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Chauhan RP, Fogel R, Limson J. Overview of Diagnostic Methods, Disease Prevalence and Transmission of Mpox (Formerly Monkeypox) in Humans and Animal Reservoirs. Microorganisms 2023; 11:1186. [PMID: 37317160 DOI: 10.3390/microorganisms11051186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 06/16/2023] Open
Abstract
Mpox-formerly monkeypox-is a re-emerging zoonotic virus disease, with large numbers of human cases reported during multi-country outbreaks in 2022. The close similarities in clinical symptoms that Mpox shares with many orthopoxvirus (OPXV) diseases make its diagnosis challenging, requiring laboratory testing for confirmation. This review focuses on the diagnostic methods used for Mpox detection in naturally infected humans and animal reservoirs, disease prevalence and transmission, clinical symptoms and signs, and currently known host ranges. Using specific search terms, up to 2 September 2022, we identified 104 relevant original research articles and case reports from NCBI-PubMed and Google Scholar databases for inclusion in the study. Our analyses observed that molecular identification techniques are overwhelmingly being used in current diagnoses, especially real-time PCR (3982/7059 cases; n = 41 studies) and conventional PCR (430/1830 cases; n = 30 studies) approaches being most-frequently-used to diagnose Mpox cases in humans. Additionally, detection of Mpox genomes, using qPCR and/or conventional PCR coupled to genome sequencing methods, offered both reliable detection and epidemiological analyses of evolving Mpox strains; identified the emergence and transmission of a novel clade 'hMPXV-1A' lineage B.1 during 2022 outbreaks globally. While a few current serologic assays, such as ELISA, reported on the detection of OPXV- and Mpox-specific IgG (891/2801 cases; n = 17 studies) and IgM antibodies (241/2688 cases; n = 11 studies), hemagglutination inhibition (HI) detected Mpox antibodies in human samples (88/430 cases; n = 6 studies), most other serologic and immunographic assays used were OPXV-specific. Interestingly, virus isolation (228/1259 cases; n = 24 studies), electron microscopy (216/1226 cases; n = 18 studies), and immunohistochemistry (28/40; n = 7 studies) remain useful methods of Mpox detection in humans in select instances using clinical and tissue samples. In animals, OPXV- and Mpox-DNA and antibodies were detected in various species of nonhuman primates, rodents, shrews, opossums, a dog, and a pig. With evolving transmission dynamics of Mpox, information on reliable and rapid detection methods and clinical symptoms of disease is critical for disease management.
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Affiliation(s)
- Ravendra P Chauhan
- Biotechnology Innovation Centre, Rhodes University, Makhanda 6139, Eastern Cape, South Africa
| | - Ronen Fogel
- Biotechnology Innovation Centre, Rhodes University, Makhanda 6139, Eastern Cape, South Africa
| | - Janice Limson
- Biotechnology Innovation Centre, Rhodes University, Makhanda 6139, Eastern Cape, South Africa
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Kolakowska A, Brichler S, Delagrèverie H, Marin J, Alloui AC, Cailhol J. Cross sectional survey of Varicella-Zoster virus and measles seropositivity in people living with HIV in a Parisian suburb and a review of current immunization guidelines. Vaccine 2023; 41:3266-3274. [PMID: 37085454 DOI: 10.1016/j.vaccine.2023.03.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/25/2023] [Accepted: 03/23/2023] [Indexed: 04/23/2023]
Abstract
According to evidence-based guidelines, vaccines against measles and varicella are generally recommended to susceptible HIV-positive patients, as long as they are not severely immunocompromised. However, routine screening to determine serologic status is not recommended. We conducted a seroprevalence study of anti-measles and anti-Varicella-Zoster virus (VZV) antibodies in adults living with HIV (PLWHA) consulting at Avicenne University Hospital in a Parisian suburb. Sera were collected in years 2018-2020 and tested by commercial immunoassays in 268 patients. Most of the patients were born in Sub-Saharan Africa (55 %) and only 23 % in Europe. Measles and varicella seropositivity were present respectively in 91.4 % and 96.2 % of patients. One patient in ten was seronegative to at least one of tested diseases. In the univariate analysis, only younger age (p = 0.027) was associated with a higher risk of measles seronegativity, while shorter time since arrival in France (p < 0.001) and shorter time since HIV discovery (p = 0.007) were associated with a higher risk of VZV seronegativity. In multivariate analysis no association was found. This study highlights the absence of specific risk factors for VZV and measles seronegativity in PLWHA and supports the importance of routine screening, in order to increase immunization rates and reduce risk of complications.
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Affiliation(s)
- A Kolakowska
- Service de Maladies Infectieuses et Tropicales, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France.
| | - Ségolène Brichler
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - Héloise Delagrèverie
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - Julie Marin
- Université Sorbonne Paris Nord and Université Paris Cité, Inserm, IAME, F-93000 Bobigny, France
| | - Ahmed-Chakib Alloui
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - Johann Cailhol
- Service de Maladies Infectieuses et Tropicales, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France; Laboratoire Educations et Promotion de la Santé, UR3412, Sorbonne Paris Nord University, Bobigny, France.
