Handbook on implementing syndromic surveillance in migrant reception/detention centres and other refugee settings : technical document

The large volume of asylum seekers and irregular migrants entering continental Europe constitutes a public health challenge. Migrant facilities in many European Union (EU) Member States have the potential to be overwhelmed with much higher numbers of migrants than the sites were originally designed for. Although migrants entering Europe tend to be in relatively good health, crowded living situations favour communicable disease spread. In 2015, an ECDC-sourced Expert Opinion on public health measures in migrant centres and refugee settings recommended developing guidance on the implementation of syndromic surveillance. At the same time, numerous country visits of the WHO PHAME project (Public Health Aspects of Migration in Europe) and of the International Organization for Migration (IOM) EQUI-HEALTH project 'Fostering Health Provisions for Migrants, Roma and Other Vulnerable Groups' flagged the need to develop or strengthen health information systems, including syndromic surveillance, in these settings. The objective of this handbook is therefore to assist public health authorities in developing syndromic surveillance protocols that complement routine surveillance in migrant reception/detention centres and refugee hosting sites (hereafter referred to as 'migrant centres'). Such protocols can assist in the detection of events such as large outbreaks or single cases of outbreak-prone conditions that would require an assessment in order to trigger and guide an appropriate public health response. The handbook considers both the technical and practical aspects of establishing syndromic surveillance systems. The technical examples and the suggested key phases of syndromic surveillance implementation are based on scientific evidence and in-the-field experience collected from peer-reviewed literature and other authoritative reports and expert feedback. Participating EU Member States, the IOM and WHO contributed to the review of this handbook.