This year, the world watched the emergence of a new strain of influenzavirus. Health officials are still closely monitoring the spread of theH1N1 virus and taking steps to protect vulnerable people - especiallyimmigrants and refugees - from the disease.
Immigrants becomevulnerable because moving from one country to another - especiallyunder stressful circumstances - can be an emotionally wrenchingexperience. Research shows that immigration is also a physicallyexhausting process that leaves immigrants and refugees more vulnerableto disease.
For example, immigrants and refugees tend to have alower rate of immunization, says Tulane University public health expertMaureen Lichtveld.
"Just the regular immunization? just thestress and irregularity of moving and being part of a new country and anew community brings that with it? the process of moving and theprocess of acculturation and a new society brings with it unprecedentedlevels of stress," Lichtveld says. "Also, learning a new language,getting a new job, all things that make you more vulnerable in general."
Lichtveldsays these kinds of stressors put refugees and immigrants at higherrisk of a disease such as pandemic flu - regardless of the countrythey're coming from or going to. She says that as a result, they alsotend to have a higher rate of infectious diseases.
Lichtveld anda group of public health experts worked together to createrecommendations to address the vulnerabilities among refugees andimmigrants. They determined the best interventions that should be doneby governmental and non-governmental organizations, other measures thatcan be done by individual health care providers and, finally, actionsthat can taken at the community level.
"We need to worktogether to make sure that communities are engaged and understand andwill collaborate when we provide the advice - as we did with the recentH1N1 outbreak - to remain at home when you are ill," Lichtveld says.
"Weneed to be able to make sure that we can indeed implement voluntaryisolation and quarantine, that when we advise to take personalprotective measures that those indeed are implemented."
Lichtveldand her colleagues also recommended that mental health issues beaddressed aggressively during and after an incident such as a diseaseoutbreak. She says, unfortunately, mental health is often anafterthought in the response strategy.
"Mental health is one ofthe longest and longest lasting adverse impacts of a disaster,"Lichtveld says. "And you can look at the pandemic flu, in fact, as adisaster."
She says outbreaks like pandemic flu put added stresson people who are already trying to acculturate to a new area. Thesepandemics create fear and anxiety in people who already are unsure oftheir place a new society and often don't know where to turn for help.
Lichtveldsays public health leaders have learned from other infectious diseaseoutbreaks. She says they need to apply the lessons learned to allmembers of their society, even the newest ones.
Her paper is published in the .