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Manfredi L, Sciannameo V, Destefanis C, Prisecaru M, Cossu G, Gnavi R, Macciotta A, Catalano A, Pepe RR, Sacerdote C, Ricceri F. Health status assessment of a population of asylum seekers in Northern Italy. Global Health 2022; 18:57. [PMID: 35659014 PMCID: PMC9164173 DOI: 10.1186/s12992-022-00846-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/02/2022] [Indexed: 11/11/2022] Open
Abstract
Background Since 2011 Italy has faced an extraordinary increase in migrants arrivals, mainly from the Mediterranean route, one of the world’s most dangerous journeys. The purpose of the present article is to provide a comprehensive picture of the migrants' health status in the "T. Fenoglio" centre, Settimo Torinese (Turin, Italy). Methods A retrospective cross-sectional study was conducted using data collected from June 2016 to May 2018 on adult migrants (over 18 years old) from Africa, Middle East and South East Asia (Bangladesh, Cambodia, India, Nepal). Data was collected through the migrants' medical records. Descriptive statistics were performed on socio-demographic variables. The diagnosed diseases were anonymously registered and classified according to the International Classification of Primary Care (ICPC-2). Conditional Inference Trees were used to perform a descriptive analysis of the sample and to detect the covariates with the strongest association with the variables Disease on arrival, Disease after arrival, ICPC on arrival and ICPC after arrival. Results Analyzed observations were 9 857. 81.8% were men, median age was 23 (Interquartile range: 20.0–27.4). 70.3% of the sample came from Sub-Saharan Africa. 2 365 individuals (24%) arrived at the centre with at least one disease. On arrival, skin (27.71%), respiratory (14.46%), digestive (14.73%) and generic diseases (20.88%) were the most frequent. During the stay respiratory diseases were the most common (25.70%). The highest probability of arriving with a disease occurred in 2018 and during the period September–November 2016, in particular for people from the Horn of Africa. During this period and also in the first half of 2017, skin diseases were the most reported. In seasons with lower prevalence of diseases on arrival the most common disease code was generic for both men and women (usually fever or trauma). Conclusions This study provides information on the diverse diseases that affect the asylum seekers population. In our sample, the Horn of Africa was the most troubled area of arrival, with severe conditions frequently reported regarding skin diseases, in particular scabies. 2018 was the most critical year, especially for migrants from the Horn of Africa and Sub-Saharan Africa. During the stay at the camp, the prevalence of respiratory diseases increased. However, skin diseases remained the main issue for people from the Horn of Africa. Overall, the most reported diseases in the sample were dermatological, respiratory, digestive and generic diseases, both on arrival and during the stay. A better understanding of the health status of asylum seekers is an important factor to determine a more efficient reception and integration process and a better allocation of economic resources in the context of migrants' health care. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00846-0.
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Affiliation(s)
- Luca Manfredi
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy.
| | - Veronica Sciannameo
- Department of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | | | - Marta Prisecaru
- Degree in Strategy and Policy, University of Turin, Turin, Italy
| | - Giorgia Cossu
- Degree in Strategy and Policy, University of Turin, Turin, Italy
| | - Roberto Gnavi
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy
| | - Alessandra Macciotta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Alberto Catalano
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città Della Salute E Della Scienza University-Hospital, Turin, Italy
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy.,Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Bopp L, Kreuter A, von Stebut E, Fabri M. [Virus-induced exanthems in returning travellers]. Hautarzt 2022; 73:462-474. [PMID: 35554622 PMCID: PMC9100320 DOI: 10.1007/s00105-022-05001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 10/25/2022]
Abstract
Dermatological diseases are among the most common travel-associated diseases. In particular, viral infections not only with tropical and subtropical pathogens, but also with viruses common in Germany, which are often accompanied by skin rashes and general symptoms, are of great importance. In addition to an accurate travel history and possible risk exposures, epidemiological information on country-specific risks in combination with molecular and serological analyses is helpful in making the correct diagnosis. This article provides an overview of important virus-induced exanthems in returned travellers.
