Introduction to the Risk of Introducing Tropical Diseases by Migrants and Refugees

Travellers, regardless of their status, including students, tourists, businesspeople, and migrants, pose a risk of introducing new diseases to other areas, especially when crossing borders. This risk is particularly relevant to refugees and migrants, who often traverse long distances and may be in a state of poor health upon arrival. However, the risk of introducing tropical diseases from temperate regions into temperate areas is relatively low given the improved living conditions and healthcare systems in these regions. This article explores whether the risk is substantial and the mitigating factors that reduce it.

General Traveler and Health Risks

Everyone who travels over large distances increases the risk of introducing new diseases to other areas. This includes exchange students, tourists, business people, migrants of all sorts, and refugees. Social status does not affect this risk. Every sick person who crosses borders is a potential risk factor. Nonetheless, if someone traveling from a country with different illnesses is informed and receives medical attention upon the onset of symptoms, the risk can be mitigated. However, this is less effective for illegal immigrants who may not seek medical attention.

Europe, in particular, poses a unique case. Many refugees travel for a prolonged period, spending significant time in non-tropical countries before reaching southern Europe. By this time, they are likely to have been checked by medical staff. Therefore, the fear of introducing tropical diseases through this route is not a reasonable concern. Instead, regular air travel and the transport of goods between continents pose a much greater threat due to the rapid spread and cross-contamination that can occur.

Refugee Disease Profiles and Risk Assessment

Most refugees today live in urban areas, and their disease profiles reflect a world where most people live in cities and towns. This means that they typically have chronic diseases rather than tropical infectious diseases. When these refugees move to temperate areas, particularly those with good water and sanitation as norms, they pose a minimal risk for introducing tropical diseases.

In refugee camps, however, the disease profile changes. Here, the most common diseases are infectious in nature, such as malaria, measles, diarrhoea, and acute respiratory infections. However, the risk of introducing these diseases to temperate areas is limited. For instance, moving from a malaria-free zone to a zone where malaria is prevalent poses a greater risk, especially if the refugees have not developed any immunity to it. Measles can be easily vaccinated against, and while diarrhoea may have multiple causes, good water sanitation and hygiene, and access to health services can prevent its transmission.

Acute respiratory infections are influenced by overcrowding, under-nutrition, exposure to indoor cooking smoke, and other environmental contaminants. While these factors increase the risk of transmission in refugee camps, the overall risk of introduction to temperate areas is low due to better health care systems and living conditions.

Conclusion: Mitigating the Risk

Given the improved living conditions, less conducive climate for disease spread, and stronger health care systems in temperate regions, the risk of refugees and migrants introducing tropical diseases is minimal. While it is important to remain alert and provide resources for proper medical care, the current evidence suggests that regular travel and international trade pose a greater risk for the spread of diseases. Therefore, efforts should focus on addressing and preventing diseases in refugee camps and improving health care in both the source and destination regions.