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Health risks of migrants to UK can last for years after arrival

GPs have key role in ensuring prompt and culturally sensitive treatment, says Health Protection Agency

Caroline White

Wednesday, 21 December 2011

Some migrants to the UK have disproportionately high rates of infectious disease and can have increased health risks for several years after arrival, reveals the second report on migrant health published by the Health Protection Agency.

The report, which draws on surveillance data from 2005 to 2010, shows that in 2010 more than one in 10 (12%) people living in the UK were estimated to have been born abroad, up from 8% in 2001.

Most long term migrants have similar health concerns to indigenous residents of the same age, shows the report.

But last year almost three out of four (73%) of TB cases, almost 60% of newly diagnosed cases of HIV, and 80% of hepatitis B infected UK blood donors were born abroad. Furthermore, UK residents born overseas can have increased health risks for many years after arrival in the UK, says the report.

More than three quarters (77%) of TB cases among those born outside the UK in 2010 were diagnosed two or more years after arrival in the UK, and half of men who have sex with men with a newly diagnosed HIV infection between 2001 and 2010 had probably acquired their infection within the UK.

UK residents travelling to visit friends and relatives in their country of origin are also the main risk group for infections diagnosed in the UK, such as malaria and enteric fever, says the HPA.

Where information was available, 61% of malaria cases reported in the UK in 2010 and 87% of enteric fever cases in England, Wales and Northern Ireland were in non-UK born residents who had returned from trips to their country of origin, the figures show.

Dr Jane Jones, Head of the Travel and Migrant Health Section at the HPA, said: “The majority of non-UK born residents do not have infectious diseases but some are at higher risk than UK born residents because of their exposures and their life experiences prior to, during, and after migration.”

Timely identification of risk and diagnosis of infection can improve health outcomes. Primary care practitioners in particular play a vital role in identifying people at risk and ensuring appropriate management, and it is important to remember that risk to the non-UK born residents does not end on arrival in the UK,” she added.

UK doctors need to be particularly vigilant, warns the report, as they are unlikely to be familiar with with the clinical presentation of some infectious diseases that are rarely diagnosed in the UK. For example, Chagas disease has currently only been reported in a small number of migrants from South America and is likely to be underdiagnosed, it says.

UK residents born overseas need access to culturally competent and language supported services, recommends the report, which emphasises the importance of a co-ordinated approach to assessing a new migrant patient’s health needs, including improving the collection of country of birth information an indicator of possible risk.

Earlier this year, the HPA launched an online Migrant Health Guide in a bid to assist primary care practitioners caring for people who have come to live in the UK from abroad.

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