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Affiliation(s)
- Luisa Bopp
- Medizinische Fakultät und Uniklinik Köln, Klinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Oberhausen, Deutschland
| | - Esther von Stebut
- Medizinische Fakultät und Uniklinik Köln, Klinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - Mario Fabri
- Medizinische Fakultät und Uniklinik Köln, Klinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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Logrosa G, Mata MA, Lachica ZP, Estaña LM, Hassall M. Integrating Risk Assessment and Decision-Making Methods in Analyzing the Dynamics of COVID-19 Epidemics in Davao City, Mindanao Island, Philippines. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:105-125. [PMID: 34269475 PMCID: PMC8447332 DOI: 10.1111/risa.13779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/19/2021] [Accepted: 05/22/2021] [Indexed: 06/13/2023]
Abstract
The COVID-19 pandemic has become a public health crisis in the Philippines and the attention of national and local health authorities is focused on managing the fluctuating COVID-19 cases. This study presents a method that integrates risk management tools into health care decision-making processes to enhance the understanding and utilization of risk-based thinking in public health decision making. The risk assessment consists of the identification of the key risk factors of the COVID-19 contagion via bow-tie diagrams. Second, the safety controls for each risk factor relevant to the Davao City context are taken into account and are identified as barriers in the bow-tie. After which, the prioritization of the identified COVID-19 risks, as well as the effectiveness of the proposed interventions, is performed using the analytic hierarchy process. Consequently, the dynamics of COVID-19 management initiatives were explored using these priorities and a system of ordinary differential equations. Our results show that reducing the number of COVID-19 fatalities should be the top priority of the health authorities. In turn, we predict that the COVID-19 contagion can be controlled and eliminated in Davao city in three-month time after prioritizing the fatalities. In order to reduce the COVID-19 fatalities, health authorities should ensure an adequate number of COVID-ready ICU facilities. The general public, on the other hand, should follow medical and science-based advice and suspected and confirmed COVID-19 patients should strictly follow isolation protocols. Overall, an informed decision-making is necessary to avoid the unwanted consequences of an uncontrolled contagion.
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Affiliation(s)
- Gernelyn Logrosa
- Office for Research, Development and InnovationMalayan Colleges MindanaoDavao CityPhilippines
- Center for Applied ModelingData Analytics, and Bioinformatics for Decision Support Systems in HealthDavao CityPhilippines
| | - May Anne Mata
- Center for Applied ModelingData Analytics, and Bioinformatics for Decision Support Systems in HealthDavao CityPhilippines
- Department of Mathematics, Physics, and Computer ScienceUniversity of the Philippines MindanaoDavao CityPhilippines
- University of the Philippines Resilience InstituteUniversity of the PhilippinesQuezon CityPhilippines
| | - Zython Paul Lachica
- Center for Applied ModelingData Analytics, and Bioinformatics for Decision Support Systems in HealthDavao CityPhilippines
- Department of Mathematics, Physics, and Computer ScienceUniversity of the Philippines MindanaoDavao CityPhilippines
- University of the Philippines Resilience InstituteUniversity of the PhilippinesQuezon CityPhilippines
| | - Leo Manuel Estaña
- Center for Applied ModelingData Analytics, and Bioinformatics for Decision Support Systems in HealthDavao CityPhilippines
- Department of Mathematics, Physics, and Computer ScienceUniversity of the Philippines MindanaoDavao CityPhilippines
| | - Maureen Hassall
- School of Chemical EngineeringUniversity of QueenslandAustralia
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Acute respiratory infections in an adult refugee population: an observational study. NPJ Prim Care Respir Med 2021; 31:50. [PMID: 34934070 PMCID: PMC8692464 DOI: 10.1038/s41533-021-00261-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 11/03/2021] [Indexed: 11/08/2022] Open
Abstract
The presence of acute infectious respiratory diseases (ARD) is one of the main reasons why recently arrived refugees seek medical help. This paper investigates the incidence rates of acute respiratory diseases in an adult refugee population as well as associated sociodemographic factors and drug treatments. We conducted a retrospective observational study of deidentified medical records. The data were collected between 2015 and 2019 in the health care centers of two large German initial reception centers for refugees. Multivariable analyses controlling for sociodemographics were carried out using generalized estimating equations. Out of 10,431 eligible residents, 6965 medical encounters of 2840 adult patients were recorded over 30 months. Of all the adult patients, 34.4% sought medical help for a respiratory symptom or diagnosis at least once. Older patients and patients from Sub-Saharan Africa sought help less often. The occurrence of ARD showed a typical distribution over the course of the year. Facility occupancy was not associated with ARD occurrence. Acute respiratory symptoms are a leading cause for adult refugee patients to seek medical care. The doctor contact rates due to ARD were consistently two to three times higher among refugees than among German residents.
