiyong

et al. 2020

IJERPH

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On 22 March 2019 the Thai Department of Disease Control (DDC) was notified that 16 workers, including Thai and Myanmar migrant workers, from two factories located in Nakhon Phathom Province, had presented with a fever with rash during the previous 2 weeks. Active case finding was conducted among workers in both factories using face-to-face interviews. Suspected cases were defined as a worker who developed fever with rash with one of the following symptoms: cough, coryza or conjunctivitis. Testing for measles IgM antibodies and viral identification through throat swabs by polymerase chain reaction (PCR) were performed to confirm diagnosis. Vaccination history among cases was reviewed. Nationality and age-specific attack rates (AR) were calculated. An environmental study and a social network analysis were conducted to better understand the transmission process. A total 56 cases (AR = 0.97%) were identified. Of 21 serum measles IgM collected, 8 (38.0%) were positive. Of 8 throat swabs collected, 5 (62.5%) were positive for measles genotype D8. The disease attack rate in migrant employees was twice as large as the rate in Thai counterparts (AR = 0.7 and 1.4%). The first case was identified as a Myanmar worker who arrived in Thailand two weeks prior to his illness. The Myanmar workers’ accommodation was more crowded than that for Thai workers. The hot spots of transmission were found at a drinking water tank which had shared glasses. Among the cases, 62.5% could not recall their vaccination history, and 25% had never had an injection containing a measles vaccination. The majority of migrant cases had never completed a two-dose measles vaccination. To halt the outbreak, measles vaccines were administered to the employees, particularly those working in the same sections with the cases and shared glasses were removed. For future policy action, a vaccination program should be incorporated into the work permit issuance process.

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“…Refugee populations in Greece in the early 2000s were avoiding established shelters for the fear of being departed, therefore they lived in crowded conditions among their own immigrant groups [28]. Hepatitis A viral disease (HAV) in Greece has remained high at 17.1% among non-immunized children [29] [30,31].…”

Section: Hepatitismentioning

confidence: 99%

Health Security and the Refugee Crisis in Greece: The Refugee Perspective

Papadimos¹,

Pappada²,

Lyaker³

et al. 2021

Contemporary Developments and Perspectives in International Health Security - Volume 1

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The flight of refugees has been part of the human condition since the beginning of time. Recent events in the Middle East have caused a mass migration of refugees from Syria, Iraq, and Afghanistan. Their primary destination has been Europe, more specifically, the affluent, better industrialized countries of central and northern Europe. However, the European law currently requires that refugees must be processed at the first port of entry to Europe. In most cases, this involves the eastern Aegean Sea islands of Greece. Here the refugee camps have become overcrowded and underfunded, and have little medical care and security. The Greek government has limited resources and the response for support from the more affluent European countries has been underwhelming. Here we summarize the lack of health security from the refugee perspective of those that are awaiting entry to Europe and are encamped in Greece.

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Increasing childhood vaccination coverage of the refugee and migrant population in Greece through the European programme PHILOS, April 2017 to April 2018

Cited by 26 publications

References 1 publication

Measles epidemic in pediatric population in Greece during 2017–2018: Epidemiological, clinical characteristics and outcomes

Measles epidemic in pediatric population in Greece during 2017–2018: Epidemiological, clinical characteristics and outcomes

Investigation of Measles Outbreak among Thai and Migrant Workers in Two Factories in Nakhon Pathom, Thailand, 2019

Health Security and the Refugee Crisis in Greece: The Refugee Perspective

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