A Syndrome-Based Surveillance System for Infectious Diseases Among Asylum Seekers in Austrian Reception Centers, 2015-2018: Analysis of Reported Data

Ziad El-Khatib; Karin Taus; Lukas Richter; Franz Allerberger; Daniela Schmid

doi:10.2196/11465

A Syndrome-Based Surveillance System for Infectious Diseases Among Asylum Seekers in Austrian Reception Centers, 2015-2018: Analysis of Reported Data

JMIR Public Health Surveill. 2019 Feb 27;5(1):e11465. doi: 10.2196/11465.

Authors

Ziad El-Khatib^{1

2}, Karin Taus¹, Lukas Richter¹, Franz Allerberger¹, Daniela Schmid¹

Affiliations

¹ Department of Surveillance and Infectious Disease Epidemiology, Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria.
² Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.

PMID: 30810535
PMCID: PMC6414818
DOI: 10.2196/11465

Abstract

Background: Austria 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.

Objective: We 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.

Methods: We 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.

Results: We 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.

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. None of the identified alerts escalated to an outbreak.

Keywords: Austria; asylum seekers; epidemiological monitoring; mass health monitoring; population surveillance; public health surveillance; refugee health; refugees; syndrome surveillance system.

©Ziad El-Khatib, Karin Taus, Lukas Richter, Franz Allerberger, Daniela Schmid. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 27.02.2019.