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Müller F, Chandra S, Wright V, Rashid M, Redditt V. Concordance of self-reported varicella history and serology among adolescent and adult refugee patients at a primary care clinic in Toronto, Canada. Vaccine 2021; 39:6391-6397. [PMID: 34563396 DOI: 10.1016/j.vaccine.2021.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Previous studies have found higher rates of varicella susceptibility among migrants from tropical regions. This study seeks to estimate the prevalence of varicella susceptibility in a cohort of newly arrived refugees and refugee claimants at a primary care clinic in Toronto and to compare patients' self-reported history of varicella infection with serologic test results. METHODS We conducted a retrospective chart review of 1888 refugee patients aged 13 years and older rostered at a specialized primary care clinic in Toronto from December 2011 to October 2017. Basic sociodemographic variables, self-reported varicella history, and varicella serologic results were examined. RESULTS Based on serologic testing, 8.5% of individuals were varicella non-immune, with highest rates of varicella susceptibility among adolescents aged 13-19 years (13.5%). All adults over age 60 were varicella immune on serology (n = 56). A positive self-reported history of varicella infection was strongly predictive of varicella immunity on serology (PPV 96.8%; 95% CI: 95.2-97.9). A self-reported history of no prior varicella infection did not correlate reliably with serologic test results (NPV 15.8%; 95% CI: 13.3-18.0). A substantial proportion of patients (34.1%) were unsure of their varicella history. CONCLUSION Identification and immunization of varicella susceptible refugee newcomers remains a health care priority. Self-reported history of varicella infection had mixed reliability as a predictor of varicella immunity.
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Affiliation(s)
- Frank Müller
- Crossroads Clinic Women's College Hospital 76 Grenville Street, Toronto ON, M5S 1B2, Canada; Department of General Practice, University Medical Center Göttingen/Georg-August-University, Humboldtallee 38, 37073 Göttingen, Germany.
| | - Shivani Chandra
- Crossroads Clinic Women's College Hospital 76 Grenville Street, Toronto ON, M5S 1B2, Canada; Women's College Hospital Institute for Health System Solutions and Virtual Care Women's College Hospital 76 Grenville Street, Toronto, ON M5S 1B2, Canada.
| | - Vanessa Wright
- Crossroads Clinic Women's College Hospital 76 Grenville Street, Toronto ON, M5S 1B2, Canada.
| | - Meb Rashid
- Crossroads Clinic Women's College Hospital 76 Grenville Street, Toronto ON, M5S 1B2, Canada; Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, ON M5G 1V7, Canada.
| | - Vanessa Redditt
- Crossroads Clinic Women's College Hospital 76 Grenville Street, Toronto ON, M5S 1B2, Canada; Women's College Hospital Institute for Health System Solutions and Virtual Care Women's College Hospital 76 Grenville Street, Toronto, ON M5S 1B2, Canada; Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, ON M5G 1V7, Canada.
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Deal A, Halliday R, Crawshaw AF, Hayward SE, Burnard A, Rustage K, Carter J, Mehrotra A, Knights F, Campos-Matos I, Majeed A, Friedland JS, Edelstein M, Mounier-Jack S, Hargreaves S. Migration and outbreaks of vaccine-preventable disease in Europe: a systematic review. THE LANCET. INFECTIOUS DISEASES 2021; 21:e387-e398. [PMID: 34626552 DOI: 10.1016/s1473-3099(21)00193-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/04/2021] [Accepted: 03/17/2021] [Indexed: 12/25/2022]
Abstract
Migrant populations are one of several underimmunised groups in the EU or European Economic Area (EU/EEA), yet little is known about their involvement in outbreaks of vaccine-preventable diseases. This information is vital to develop targeted strategies to improve the health of diverse migrant communities. We did a systematic review (PROSPERO CRD42019157473; Jan 1, 2000, to May 22, 2020) adhering to PRISMA guidelines, to identify studies on vaccine-preventable disease outbreaks (measles, mumps, rubella, diphtheria, pertussis, polio, hepatitis A, varicella, Neisseria meningitidis, and Haemophilus influenzae) involving migrants residing in the EU/EEA and Switzerland. We identified 45 studies, reporting on 47 distinct vaccine-preventable disease outbreaks across 13 countries. Most reported outbreaks involving migrants were of measles (n=24; 6496 cases), followed by varicella (n=11; 505 cases), hepatitis A (n=7; 1356 cases), rubella (n=3; 487 cases), and mumps (n=2; 293 cases). 19 (40%) outbreaks, predominantly varicella and measles, were reported in temporary refugee camps or shelters. Of 11 varicella outbreaks, nine (82%) were associated with adult migrants. Half of measles outbreaks (n=11) were associated with migrants from eastern European countries. In conclusion, migrants are involved in vaccine-preventable disease outbreaks in Europe, with adult and child refugees residing in shelters or temporary camps at particular risk, alongside specific nationality groups. Vulnerability varies by disease, setting, and demographics, highlighting the importance of tailoring catch-up vaccination interventions to specific groups in order to meet regional and global vaccination targets as recommended by the new Immunisation Agenda 2030 framework for action. A better understanding of vaccine access and intent in migrant groups and a greater focus on co-designing interventions is urgently needed, with direct implications for COVID-19 vaccine delivery.
