Study 16 — The Invisible Burden: A Proposal for an Integrated Infectious Disease Screen at Immigrant Health Intake

Background. Four independent studies in the Hidden Infections series have documented a consistent pattern: patients from endemic regions arrive in high-income countries carrying organisms that cause serious, treatable disease. In each case, the organism is not tested for, the resulting harm is attributed to a different diagnosis, and the patient is managed for a condition that is not the underlying cause. The organisms documented across these four studies are Taenia solium (neurocysticercosis; Study 14 ([10.5281/zenodo.20402651](https://doi.org/10.5281/zenodo.20402651))), Trypanosoma cruzi (Chagas cardiomyopathy; Study 3 ([10.5281/zenodo.20402626](https://doi.org/10.5281/zenodo.20402626))), Paragonimus spp. (pulmonary paragonimiasis; Study 5 ([10.5281/zenodo.20402633](https://doi.org/10.5281/zenodo.20402633))), and Strongyloides stercoralis (corticosteroid hyperinfection; the series Strongyloides CEA). No single guideline from the CDC, ECDC, WHO, or any national immigrant health programme currently covers all four organisms in a combined intake screen. Proposal. This paper proposes an integrated single-appointment infectious disease screen at immigrant health intake, combining a...