Department of Research, Strategic Studies and International Relations 04-09-2024

The 17th WHO Epidemiological Bulletin for South-East Asia underscores the urgent need for coordinated global action to address the rising tide of infectious diseases in the region. From the spread of a new mpox strain to the resurgence of cholera and the relentless advance of dengue fever, the challenges are immense. The WHO’s proactive measures and new guidance offer a roadmap for countries to strengthen their public health responses and mitigate the impact of these diseases on vulnerable populations.

The World Health Organization’s (WHO) 17th Epidemiological Bulletin for South-East Asia, released on August 21, 2024, paints a concerning picture of the region’s ongoing struggles with infectious diseases. The biweekly report sheds light on the critical health challenges facing countries in this part of the world, including a surge in mpox cases, the continued presence of cholera, and a troubling rise in dengue infections. As these diseases spread, the WHO is ramping up its response efforts, guiding how nations can better monitor and control these outbreaks.

Rising Mpox Cases: A Global Public Health Emergency

One of the most alarming updates from the WHO bulletin is the rapid escalation of mpox cases, particularly in the Democratic Republic of the Congo (DRC). The WHO Director-General has declared this upsurge a Public Health Emergency of International Concern (PHEIC), marking it as a significant threat to the African continent and the global community. The new strain, Clade 1b, has been identified as the culprit behind the recent spike in cases. This strain is of particular concern because it is spreading through both sexual and non-sexual contact, leading to outbreaks in countries that had previously not reported mpox.

The situation is especially dire in the DRC, where over 15,600 suspected cases and 537 related deaths have been reported since the beginning of the year. This marks a staggering 160% increase compared to last year. The new Clade 1b has also been detected in neighboring countries like Burundi, Kenya, Rwanda, and Uganda, raising fears of a broader regional spread. Alarmingly, the first case of Clade 1b outside Africa was recently reported in Sweden, underscoring the virus’s potential to become a global issue.

Cholera and Acute Watery Diarrhea: Myanmar and Nepal on Alert

In addition to mpox, the WHO bulletin reports significant outbreaks of cholera and Acute Watery Diarrhea (AWD) in Myanmar and Nepal. In Myanmar, the situation is critical, with over 2,261 cases of AWD reported in the Yangon region alone. Of these, 161 cases involved severe dehydration, and 15 individuals have died, though the exact cause of death remains under investigation. Cholera has been confirmed in some of these cases, prompting a coordinated response from WHO and local health authorities.

Nepal is also grappling with cholera, with clusters of cases reported across several districts. As of mid-August 2024, 58 cases have been confirmed in districts including Lalitpur, Kathmandu, Kailali, and Pyuthan. Fortunately, no deaths have been reported so far, but the Nepalese health authorities are taking no chances. They have launched a series of public health measures, including enhanced surveillance, reactive vaccination campaigns, and widespread dissemination of hygiene and sanitation messages to prevent further spread.

Dengue Fever: A Worsening Crisis in South Asia

The WHO bulletin also highlights the ongoing dengue crisis in South Asia, particularly in Bangladesh, India, and Thailand. Bangladesh has seen a sharp increase in dengue cases, with 1,582 new cases reported in mid-August alone—a 57.1% jump from the previous week. The death toll is also rising, with nine new deaths reported during this period. Overall, Bangladesh has recorded over 9,500 cases and 74 deaths in 2024, a stark reminder of the severe impact of dengue in the region.

India is not faring much better. The states of Kerala and Karnataka are experiencing significant outbreaks, with thousands of new cases reported weekly. In Kerala, over 13,000 cases have been reported so far in 2024, while Karnataka has seen more than 21,000 cases. These numbers are alarming, particularly as the monsoon season continues, creating ideal breeding conditions for the mosquitoes that transmit the disease.

Thailand, too, is battling a severe dengue outbreak, with over 62,000 cases and 49 deaths reported so far this year. Despite ongoing efforts to control the spread, the disease continues to claim lives, highlighting the need for more robust public health interventions.

WHO’s Response and New Guidance

In response to these pressing health challenges, the WHO has regraded the global mpox situation to an acute grade 3 emergency, the highest level of health alert, and has initiated the process for Emergency Use Listing of vaccines. Additionally, the WHO is releasing funds from its Contingency Fund for Emergencies to bolster the response in the African region, particularly in the DRC.

The WHO bulletin also introduces new global guidance on monitoring public health and social measures during emergencies. This guidance aims to standardize data collection and monitoring practices, enabling countries to respond more effectively to health crises. The publication is particularly timely, given the ongoing outbreaks of mpox, cholera, and dengue in the South-East Asia region.