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Affiliation(s)
- Anna Deal
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Rae Halliday
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Alison F Crawshaw
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Sally E Hayward
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Amelia Burnard
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Kieran Rustage
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | | | - Felicity Knights
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Ines Campos-Matos
- Public Health England, London, UK; UCL Collaborative Centre for Inclusion Health, University College London, London, UK
| | - Azeem Majeed
- Department of Primary Care & Public Health, Imperial College London, London, UK
| | - Jon S Friedland
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | | | - Sandra Mounier-Jack
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
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Norman FF, Comeche B, Martínez-Lacalzada M, Pérez-Molina JA, Gullón B, Monge-Maillo B, Chamorro S, López-Vélez R. Seroprevalence of vaccine-preventable and non-vaccine-preventable infections in migrants in Spain. J Travel Med 2021; 28:6145914. [PMID: 33611577 DOI: 10.1093/jtm/taab025] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/29/2021] [Accepted: 02/15/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Updated seroprevalence studies of infections in migrants may aid the design of tailored vaccination and prevention programmes. The objective of this study was to describe the seroprevalence rates for potentially transmissible viral infections in migrants attended at a referral centre in a major European city. METHODS Descriptive analysis of seroprevalence of vaccine-preventable and non-vaccine-preventable infections in migrants attended at a centre in Madrid, Spain (2018-19). Recorded variables included age, gender, country of birth/continent of origin, time from arrival to Spain until first clinic visit, rubella, measles, mumps, varicella (VZV), hepatitis B virus (HBV), hepatitis A virus (HAV), hepatitis C virus (HCV) and HIV serology. RESULTS In total, 468 patients were included, 135 females (28.8%) and 333 males (71.2%), mean age 30.4 years. The majority of patients were from Africa (52.5%, of which 88.2% from sub-Saharan Africa), followed by Latin America (38.5%) and other areas (9%). Seroprevalence for tested migrants for rubella, measles and mumps was < 95% in the group overall (91% rubella, 88% measles, 83% mumps) and lower rates were observed in migrants >20 years (compared with those ≤ 20 years). Over 10% of females were potentially susceptible (negative/indeterminate serology) to rubella (11.4%), measles (12.7%) or mumps (10.3%). Lowest rates of rubella seropositivity were in Latin American migrants (over 12% potentially susceptible); measles and mumps seropositivity was lowest in migrants from areas other than Africa/Latin America (74% and 68%, respectively). Seroprevalence rates were 91% for VZV, 90% overall for HAV, ~6% for HBV chronic infection (~50% of migrants tested susceptible), 2% for HCV and 6% for HIV. CONCLUSIONS Differences in seroprevalence for vaccine-preventable and transmissible infections according to gender, age range and area of origin were observed. Tailored screening, vaccination and prevention strategies in potentially vulnerable migrant groups should be designed.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Belén Comeche
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Miguel Martínez-Lacalzada
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - José-Antonio Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Beatriz Gullón
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Begoña Monge-Maillo
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Sandra Chamorro
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain
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Liu Q, Yu J, Wei J, Zhang H, Jin J, Zheng W, Ruan Y, Yu J, Chen Y. Uptrend prevalence of varicella parallel with low serum antibodies and low second-dose rate among children 10-14 years old in Wenzhou, China. Hum Vaccin Immunother 2021; 17:363-371. [PMID: 32614651 DOI: 10.1080/21645515.2020.1775458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
In recent years, the incidence of varicella cases is rising, and outbreaks of varicella are frequently being reported worldwide. Our study aims to analyze the association between the varicella incidence and serum antibody level in the post-vaccine era. We retrieved and analyzed the incidence and prevalence data for children age 1-14 years in Wenzhou, China during 2010-2018. A cross-sectional seroepidemiology analysis was carried out in a series of 168 general healthy children age 1-14 years as well as children at a varicella outbreak in Wenzhou. Our data showed a significant surge in the incidence and prevalence of varicella in children aged 10-14 years in 2017 and 2018 while they were kept relatively stable in 2010-2016. The seroepidemiological analysis revealed a 7.3-fold significantly higher level of serum varicella IgG in healthy control students who exposed at the outbreak than that in general healthy children (median 523.5 vs. 71.7 mIU/mL, p < .01). The children 10-14 years old had the lowest rate of second-dose vaccination among the three age classes (7%, 41%, and 65% in 10-14, 5-9, and 2-4 age class, respectively), and children 5-9 years old who received the second dose had a higher level of serum protective IgG than those who did not (254.7 vs 98 mIU/mL, p = .06). The findings from the present study warn a two-dose vaccine schedule to reduce the climbing incidence and prevalence observed in the older children and suggest a higher serum IgG threshold for effective protection of children from the varicella outbreak.
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Affiliation(s)
- Qi Liu
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Jiake Yu
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Jingjiao Wei
- Wenzhou Division, Zhejiang Center for Disease Control and Prevention , Wenzhou, Zhejiang, China
| | - Hu Zhang
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Jie Jin
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Weikun Zheng
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Yufei Ruan
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Jinsheng Yu
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Yiping Chen
- Department of Pediatric Infectious Disease, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University , Wenzhou, Zhejiang, China
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Abstract
"Currently, an estimated 70.8 million individuals worldwide are forcibly displaced due to war, violence, and persecution. Barriers to providing dermatologic care include the large number of affected people, their movement within and across international borders, security issues, and limited access to dermatology expertise and formularies. Screening protocols for skin diseases and sexually transmitted infections differ worldwide, raising the need for shared guidelines to assess migrants' health. This article reviews the literature of skin and sexually transmitted infections in migrants and displaced persons, highlighting the impact of social determinants on skin health and challenges faced in providing care."
