Public health aspects of migration - Communicable diseases, preparedness and surveillance. Demystifying the misconceptions
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Presentations delivered by Dr Nedret Emiroglu (Director, Division of Communicable Diseases and Health Security at the WHO Regional Office for Europe) - High-level meeting on refugee and migrant health (23-24 November 2015, Rome, Italy)
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Public health aspects of migration - Communicable diseases, preparedness and surveillance. Demystifying the misconceptions
- 2. Dr Nedret Emiroglu Director, Division of Communicable Diseases and Health Security WHO Regional Office for Europe Public health aspects of migration Communicable diseases, preparedness and surveillance Demystifying the misconceptions
- 3. Context to be prepared! Assessing communicable disease risks; • Diverse epidemiology of diseases in the country of origin • Diverse socio economic status • Population on the move; increased vulnerability • Language and cultural barriers
- 4. Misconceptions about communicable diseases X Communicable diseases are common among the refugees and migrants X Refugees and migrants pose communicable disease threat to the host population X Outbreaks cannot be predicted, prevented and controlled
- 5. Guiding principles for prevention and control of communicable diseases • Informed decision for prioritized public health policies and action based on the risk analysis and evidence • Adequate public health capacity for preparedness and response • Strengthened disease surveillance systems • Providing equitable and migrant-sensitive health services; ensuring continuum of care • Ensuring access to comprehensive health promotion and prevention
- 6. Prioritization matrix for communicable disease
- 7. Key public health messages on communicable disease • Region is well equipped to detect and manage public health threats • Risk of transmission of vaccine preventable diseases is low (WHO, UNICEF, UNHCR joint statement) • Risk of importation of highly infectious agents is extremely low • Refugees are more vulnerable to food and waterborne diseases • Influenza and respiratory infections rates expected to raise during winter • Universal access to prevention, diagnosis and treatment for TB and HIV/AIDS is essential
- 8. WHO will continue to support • Provide evidence and epidemiologic information through its networks at global, regional and country level • Advise on policy options and evidence- based interventions, support development of national preparedness plans • Facilitate exchange of know-how among countries and capacity building • Provide operational and logistical support and medical supplies
- 9. Thank you very much for your attention
Notas del editor
- Countries should implement policies that allow migrants to have access to a broad range of health services, including prevention and care. This will also be beneficial for the receiving populations. Migration has public health implications and is a challenge both for the migrants and the receiving countries. Migrants are more exposed to avoidable health risks that impact both their physical and mental health and wellbeing. The common systematic association between migration and importation of infectious diseases is not true.
- These are common misconceptions which are not based on any evidence.
- This is an overview of prioritization matrix for communicable diseases which shall be considered as a dynamic tool and array of rare to common diseases and conditions and from low mortality to high mortality ones. Refugees and migrants, depending from their country of origin as well as the conditions of their travel to Europe are vulnerable to a range of communicable diseases, this analysis may change with vaccination coverage and/or living conditions, but in general there are only a handful of diseases which are common among them. Water, sanitation, hygiene and nutrition are essential elements of prevention.
- Key messages: - There is a high vaccination coverage among most migrants, except those coming from conflict zones where the immunization may have been hindered; TB and HIV/AIDs are not common among refugees and migrants coming from the Middle East, however TB and HIV/AIDS may be found among those coming from Sub-Saharan Africa, screening shall be only conducted with informed consent and in order to provide treatment and care. The risk of getting infected with HIV/AIDS may increase during the travel and after arrival, due to possible exploitation; Refugees are vulnerable to food and waterborne diseases due to their long travel and lack of access to water and sanitation; Influenza and other respiratory infections rates may change with the winter season; Other communicable diseases like Malaria, Leishmaniosis and cutaneous diphtheria may be encountered but are readily treatable.