The ability to give immigrants the care they need , and citizens the protection to which they are entitled is a difficult but vital and achievable outcome for the stability of the nation .”
the chain of transmission . The public concern on this subject can be even more readily seen when considering the un-quarantined immigration nurse Kaci Hickox from Sierra Leone . While debate surrounded her medical state upon arrival , even after she was declared pathogen-free , many persons thought she should still be kept in isolation . While the reaction of American society was mostly due to gargantuan amounts of media coverage and disturbing symptoms of Ebola , a lesson applicable to all forms of infectious disease can be learned . That lesson is : infectious disease is spread from person to person , and therefore immigration is commonly agreed upon by both the public and scientific sectors as a hazard for the introduction of disease . This conclusion does not mean that immigration should be halted , but rather than those responsible for the safety of public health should be given the information and tools they require to make wise decisions regarding this issue .”
Dallas , et al . ( 2018 ) continue , “ Indeed , simply possessing these tools has obviously not been enough , as judged by the imperfect outcomes seen thus far in cross-border transfer of disease . The ability to give immigrants the care they need , and citizens the protection to which they are entitled is a difficult but vital and achievable outcome for the stability of the nation . The actualization of this outcome is a constant struggle due to the gap that often exists in the primary missions that are perceived between security and public health officials , whose goals are not always aligned . The growth of these two elements as a synchronized system is imperative to the future of cross-border disease control .”
Taking the opposite position is the World Health Organization ( WHO ), which asserts that there is no systemic association between migration and communicable diseases : “ In spite of the common perception of an association between migration and the importation of infectious diseases , there is no systematic association . Communicable diseases are associated primarily with poverty . Migrants often come from communities affected by war , conflict or economic crisis and undertake long , exhausting journeys that increase their risks for diseases that include communicable diseases , particularly measles , and food- and waterborne diseases .”
Regarding tuberculosis , WHO says migrants ’ risk for being infected or developing TB depends on the TB incidence in their country of origin ; the living and working conditions in the country of immigration , including access to health services and social protection ; whether they have been in contact with an infectious case ( including the level of infectiousness and how long they breathed the same air ); and the method of travel ( the risk for
infection being higher in poorly ventilated spaces ). WHO insists that , “ TB is not easily transmissible , and active disease occurs in only a proportion of those infected ( from 10 percent lifetime risk to 10 percent per year in HIV-positive people ) and within a few months or a few years after infection . TB is not often transmitted from migrants to the resident population because of limited contact .”
Regarding influenza and other common respiratory infections , WHO asserts that refugees and migrants do not pose an increased threat for further spread of respiratory infections from influenza viruses , respiratory syncytial virus , adenovirus , parainfluenza virus to the populations of the receiving countries , where these are common infections that circulate widely . WHO adds that it “ supports policies to provide seasonal influenza vaccine to risk groups , irrespective of their legal status .”
Regarding vector-borne diseases , WHO does acknowledge that “ the risk for reintroduction and localized outbreaks of vector-borne diseases such as malaria and leishmaniasis can be increased by a mass influx of refugees . WHO recognizes “ the continual threat of reintroduction and the need for continued vigilance to ensure that any resurgence can be rapidly contained .”
WHO also does not recommend obligatory screening of refugee and migrant populations for diseases ; it asserts , “ There is no clear evidence of benefits ( or cost-effectiveness ); furthermore , it can cause anxiety in individual refugees and the wider community . WHO strongly recommends , however , that health checks be offered and provided to ensure access to healthcare for all refugees and migrants requiring health protection . Checks should be performed for both communicable diseases and NCDs , while respecting the human rights and dignity of refugees and migrants . The results of screening must never be used as a reason or justification for ejecting a refugee or a migrant from a country . Obligatory screening may deter migrants from asking for a medical check-up , thus jeopardizing identification of high-risk patients .”
WHO notes further , “ Triage is recommended at points of entry to identify health problems in refugees and migrants soon after their arrival . Proper diagnosis and treatment must follow , and the necessary health care must be ensured for specific population groups ( children , pregnant women and the elderly ). Every person on the move must have full access to a hospitable environment , to prevention ( such as vaccination ) and , when needed , to high-quality health care , without discrimination on the basis of gender , age , religion , nationality , race or legal status . This is the safest way to ensure that the resident population is not unnecessarily exposed to imported infectious agents . WHO supports policies to provide healthcare services to migrants and refugees irrespective of their legal status , as part of universal health coverage .”
WHO also calls for healthcare access for refugees and migrants : “ Legal status is one of the most important determinants of the access of migrants to health services in a country . Each refugee and migrant must have full , uninterrupted access to a hospitable environment and , when needed , to high-quality health care , without discrimination based on gender , age , religion , nationality or race . WHO supports policies to provide healthcare services irrespective of migrants ’ legal status . As rapid access to healthcare can result in cure , it can avoid the spread of diseases ; it is therefore in the interests of both migrants and the receiving country to ensure that the resident population is not unnecessarily exposed to the importation of infectious agents .”