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Greenaway C, Greenwald ZR, Akaberi A, Song S, Passos-Castilho AM, Abou Chakra CN, Palayew A, Alabdulkarim B, Platt R, Azoulay L, Brisson M, Quach C. Epidemiology of varicella among immigrants and non-immigrants in Quebec, Canada, before and after the introduction of childhood varicella vaccination: a retrospective cohort study. THE LANCET. INFECTIOUS DISEASES 2020; 21:116-126. [PMID: 32711690 DOI: 10.1016/s1473-3099(20)30277-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/05/2020] [Accepted: 03/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Many immigrants are susceptible to varicella on arrival to Canada because of different transmission dynamics in their countries of origin and scarcity of vaccination. Universal childhood vaccination programmes decrease varicella incidence rates through herd immunity, but the accumulating number of susceptible adult immigrants could remain at risk for severe varicella. Our aim was to describe the epidemiology of varicella among immigrants and non-immigrants before and after childhood varicella vaccination. METHODS We did a population-based, retrospective cohort study of all varicella cases in Quebec, Canada, diagnosed between 1996 and 2014 in administrative health databases linked to immigration data. Cases of varicella met diagnostic codes in the International Classification of Diseases, Ninth and Tenth Revision Canadian modifications. Cases with a co-occurring zoster diagnostic code and immigrants from Australia, New Zealand, the USA, and western European countries were excluded. Vaccination periods included pre-vaccination (1996-98), private vaccination (1999-2005), and public vaccination (2006-14). Incidence rate and comparative rate ratios were estimated using census data. FINDINGS A total of 231 339 varicella cases diagnosed between Jan 1, 1996, and Dec 31, 2014, were linked to 1 115 696 immigrants who arrived between Jan 1, 1980, and Dec 31, 2014. 1444 herpes zoster cases and 1276 immigrants from Australia, western Europe, New Zealand, and the USA were excluded. Among 228 619 varicella cases, 13 315 (5·8%) occurred in immigrants. In pre-vaccination versus public vaccination periods, varicella incidence declined in immigrants by 87% (95% CI 86·6-87·9; 324·3 cases per 100 000 person-years to 40·9 cases per 100 000 person-years) and in non-immigrants by 93% (92·4-92·7; 484 cases per 100 000 person-years to 36 cases per 100 000 person-years). Mean age at diagnosis increased in both groups (15·1 vs 19·4 years in immigrants and 8·4 vs 12·0 years in non-immigrants). In the public vaccination period, immigrants younger than 50 years had higher varicella rates than non-immigrants, with relative risk ranging from 1·53 (95% CI 1·37-1·72) to 4·64 (3·90-5·53) with the highest risk in adolescents and young adults, and people from Latin America and the Caribbean (age-specific incidence rate ratio [aIRR]I-NI pre-vaccination 2·19 and post-vaccination aIRRI-NI6·07) and south Asia (aIRRI-NI pre-vaccination 3·41 and aIRRI-NI post-vaccination 4·46) and in childbearing women (15-40 years; IRRI-NI 2·48). INTERPRETATION Immigrant adolescents, young adults, and women of childbearing age had higher age-standardised rates of varicella than non-immigrants, with increasing disparities following vaccine introduction. Immigrants younger than 50 years of age would benefit from targeted vaccination upon arrival to host countries. FUNDING The Canadian Institutes of Health Research and The Department of Medicine, Jewish General Hospital, Montreal, QC, Canada.
