Table 1.

Emerging infectious diseases and role of migrants, public health officials, and clinicians

Type of Infection	Role of Migrants	Public Health/Policy Role	Role of Clinicians
Acute infectious diseases with risk for local transmission: measles, rubella, varicella, pertussis, hepatitis A	May arrive ill or incubating infection (measles, hepatitis A) May be more susceptible than local population (varicella)	Immunization policy (provide vaccines before arrival for refugees, adoptees) Financing of and access to immunizations for immigrants	Recognition of infections uncommon in the local population Identification of need for and provision of immunizations to immigrants
Infectious diseases with latency or asymptomatic states with some risk for local transmission	May arrive ill or may reactivate disease many years later (TB) Family/community members may need immunization	Culturally appropriate TB programs Financing and provision of access to immunizations	Identification of at-risk individuals and family members and provision of appropriate preventive measures Diagnosis of infection in asymptomatic individual (LTBI, hepatitis B infection)
Infectious diseases with low potential for local transmission	Bear a disproportionate burden of disease in some communities (HIV)	Culturally appropriate treatment programs and prevention initiatives (HIV) Blood screening policies (HIV, Chagas)	Recognition of infections rare in local population (Chagas)
Infectious diseases with oncologic potential	Bear an increased burden of disease (Hepatitis B, C; HPV; H pylori) Have less access to, or less acceptance of, screening procedures (HPV)	Educational initiatives about diseases Provision and financing of screening and immunizations	Screening for infectious diseases Regular monitoring of those infected for development of sequelae Education about transmission, reduction of risk for disease and sequelae Routine cancer screening (Pap smears, colonoscopy, and so forth)
Vector-borne diseases	May arrive infected; may be more likely to visit tropical/subtropical areas with these infections when visiting relatives Intermediate hosts	Monitoring/reduction of vector populations Surveillance	Recognition of diseases rare in the local population