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Fabris S, d'Ettorre G, Spagnolello O, Russo A, Lopalco M, D'Agostino F, Vassalini P, Celani L, Aronica R, Gabrielli S, d'Ettorre G, Angeletti S, Mastroianni CM, Ciccozzi M, Ceccarelli G. SARS-CoV-2 Among Migrants Recently Arrived in Europe From Low- and Middle-Income Countries: Containment Strategies and Special Features of Management in Reception Centers. Front Public Health 2021; 9:735601. [PMID: 34917571 PMCID: PMC8669389 DOI: 10.3389/fpubh.2021.735601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/18/2021] [Indexed: 12/19/2022] Open
Abstract
Despite the “migrants and COVID-19” topic has been neglected since felt marginal concerning other aspects of the SARS-CoV-2 pandemic, it represents a relevant public health issue in the European countries. This report describes COVID-19 containment strategies adopted in a large Italian reception center hosting recently arrived asylum-seeker migrants. Risk assessment and prevention measures adopted were described. Geo-spatial epidemiological analysis of the outbreak was reported. Significant gaps in the knowledge of self-protection measures from contagious diseases and in the perception of the pandemic risk were observed in migrants; health promotion activities, targeted to remove cultural barriers and improve behaviors appropriate to individual protection, were able to fulfill this gap. In low-resource settings, especially in closed communities, the implementation of social distancing strategies, the systematic use of individual protection devices, and active syndromic surveillance are essential tools to limit the risk of outbreaks. In the event of an outbreak, it is relevant to rapidly activate containment procedures based on systematic screening, isolation, and quarantine, taking into consideration the limits of tracing contacts within a closed community. Not being able to trace certain contacts, the geo-spatial epidemiological analysis of cases distribution could be key in the management of the outbreak. Interestingly, positive cases identified in our facility were all clinically pauci-symptomatic or asymptomatic. Dedicated strategies are needed to minimize the chance of SARS-CoV-2 transmission in a limited space such as reception centers and a vulnerable population such as migrants.
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Affiliation(s)
- Silvia Fabris
- National Center for Control and Emergency Against Animal Diseases and Central Crisis Unit - Office III, Directorate General for Animal Health and Veterinary Drugs, Italian Ministry of Health, Rome, Italy.,Medical Statistics and Epidemiology Unit, Campus Bio-Medico University, Rome, Italy
| | - Gabriella d'Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.,Infectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy
| | - Ornella Spagnolello
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Maurizio Lopalco
- Medical Center, Extraordinary Reception Center "Mondo Migliore", Rocca di Papa, Italy
| | - Fausto D'Agostino
- Italian Ministry of Health, Rome, Italy.,Anesthesia and Resuscitation Unit, Campus Bio-Medico University, Rome, Italy
| | - Paolo Vassalini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.,Infectious Diseases Unit, Belcolle Hospital, Viterbo, Italy
| | - Luigi Celani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Raissa Aronica
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Simona Gabrielli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.,Unit of Parasitology, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy
| | - Gabriele d'Ettorre
- Unit of Occupational Prevention and Protection, Azienda Sanitaria Locale Lecce, Lecce, Italy
| | - Silvia Angeletti
- Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome, Rome, Italy
| | - Claudio M Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.,Infectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy
| | - Massimo Ciccozzi
- Medical Statistics and Epidemiology Unit, Campus Bio-Medico University, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.,Infectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.,Medical Center, Extraordinary Reception Center "Mondo Migliore", Rocca di Papa, Italy.,Migrants and Global Health Research Organization, Rome, Italy
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Infectious disease outbreaks among forcibly displaced persons: an analysis of ProMED reports 1996-2016. Confl Health 2020; 14:49. [PMID: 32704307 PMCID: PMC7374653 DOI: 10.1186/s13031-020-00295-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 07/15/2020] [Indexed: 01/05/2023] Open
Abstract
Background The United Nations Refugee Agency (UNHCR) estimates the number of forcibly displaced people increased from 22.7 million people in 1996 to 67.7 million people in 2016. Human mobility is associated with the introduction of infectious disease pathogens. The aim of this study was to describe the range of pathogens in forcibly displaced populations over time using an informal event monitoring system. Methods We conducted a retrospective analysis of ProMED, a digital disease monitoring system, to identify reports of outbreak events involving forcibly displaced populations between 1996 and 2016. Number of outbreak events per year was tabulated. Each record was assessed to determine outbreak location, pathogen, origin of persons implicated in the outbreak, and suspected versus confirmed case counts. Results One hundred twenty-eight independent outbreak events involving forcibly displaced populations were identified. Over 840,000 confirmed or suspected cases of infectious diseases such as measles, cholera, cutaneous leishmaniasis, dengue, and others were reported in 48 destination countries/territories. The average rate of outbreak events concerning forcibly displaced persons per total number of reports published on ProMED per year increased over time. The majority of outbreak events (63%) were due to acquisition of disease in the destination country. Conclusion This study found that reports of outbreak events involving forcibly displaced populations have increased in ProMED. The events and outbreaks detected in this retrospective review underscore the importance of capturing displaced populations in surveillance systems for rapid detection and response.
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