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Affiliation(s)
- Christina Greenaway
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada; Division of Infectious Diseases, Jewish General Hospital, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
| | - Zoe R Greenwald
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Arash Akaberi
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| | - Sunny Song
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| | - Ana Maria Passos-Castilho
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| | - Claire Nour Abou Chakra
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| | - Adam Palayew
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Balquis Alabdulkarim
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| | - Robert Platt
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Laurent Azoulay
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Marc Brisson
- Research Group in Mathematical Modeling and Health Economics of Infectious Disease, Laval University, QC, Canada
| | - Caroline Quach
- Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, QC, Canada
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Infectious disease outbreaks among forcibly displaced persons: an analysis of ProMED reports 1996-2016. Confl Health 2020; 14:49. [PMID: 32704307 PMCID: PMC7374653 DOI: 10.1186/s13031-020-00295-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 07/15/2020] [Indexed: 01/05/2023] Open
Abstract
Background The United Nations Refugee Agency (UNHCR) estimates the number of forcibly displaced people increased from 22.7 million people in 1996 to 67.7 million people in 2016. Human mobility is associated with the introduction of infectious disease pathogens. The aim of this study was to describe the range of pathogens in forcibly displaced populations over time using an informal event monitoring system. Methods We conducted a retrospective analysis of ProMED, a digital disease monitoring system, to identify reports of outbreak events involving forcibly displaced populations between 1996 and 2016. Number of outbreak events per year was tabulated. Each record was assessed to determine outbreak location, pathogen, origin of persons implicated in the outbreak, and suspected versus confirmed case counts. Results One hundred twenty-eight independent outbreak events involving forcibly displaced populations were identified. Over 840,000 confirmed or suspected cases of infectious diseases such as measles, cholera, cutaneous leishmaniasis, dengue, and others were reported in 48 destination countries/territories. The average rate of outbreak events concerning forcibly displaced persons per total number of reports published on ProMED per year increased over time. The majority of outbreak events (63%) were due to acquisition of disease in the destination country. Conclusion This study found that reports of outbreak events involving forcibly displaced populations have increased in ProMED. The events and outbreaks detected in this retrospective review underscore the importance of capturing displaced populations in surveillance systems for rapid detection and response.
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New approaches to controlling an outbreak of chickenpox in a large immigration detention setting in England: the role of serological testing and mathematical modelling. Epidemiol Infect 2020; 148:e25. [PMID: 32036802 PMCID: PMC7026903 DOI: 10.1017/s095026882000014x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Chickenpox is caused by varicella-zoster-virus (VZV) and is highly contagious. Immigration detention settings are a high-risk environment for primary VZV transmission, with large, rapidly-changing populations in close quarters, and higher susceptibility among non-UK-born individuals. During outbreaks, operational challenges occur in detention settings because of high-turnover and the potential need to implement population movement restriction for prolonged periods. Between December 2017 and February 2018, four cases of chickenpox were notified amongst 799 detainees in an immigration removal centre (IRC). Microbiological investigations included case confirmation by vesicular fluid polymerase chain reaction, and VZV serology for susceptibility testing. Control measures involved movement restrictions, isolation of cases, quarantining and cohorting of non-immune contacts and extending VZV immunity testing to the wider detainee population to support outbreak management. Immunity was tested for 301/532 (57%) detainees, of whom 24 (8%) were non-immune. The level of non-immunity was lower than expected based on the existing literature on VZV seroprevalence in detained populations in England. Serology results identified non-immune contacts who could be cohorted and, due to the lack of isolation capacity, allowed the placement of cases with immune detainees. The widespread immunity testing of all detainees was proving challenging to sustain because it required significant resources and was having a severe impact on operational capacity and the ability to maintain core business activities at the IRC. Therefore, mathematical modelling was used to assess the impact of scaling back mass immunity testing. Modelling demonstrated that interrupting testing posed a risk of one additional case compared to continuing with testing. As such, the decision was made to stop testing, and the outbreak was successfully controlled without excessive strain on resources. Operational challenges generated learning for future outbreaks, with implications for a local and national policy on IRC staff occupational health requirements, and proposed reception screening of detainees for VZV immunity.
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Giambi C, Del Manso M, Marchetti G, Olsson K, Adel Ali K, Declich S. Immunisation of migrants in EU/EEA countries: Policies and practices. Vaccine 2019; 37:5439-5451. [PMID: 31296374 DOI: 10.1016/j.vaccine.2019.06.068] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/16/2019] [Accepted: 06/22/2019] [Indexed: 12/12/2022]
Abstract
In recent years various EU/EEA countries have experienced an influx of migrants from low and middle-income countries. In 2018, the "Vaccine European New Integrated Collaboration Effort (VENICE)" survey group conducted a survey among 30 EU/EEA countries to investigate immunisation policies and practices targeting irregular migrants, refugees and asylum seekers (later called "migrants" in this report). Twenty-nine countries participated in the survey. Twenty-eight countries reported having national policies targeting children/adolescent and adult migrants, however vaccinations offered to adult migrants are limited to specific conditions in seven countries. All the vaccinations included in the National Immunisation Programme (NIP) are offered to children/adolescents in 27/28 countries and to adults in 13/28 countries. In the 15 countries offering only certain vaccinations to adults, priority is given to diphtheria-tetanus, measles-mumps-rubella and polio vaccinations. Information about the vaccines given to child/adolescent migrants is recorded in 22 countries and to adult migrants in 19 countries with a large variation in recording methods found across countries. Individual and aggregated data are reportedly not shared with other centres/institutions in 13 and 15 countries, respectively. Twenty countries reported not collecting data on vaccination uptake among migrants; only three countries have these data at the national level. Procedures to guarantee migrants' access to vaccinations at the community level are available in 13 countries. In conclusion, although diversified, strategies for migrant vaccination are in place in all countries except for one, and the strategies are generally in line with international recommendations. Efforts are needed to strengthen partnerships and implement initiatives across countries of origin, transit and destination to develop and better share documentation in order to guarantee a completion of vaccination series and to avoid unnecessary re-vaccination. Development of migrant-friendly strategies to facilitate migrants' access to vaccination and collection of vaccination uptake data among migrants is needed to meet existing gaps.
