Review of infectious diseases in refugees and asylum seekers—current status and going forward

Abstract

An unprecedented rise in the number of asylum seekers and refugees was seen in Europe in 2015, and it seems that numbers are not going to be reduced considerably in 2016. Several studies have tried to estimate risk of infectious diseases associated with migration but only very rarely these studies make a distinction on reason for migration. In these studies, workers, students, and refugees who have moved to a foreign country are all taken to have the same disease epidemiology. A common disease epidemiology across very different migrant groups is unlikely, so in this review of infectious diseases in asylum seekers and refugees, we describe infectious disease prevalence in various types of migrants. We identified 51 studies eligible for inclusion. The highest infectious disease prevalence in refugee and asylum seeker populations have been reported for latent tuberculosis (9-45%), active tuberculosis (up to 11%), and hepatitis B (up to 12%). The same population had low prevalence of malaria (7%) and hepatitis C (up to 5%). There have been recent case reports from European countries of cutaneous diphtheria, louse-born relapsing fever, and shigella in the asylum-seeking and refugee population. The increased risk that refugees and asylum seekers have for infection with specific diseases can largely be attributed to poor living conditions during and after migration. Even though we see high transmission in the refugee populations, there is very little risk of spread to the autochthonous population. These findings support the efforts towards creating a common European standard for the health reception and reporting of asylum seekers and refugees.

From Uganda to Italy: a case of nephrotic syndrome secondary to Plasmodium infection, Quartan malarial nephropathy and kidney failure

“…Malaria has low prevalence or is less known in our continent and requires more medical attention by European clinicians. 6 Furthermore, kidney involvement during malaria is considered as a negative prognostic factor. 7 Asymptomatic immigrants from more common endemic malaria areas (West Africa, Southeast Asia, Eastern Indonesia) or other people with anamnestic history or malaria need to undergo clinical surveillance in order to avoid late recrudescence or complications like GN, with more sensitive diagnostic tools.…”

Infectious Diseases among Refugee Children

“…Outbreaks of vaccine-preventable diseases (e.g., measles), and gastrointestinal and cutaneous infections have been reported in the early settlement period [107,108]. Health care workers must be aware of the clinical presentations of other tropical infectious diseases prevalent in the refugee country of origin, such as typhoid fever, Zika, cysticercosis, echinococcosis, leprosy, cutaneous diphtheria, chronic helminthiasis, and louse-borne relapsing fever [24,109].…”

“…Healthcare providers caring for refugee children must be aware of communicable diseases that are endemic to the refugee's country of origin. Priority infectious diseases affecting refugees and other newly arriving migrants to high-income countries include tuberculosis (TB) (active and latent), HIV, hepatitis B, hepatitis C, vaccine-preventable diseases (such as measles, mumps, rubella, diphtheria, tetanus, pertussis, and Haemophilus influenzae type b), and parasitic infections (such as strongyloidiasis and schistosomiasis) [4,[22][23][24]. In the EU and EEA, infectious diseases are the most common cause of illness in migrant children living in refugee camps and other reception areas, including acute respiratory tract infections, outbreaks of vaccine-preventable diseases, such as measles, and skin infection (e.g., scabies, pediculosis); gastrointestinal infection (e.g., shigellosis); typhoid fever; hepatitis A; tuberculosis; and malaria [25,26].…”

Population dynamics, pathogen detection and insecticide resistance of mosquito and sand fly in refugee camps, Greece

“…Currently over 135 000 refugees are hosted in the country [1,2], the majority in temporary accommodation sites/refugee camps with varied levels of infrastructures, housing conditions and amenities. Displaced populations travelling and living under poor conditions with limited access to healthcare are at a high risk of exposure to vector borne disease (VBD) infections [3][4][5]. The risk for VBD transmission is augmented in a context of host country disease endemicity (or high prevalence of disease vectors), inadequate or absent vector control in host regions, and VBD endemicity in the refugee travel route regions and countries of origin.…”