Table 1 National and international guidelines with recommendations regarding infectious diseases, including respiratory infectious diseases
Guideline | Main recommendations regarding particular issues | ||||
|---|---|---|---|---|---|
Region/Country | Guideline | Vaccinations | Screening or other diagnostic assessment | Health-literacy | Housing |
Europe[21] | European Centers for Disease Control and Prevention (ECDC) / WHO regional office for Europe | Country specific vaccination schedule should be implemented for all refugees/asylum seekers/migrants staying for one week or more Main priority should be MMR and Polio vaccines Vaccination should not be implemented at border crossings unless in the presence of an outbreak | Regarding less of their legal status equitable and non-discriminatory access to essential health care services with preventive and curative interventions should be granted to all refugees and asylum seekers All member countries should be prepared at any time to epidemiologically assess and adequately react to any outbreak situation | None | Overcrowding should be avoided (not giving numbers) Clean sanitary institutions and clothing should be available |
Switzerland[20] | Schweizerische Gesellschaft für Infektionskrankheiten | Following the same vaccination schedule as for indigenous previously unimmunised adults/children Vaccination only valid when written documentation is available | All refugee children under 5 y.o. Should be screened for TB using tuberculin skin test regardless of BCG vaccination status and country of origin All adults and children > 5 y.o. Should be screened for TB only in case of symptoms using IGRA or TST on Syphilis Screening for all children < 2 y.o. And all juvenile refugees 12–15 y.o | None | None |
Robertkochinstitut | Documentation of vaccination status Valid documentation leads to enrolment of national vaccination schedule for all residents Invalid documentation leads to accomplishment of separate minimum vaccination schedule All refugees should be vaccinated against influenza not only high risk population | Examination not focussing on personal health status but on outbreak prevention in the first line General anamnesis focussing on infectious diseases Full body examination including vital parameters focussing on infectious diseases and rashes Screening for active lung TB by x-ray (exceptions for pregnant women and children under 15 y.o | None | None | |
Australia[13] | Australian Government—Departement of Health | Vaccination status of refugees is not routinely assessed, differing by states All refugees arriving to Australia should receive vaccination catch-up vaccinations Pre-departure vaccinations and valid documentations of previous vaccinations should be considered and all vaccinations to children under 7 y.o. Should be reported to ACIR (Australian Childhood Immunisation Register) | In all arriving people with refugee-like background a general assessment regarding HIV, disability, strongyloides serology and other should be conducted Some assessments like syphilis serology, vitamin- or ferritin status should be conducted by individual risk Some assessments like Malaria status, Hepatitis C and Schistosoma serology should be conducted by respective country of origin | None | None |
USA[14] | Centers for Disease Control and prevention | Vaccination only valid when written documentation is available Overseas vaccination program implemented by registered physicians before departure to US consisting of two doses of several vaccines with 1–2 months of time in between -post-arrival after assessment of immunization status an age-adjusted vaccination schedule will be implemented. Serologic testing may be used for evaluating vaccination-status | If possible medical examination by special physicians will be implemented before departure from overseas. Except from vaccination status assessment there will be also presumptive treatment with albendazole enrolled Broad medical examination by special physicians implemented during the first months after arrival in the US. Physical status as well as nutritional status, lead-test, laboratory testing and age adjusted TB screening will be assessed. Vaccination coverage is assessed and records from former overseas examination will be checked and completed | None | None |
Canada[16] | National Advisory Committee on Immunization (NACI) Committee to Advise on Tropical Medicine and Travel (CATMAT) https://www.canada.ca/en/public-health/services/canadian-immunization-guide.html | Vaccination status is assessed prior to arrival with only documented proof of vaccination accepted as valid Catch-up schedule is oriented to country of origin and age of individual -MMR and Varicella vaccination should not be given in case of suspected active tuberculosis | Before arriving in Canada refugee claimants are enrolled in Immigration Medical Examinations TB-screening using TST is implemented to migrants from high-risk countries Laboratory examinations are implemented after arrival in Canada checking for full blood cell count, sickle cell status, HIV status (when coming from high-burden countries) and other | None | None |
United Kingdom[17] | National Institute for Health Care Excellence https://www.gov.uk/government/collections/migrant-health-guide-countries-a-to-z | Vaccination status of refugees residing in the UK should always be assessed by physicians. Age adjusted national catch-up-schedule is implemented | Existing assessment guidelines for many different countries: every country of origin has its respective schedule for migrant health Newly arriving migrants are evaluated by assessing their psycho-social status, sexual-behaviour, ethinicity and risk of communicable diseases, as well as personal health issues such as hearing, seeing and risk factors for chronic diseases LTBI screening is implemented for all immigrants having spent significant time or being born in high-risk areas using TST or IGRA -active TB screening is implemented to all immigrants migrating from high incidence countries using chest x-ray | Newly arriving migrants should be informed how the NHS works and how it differs to health systems they are used to | None |