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Affiliation(s)
- Cristina Giambi
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Martina Del Manso
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Giulia Marchetti
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; Sapienza Università di Roma, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Kate Olsson
- European Centre for Disease Prevention and Control, Gustav III:s boulevard 40, 169 73 Solna, Sweden.
| | - Karam Adel Ali
- European Centre for Disease Prevention and Control, Gustav III:s boulevard 40, 169 73 Solna, Sweden.
| | - Silvia Declich
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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Zhang L, Ma W, Liu Y, Wang Y, Sun X, Hu Y, Deng X, Lu P, Tang F, Wang Z, Zhou M. Analysis of sero-epidemiological characteristics of varicella in healthy children in Jiangsu Province, China. BMC Infect Dis 2018; 18:563. [PMID: 30428851 PMCID: PMC6234534 DOI: 10.1186/s12879-018-3496-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 11/01/2018] [Indexed: 01/28/2023] Open
Abstract
Background In recent years, outbreaks of varicella have continued to occur, and the coverage rate of varicella vaccine in Jiangsu Province, China, remains unclear. This study aims to analyse the levels of immune antibody against varicella and obtain a comprehensive understanding of the varicella attenuated live vaccine (VarV) coverage rate in children aged 1–9 years in Jiangsu Province. Methods From June to October 2016, a cross-sectional survey was conducted to collect 3631 serum samples from healthy children aged 1–9 years in Jiangsu Province. The immunoglobulin G (IgG) antibody levels of varicella were detected by enzyme-linked immunosorbent assay (ELISA). Results The VarV coverage rate of healthy children was only 43.1% (95% CI: 41.1–44.7%). The seroprevalence after vaccination with a single dose of VarV was only 57.1%, and the overall seropositivity and geometric antibody titre (GMC) were 43.5% and 225.4 mU/ml, respectively. The seropositivity was significantly higher in girls than in boys (χ2 = 18.82, P < 0.001). The difference in seropositivity between the 5–9 age group and 1–4 age group was statistically significant (χ2 = 84.31, P < 0.001). The difference in seropositivity between different regions was statistically significant, with the highest seropositivity in the northern area, 53.7% (χ2 = 35.64, P < 0.001). The seropositivity in the group receiving one dose of VarV was significantly higher than that of the unvaccinated group (χ2 = 205.16, P < 0.001). Linear regression analysis suggested that the GMC of varicella antibodies wanes with the time since vaccination (F = 65.01, P = 0.002). Conclusion The VarV coverage rate of healthy children in Jiangsu Province was low. Sero-conversion rates were also low after one dose of VarV, and the immune effectiveness of a single dose of VarV was limited. To control the spread of varicella, VarV should be included in the routine immunization program, and strengthened immunization measures for the varicella-susceptible population warrant additional consideration.
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Affiliation(s)
- Lei Zhang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu Province, China
| | - Wang Ma
- First Affiliated Hospital of Nanjing Medical University, Nanjing, 211166, Jiangsu Province, China
| | - Yuanbao Liu
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu Province, China
| | - Yong Wang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu Province, China
| | - Xiang Sun
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu Province, China
| | - Ying Hu
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu Province, China
| | - Xiuying Deng
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu Province, China
| | - Peishan Lu
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu Province, China
| | - Fenyang Tang
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu Province, China
| | - Zhiguo Wang
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu Province, China.
| | - Minghao Zhou
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu Province, China. .,Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu Province, China.
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Time to Rethink Refugee and Migrant Health in Europe: Moving from Emergency Response to Integrated and Individualized Health Care Provision for Migrants and Refugees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061100. [PMID: 29843445 PMCID: PMC6024938 DOI: 10.3390/ijerph15061100] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/22/2018] [Accepted: 05/25/2018] [Indexed: 11/17/2022]
Abstract
In the last three years, the European Union (EU) is being confronted with the most significant influx of migrants and refugees since World War II. Although the dimensions of this influx-taking the global scale into account-might be regarded as modest, the institutional response to that phenomenon so far has been suboptimal, including the health sector. While inherent challenges of refugee and migrant (R&M) health are well established, it seems that the EU health response oversees, to a large extend, these aspects. A whole range of emergency-driven health measures have been implemented throughout Europe, yet they are failing to address adequately the changing health needs and specific vulnerabilities of the target population. With the gradual containment of the migratory and refugee waves, three years after the outbreak of the so-called 'refugee crisis', we are, more than ever, in need of a sustainable and comprehensive health approach that is aimed at the integration of all of migrants and refugees-that is, both the new and old population groups that are already residing in Europe-in the respective national health systems.
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