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The number of asylum seekers entering the Netherlands has increased. However, the screening, detection and treatment of infectious diseases in asylum seekers has barely changed over the last 15 years. Infectious diseases, including vaccine-preventable diseases are being carried into the Netherlands by asylum seekers. However, neither the number nor the type of disease pose a real threat to public health. It is important to be alert to carriers of multidrug-resistant organisms among asylum seekers. National screening programmes are offered for a number of infectious diseases, but not for all diseases relevant to asylum seekers. Hygiene and sanitary facilities are essential in the care of asylum seekers, due mainly to the relatively high prevalence of scabies. Infectious disease control for asylum seekers in the Netherlands can be improved. Focusing on the country of origin is important. The current European Centre for Disease Prevention and Control Guidelines concerning medical care for asylum seekers should be implemented in the Netherlands.

Objective: To study the extent to which follow-up diagnostics, referral to secondary care and follow-up are in accordance with the practice guideline of the Dutch College of General Practitioners 'Viral hepatitis and other liver disorders' after a hepatitis B (HBV) or C (HCV) infection has been diagnosed at the general practice., Design: Retrospective cohort study., Method: Patient records were obtained from the Dutch 'Integrated primary care information' (IPCI) database which contains data from patients from general practices. Records of patients with a first-time positive HBsAg or anti-HCV test result in the period between 2008 and 2015 were manually validated and data on follow-up diagnostics, referral and follow-up were found., Results: A total of 117 patients tested positive for HBsAg and 101 patients tested positive for anti-HCV. Most HBV patients were subsequently tested for HBeAg (92%) and ALT (80%). Of the 41 HBV patients who were eligible for referral, 37 (90%) were actually referred to a specialist. 49 HCV patients (49%) were found negative after a confirmation or RNA test. 87% of the remaining 52 HCV patients were referred (n = 45). 21 (43%) of the 49 HBV patients who were not eligible for referral were tested for ALT after an average of 11.5 months. 14 (29%) of these patients subsequently received a second follow-up ALT test and 8 (16%) received a third., Conclusion: Almost all HBV and HCV patients who are eligible for referral, are actually referred to a specialist. Most HBV patients received the correct follow-up diagnostics after a positive HbsAg test result. However, in few HBV patients who were not eligible for referral, was the ALT level checked every year for three years. The general practitioner, as well as the patient, should receive a reminder for this.

Objective: To gain insight into how the Dutch general public viewed the risk during the course of the recent pandemic, into how many and which people took precautionary measures, and into the extent to which people trust the information provided by the government., Design: Online survey, cross-sectional (the first two measurements) and follow-up investigations (the last two measurements)., Method: Between 10 and 17 November 2009, 754 people completed the online questionnaire. Earlier survey rounds were held in May (n = 572), June (n = 620) and August (n = 934)., Results: In November 2009, 38% of respondents considered the Mexican flu a serious disease and 36% viewed themselves as vulnerable to this flu. Feelings of anxiety had decreased versus earlier survey rounds. Of the respondents, 73% took precautionary measures against the disease. This concerned mainly hygiene measures, which were most frequently taken by people who were anxious, found hygiene measures effective, paid considerable attention to the media information on flu, and found information from the government reliable and those without children living at home. More than fifty percent (58%) of respondents indicated that they would be willing to have the vaccination if they would be eligible for this. Of the other 315 respondents, 40% indicated that they feared serious side effects, 35% that they doubted the effectiveness of the vaccine and 33% that they considered the vaccine to be insufficiently tested. Almost half of the respondents had read the information leaflet 'Fight the flu', which was sent to every home in the country. One third had seen the television campaign. Governmental institutions, notably the Ministry of Health, Welfare and Sport and the National Institute for Public Health and the Environment, were the most important sources of information and more than half of the respondents trusted this information., Conclusion: During the course of the 2009 influenza A (H1N1) pandemic, anxiety among the Dutch general public decreased progressively, while people increasingly considered themselves more vulnerable to the flu. The public therefore had a realistic view of the situation. Three quarters of the general public had taken precautionary measures against the flu. More than fifty percent would be willing to have the vaccination if they would be eligible for this. The most important reason for not wanting the vaccination was fear of serious side effects and doubts about the effectiveness of the vaccine. This is a point of attention for the development of public information campaigns about vaccinations in the future.

Risk perception of avian influenza in the Netherlands: high level of risk perception, but limited trust in protective measures Aim : To describe risk perception of avian influenza in the Netherlands in March 2006. To gain insight in the level of knowledge, precautionary actions, response and self efficacy, and use of media related to avian influenza. Methods : Through an Internet panel 579 respondents filled in an online questionnaire. Results . Risk perception of avian influenza in the Netherlands is, especially in case of an outbreak, high, 3,51 (scale 1 - 5). 23,7% of respondents believe that protection against avian influenza is possible, while 28,2% feel that they are able to protect oneself. A higher level of response and self efficacy is related to a lower level of risk perception. Respondents with an higher risk perception have taken more precautionary actions. 38% of respondents had taken at least one precautionary action. All respondents had heard of avian influenza, but knowledge was limited, 2,33 (scale 1 - 4). Television was the most important source of information. Conclusions : Risk perception of avian influenza is relatively high in the Netherlands at a time when no infections were reported. The low levels of response and self efficacy warrant attention so that advice about preventive measures will be adhered to in case of an outbreak., (© Bohn Stafleu van Loghum 2007.)