Abstract
BackgroundAustria has been among the main European countries hosting incoming asylum seekers since 2015. Consequently, there was an urgent need to predict any public health threats associated with the arriving asylum seekers. The Department of Surveillance and Infectious Disease Epidemiology at the Austrian Agency for Health and Food Safety (AGES) was mandated to implement a national syndrome-based surveillance system in the 7 reception centers by the Austrian Ministry of Interior and Ministry of Health.ObjectiveWe aimed to analyze the occurrence and spread of infectious diseases among asylum seekers using data reported by reception centers through the syndrome-based surveillance system from September 2015 through February 2018.MethodsWe deployed a daily data collection system for 13 syndromes: rash with fever; rash without fever; acute upper respiratory tract infection; acute lower respiratory tract infection; meningitis or encephalitis; fever and bleeding; nonbloody gastroenteritis or watery diarrhea; bloody diarrhea; acute jaundice; skin, soft tissue, or bone abnormalities; acute flaccid paralysis; high fever with no other signs; and unexplained death. General practitioners, the first professionals to consult for health problems at reception centers in Austria, sent the tally sheets on identified syndromes daily to the AGES.ResultsWe identified a total of 2914 cases, presenting 8 of the 13 syndromes. A total of 405 signals were triggered, and 6.4% (26/405) of them generated alerts. Suspected acute upper respiratory tract infection (1470/2914, 50.45% of cases), rash without fever (1174/2914, 40.29% of cases), suspected acute lower respiratory tract infection (159/2914, 5.46% of cases), watery diarrhea (73/2914, 2.51% of cases), and skin, soft tissue, or bone abnormalities (32/2914, 1.10% of cases) were the top 5 syndromes.ConclusionsThe cooperation of the AGES with reception center health care staff, supported by the 2 involved ministries, was shown to be useful for syndromic surveillance of infectious diseases among asylum seekers. None of the identified alerts escalated to an outbreak.
Highlights
BackgroundSince 2015, over 1.5 million refugees and asylum seekers have reached Europe [1], where Austria, Sweden, and Hungary were the top 3 countries per capita in hosting this vulnerable population [1]
The surveillance included 13 syndromes (Table 2), which we selected according to the infectious disease risks assessed for asylum seekers in Austria and to the European Centre for Disease Prevention and Control (ECDC)’s assessment for risks related to asylum seekers in Europe [13,14,15]
The syndromes were rash with fever; rash without fever; suspected acute upper respiratory tract infection (URTI); suspected acute lower respiratory tract infection (LRTI); meningitis or encephalitis; fever and bleeding; non–bloody gastroenteritis or watery diarrhea; bloody diarrhea; acute jaundice; skin, soft tissue, or bone abnormalities; acute flaccid paralysis; high fever with no other signs; and unexplained death
Summary
Since 2015, over 1.5 million refugees and asylum seekers have reached Europe [1], where Austria, Sweden, and Hungary were the top 3 countries per capita in hosting this vulnerable population [1]. The majority of these asylum seekers came from Syria (49%), Afghanistan (21%), and Iraq (9%) [2,3]. Conclusions: The cooperation of the AGES with reception center health care staff, supported by the 2 involved ministries, was shown to be useful for syndromic surveillance of infectious diseases among asylum seekers.
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