By all estimates Germany and the Netherlands have witnessed disproportionate numbers of fighters returning from conflict zones; mainly Syria. See: http://www.haaretz.com/news/middle-east/1.576543 While the terror threat is a very real one for Germany, given a number of issues they have struggled with for some time, the Netherlands, has taken a progressive approach to countering the threat posed by would-be terrorists and this approach is likely to result in quite positive consequences to public health security. While Germany and the Netherlands are at an increased risk, compared to other EU states, due to the disproportionate numbers of their populations going off to war zones, of greater concern is the re-introduction of disease into the EU upon return of their citizens. http://www.longwarjournal.org/archives/2013/12/the_german_jihadists.php
"More than a third of Syria's public hospitals are out of action, in some areas 70% of health workers have fled and 4.25 million internally displaced Syrians are living in overcrowded, unsanitary condition, it said. Shortages of safe drinking water and disruption to vaccination programs are increasing the risks With thousands of Syrians crossing the boarders each day, diseases already prevalent inside Syria are being transmitted to neighboring countries, according to the WHO's regional office for the eastern Mediterranean , just days ahead of new United Nations appeals for funds to combat the humanitarian crisis." All the risk factors that enhance the transmission of communicable diseases in emergencies are present in the current crisis in Syria and its neighbouring countries," said Jaouad Mahjour, its director for communicable diseases." :
The number of fighters returning from combat, given the above mentioned situation in country, lack of public health infrastructure, interruption in vaccine campaigns, and highly transmissible disease puts global public health security at risk. Member States within the EU may find themselves increasingly faced with outbreaks of disease which are directly attributable to the return of citizens from Syria. In contrast to others nations such as Pakistan, where Polio is also endemic, the numbers of potentially exposed individuals arriving and spreading disease is relatively low do to immigration controls which are not generally observed with nationals returning to their country of origin for example Germany. As fighters return from Syria and other conflict zones it is important to monitor these individuals, not only in terms of counter-terrorism, but also from a public health standpoint. Health screening is a vital tool. If we consider polio, which is just one of many public health threats facing returning fighters, this statement below puts the threat into context:
"The majority of European countries use inactivated polio vaccine (IPV) instead of oral polio vaccination (OPV), which is a live form of immunization. While IPV is very effective in preventing polio, it only provides partial protection from infection and is less reliable if the virus is circulating. Large numbers of Syrian refugees are leaving Syria for nearby nations and Europe. The potential for polio to be re-introduced into areas that have been free of polio for decades now exists."