Monday, May 02, 2016

Europe's governments must introduce screening for HIV, TB and scabies because of massive influx of migrants, experts warn

  • Health experts say coordinated approach to disease screening is needed
  • Doctors say refugees becoming targets for entirely preventable diseases
  • Illnesses include scabies, measles, tuberculosis, cholera and typhoid fever
Health officials across Europe must improve their disease screening in light of the unprecedented influx of refugees, experts have warned.

Migrants are at risk of carrying superbugs such as MRSA and antibiotic-resistant salmonella, which can cause havoc if they are introduced into European hospitals, according to research.

Infectious diseases which were thought to be on the decline are now re-emerging as refugees carry bugs and viruses across borders, according to data presented at a major microbiology conference yesterday.

Migrants have an increased chance of carrying HIV, tuberculosis, shigella, scabies and other parasitic infections, experts said.

A series of papers presented at the European Society of Clinical Microbiology and Infectious Disease conference in Amsterdam outlined the new risk of infectious diseases.

Refugees have flooded into Europe in unprecedented numbers over the past two years, many fleeing war, persecution and humanitarian disaster in Syria, Iraq and Libya.

A record 1.25million asylum seekers arrived in the EU last year – more than double the 564,000 who arrived in 2014 – and these figures are likely to be the tip of the iceberg because they cover only official claims.

 In the UK, 38,878 asylum seekers lodged claims last year – up 20 per cent on 2014 and the highest number since 2004. 

Refugees are likely to pick up an array of diseases and viruses as they move across the world, doctors said. Living in squalid conditions in refugee camps in Africa and the Middle East, and on their journeys across Europe, they have poor access to sanitation and often live cheek by jowl – the ideal condition for infections to multiply and spread.

Perhaps more startling, however, is the number of superbugs seen among refugees, picked up either in their country of origin or along their route to Europe.

Many of these superbugs – such as MRSA, salmonella and certain strains of ecoli – are rapidly becoming untreatable with antibiotics.

Europe has struggled to deal with the influx of refugees from countries in Africa and the Middle East ravaged by war and poverty. Migrants are pictured at the border of Greece and Macedonia
Europe has struggled to deal with the influx of refugees from countries in Africa and the Middle East ravaged by war and poverty. Migrants are pictured at the border of Greece and Macedonia

Academics from University Hospital Basel yesterday reported that patients in a Swiss refugee centre were ten times as likely to be carrying MRSA bugs as the general population.

A Norwegian study, conducted over ten years between 2006 and 2015, found that 26 per cent of cases of MRSA were acquired abroad, either as a result of migration or tourism.

And a German study, conducted at refugee reception centres in the state of Thuringia, found two strains of the shigella bug which were resistant to common antibiotics.
Refugees may carry both resistant pathogens and microbes, causing the emergence or re-emergence of infectious diseases that have become less prevalent in host countries 
Professor of Medicine Winfried Kern 
Other studies presented yesterday found that refugees were more likely to have HIV, TB, salmonella, Chagas disease and scabies.

A study of 700 people in Denmark found that refugees were more than five times as likely to have HIV as Danish-born citizens. 

The researchers said that refugees were also more likely to seek medical help at a late stage, increasing the risk of transmission.

Winfried Kern, programme director at the conference, said: ‘Healthcare services across the world are facing a number of new challenges as a result of recent mass migration.

‘Refugees may carry both resistant pathogens and microbes, causing the emergence or re-emergence of infectious diseases that have become less prevalent in host countries.

‘We recommend that public health facilities maintain and step up screening programmes and put the appropriate precautions and procedures in place to most effectively protect migrants and domestic populations in host countries.’

According to refugee agencies, more than a million migrants arrived in the EU last year, and almost 180,000 so far this year - many risking their lives to cross the sea in crowded boats. Most spend extended periods in camps ill-equipped to deal with the unprecedented influx
According to refugee agencies, more than a million migrants arrived in the EU last year, and almost 180,000 so far this year - many risking their lives to cross the sea in crowded boats. Most spend extended periods in camps ill-equipped to deal with the unprecedented influx

Professor Harkan Leblebicioglu, head of the society’s group for infections in travellers and migrants, said most people have little to worry about, because transmission usually requires close contact.

But he said hospitals should be wary of the risk, because if a refugee is admitted to hospital carrying a superbug the chance of it spreading is high. Dr Nick Beeching, of the Liverpool School of Tropical Medicine, said that NHS hospitals have well-established systems in place to spot the risk, with patients likely to be isolated if there is a chance of a disease spreading.

‘In the UK we are already prepared,’ he said. ‘We should be asking people whether they have travelled and where they have come from, and that will trigger a set treatment.’

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