Two studies recently presented at ECCMID 2016 found emerging or resistant infections and dermatologic infestations to be prevalent among refugees seeking asylum in Switzerland and the Netherlands.
These frequently detected diseases represent a “considerable burden” on the European health care system, the researchers wrote, and indicate a need for strict control and monitoring among African and Middle Eastern refugees.
MRSA, ESBL-producing bacteria rates surpass those of European population
“The amount of refugees from unstable or economically very poor regions has increased dramatically in the last years,” the researchers wrote. “For the countries where most refugees come from at the moment — Syria, Afghanistan, Eritrea or Nigeria — data about MRSA and [extended-spectrum beta-lactamase (ESBL)-producing bacteria] prevalence are not present. However, many of these persons will enter our health care system, and more data about colonization of highly resistant pathogens are desired.”
To investigate this issue, researchers examined the prevalence of MRSA and ESBL-producing bacteria within four Swiss refugee centers. Screened refugees were questioned about any skin problems, and were subsequently examined if the response was positive. MRSA was detected using pharyngeal, nasal and inguinal swabs, while ESBL-producing bacteria were identified using standard rectal swab and urine testing procedures.
Among the 261 refugees screened, MRSA and ESBL-producing bacteria were detected at rates of 16.1% and 23.7%, respectively. These findings suggest that the infections are extremely prevalent among these groups, the researchers wrote, and imply that refugees are infected with MRSA at 10 times the rate of the general European population and with ESBL-producing bacteria at a rate of five times greater. While no associations between MRSA and country of origin were identified by regression analysis, ESBL-producing bacteria were frequently found among refugees from the Middle East (P < .001).
30% of African refugees show evidence of scabies
Similar concerns of dermatologic infestation among refugees from regions with high Sarcoptes scabiei prevalence also may be well-founded, according to Dutch researchers.
Since July 2015, the Netherlands’ National Reception Centre for Asylum Seekers instituted a hygiene prevention program for all high-risk asylum seekers. Along with clothes washing with a preventive ivermectin treatment, the program registers and records refugee screening data daily. Researchers examined these data to determine scabies incidence and detect any complications arising from infestation.
There were 1,973 scabies screenings performed among refugees in the Netherlands from July 2015 to November 2015. Thirty percent of screened refugees demonstrated clinical signs of scabies, although this rate ranged from 21% to 38% monthly. The researchers wrote that complications such as abscess formations were frequently observed, and that further data on the screening program’s overall efficacy are forthcoming.
“The prevalence of scabies and its complications is high among asylum seekers from Ethiopia, Eritrea and Somalia,” they wrote. “Rigorously controlling scabies in asylum seekers is important to reduce the risk of complicated cases, reduce strain on the health care [system] and to prevent spread to other patient groups in the proximity of individuals from high-risk countries.”
Beeres D, et al. Abstract 7598. Presented at: European Congress of Clinical Microbiology and Infectious Diseases; April 9-12, 2016; Amsterdam.
Egli A, et al. Abstract 7019. Presented at: European Congress of Clinical Microbiology and Infectious Diseases; April 9-12, 2016; Amsterdam.
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