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Migration Induced Biological Health Hazard – (multidrug-resistant pathogens), MRSA: Denmark

2017/06/12

Destitute migrants from throughout the Middle East and Africa often arrive with nothing but the clothes on their backs — a destructive culture in their heads, and Third World invasive diseases in their bodies, which often include highly infectious “superbugs.”

According to WHO’s infectious disease surveillance of priority pathogens, many of these superbugs – such as MRSA, salmonella, certain strains of E. coli, and Multidrug-resistant Tuberculosis (MDR-TB) – are rapidly becoming untreatable with antibiotics.

A recent study in Denmark revealed that refugees were more than five times as likely to have HIV as Danish-born citizens. The researchers said that refugees were also more likely to seek medical help at a late stage, increasing the risk of transmission.

Another inconvenient truthExotic Diseases Invade Europe Along With Refugees


ANTIBIOTIC RESISTANCE (06): DENMARK, MRSA, ASYLUM SEEKERS
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Published Date: 2017-06-11 16:29:15
Subject: PRO/EDR> Antibiotic resistance (06): Denmark, MRSA, asylum seekers
Archive Number: 20170611.5098312

Date: Fri 9 Jun 2017 8:47 am
Source: CPH Post [edited]

A new report from the State Serum Institute (SSI) has revealed that Denmark saw the highest ever number of cases involving the antibiotic-resistant bacteria MRSA last year [2016].

The report showed there were 3550 new cases in 2016 – a considerable jump from the 2973 instances that occurred in 2015. According to SSI, asylum-seekers accounted for part of the increase.

“MRSA among asylum-seekers was calculated in 2015 and 2016, as they often come from areas with a high MRSA prevalence and are only offered PRSA [?Penicillin resistant staph aureus] treatment in Denmark if logistical conditions permit it,” SSI wrote.

“One part of the observed increase among asylum-seekers is due to a changed and more thorough registration practice and screening activity. It is recommended that asylum-seekers who are living or have lived in an asylum centre within the last 6 months are checked for MRSA at the hospital.”

The report also showed that there continues to be a very low prevalence of MRSA cases stemming from the hospital industry, which indicates that the national MRSA guidelines are working according to intentions.

The number of people who were infected during a hospital visit was at just 43 last year [2016], compared to 40 in 2015.

Furthermore, the SSI figures found there was a small increase in the number of cases involving MRSA in farm animals (the so-called CC398 bacteria) – up to 1249 from 1173 in 2015.

Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[According to the European Union (EU), migrants and asylum seekers entered the EU in record numbers since the summer of 2015. In 2015, over 2.6 million people arrived in Europe from non-EU countries. Most are men and about 30 percent were from Syria. Most (about 1 million) entered Germany in 2015 with a population of about 81 million; 37 100 entered Denmark with a population of about 5.7 million, and 82 800 entered the Netherlands with a population of about 16.9 million, having been born in non-EU countries (http://ec.europa.eu/eurostat/statistics-explained/index.php/File:Immigration_by_country_of_birth,_2015_(¹).png).

Migrants might bring infectious diseases that are endemic in their countries of origins to the EU, the risk being dependent on the incidence in their country of origin. For example, the incidence of TB ranges as low as 17 new cases per 100 000 population in the Syrian Arab Republic to 338 in Nigeria; the average TB rate in the European Region is 39 per 100 000 population (http://www.euro.who.int/en/health-topics/health-determinants/migration-and-health/migrant-health-in-the-european-region/migration-and-health-key-issues).

Outbreaks of scabies and louse-borne relapsing fever in migrants in the EU have been reported by ProMED-mail in the past, attributable to the poor living conditions in migrant camps. (see also’s below). The risk for importation of Middle East respiratory syndrome (MERS) is low, but WHO has noted that “the MERS outbreak in the Republic of Korea demonstrates that this possibility cannot be excluded” (http://www.euro.who.int/en/health-topics/health-determinants/migration-and-health/migrant-health-in-the-european-region/migration-and-health-key-issues). The WHO in this article also noted a risk for importation of viral hepatitis, vector-borne diseases such as malaria and leishmaniasis, and antimicrobial resistance.

In fact, similar to the news report above from Denmark, a high prevalence of MRSA and ESBL was recently reported among asylum seekers in the Netherlands, a EU country with a low prevalence of multidrug-resistant organisms compared to other countries in Europe (1). The abstract is reproduced below:

“Migration is one of the risk factors for the spread of multidrug-resistant organisms (MDRO). The increasing influx of migrants challenges local health care systems. To provide evidence for both hospital hygiene measure and empirical antibiotic therapy, we analysed all cultures performed in asylum seekers between January 1st 2014 and December 31st 2015 for methicillin resistant _Staphylococcus aureus_ (MRSA) and for multidrug-resistant Enterobacteriaceae (MDRE). We compared these with cultures from the Dutch patient population with risk factors for carriage of MDRO. A total of 7181 patients were screened for MRSA. 7357 _S. aureus_ were isolated in clinical cultures. Of 898 screened asylum seekers, almost 10 percent were MRSA positive. Of 118 asylum seekers with _S. aureus_ in clinical cultures almost 19 percent were MRSA positive. The general patient population had a 1.3 percent rate of MRSA in _S. aureus_ isolates. A higher rate of Panton-Valentine leukocidin (PVL) positive strains (RR: 2.4; 95 percent CI: 1.6-3.4) was found in asylum seekers compared to the general patient population. In 33 475 patients one or more Enterobacteriaceae were obtained. More than 21 percent of the asylum seekers were carrier of MDRE, most of them producing extended spectrum beta-lactamases (20.3 percent). 5.1 percent of the general patient population was MDRE carrier. It can be concluded that asylum seekers present with higher rate of MDRO compared to the general patient population. These results justify continued screening of asylum seekers to anticipate multidrug-resistant organisms during hospital care of patients.”

1. Ravensbergen SJ, Berends M, Stienstra Y, Ott A. High prevalence of MRSA and ESBL among asylum seekers in the Netherlands. PLOS One Published: April 25, 2017. https://doi.org/10.1371/journal.pone.0176481. – Mod.ML

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/111.]

See Also

Antibiotic resistance (02): WHO, priority pathogens, 20170301.4871299

2016
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Antibiotic resistance (02): UN General Assembly 2016, WHO Global Action Plan 20160923.4511617

2015
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Tuberculosis – Europe: report, ECDPC, WHO, 2015 20150319.3241714
Scabies – Switzerland: (SG) asylum seekers 20151130.3829354
Louse-borne relapsing fever – Italy: asylum seekers, poss local transmission 20151110.3779157
Louse-borne relapsing fever – Germany (02): asylum seekers 20150911.3638819
Louse-borne relapsing fever – Germany: asylum seekers, ex East Africa 20150903.3620174
Louse-borne relapsing fever – Netherlands: asylum seekers, ex Eritrea 20150731.3549645
………………………………………….sb/ml/ec/mpp

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


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