Dengue fever outbreak in Cook Island: A rising concern, efforts, challenges, and future recommendations

Upsurge of dengue outbreaks in several WHO regions: Public awareness, vector control activities, and international collaborations are key to prevent spread

Background

Dengue, the world's fastest-growing vector-borne disease, has skyrocketed in the 21st century. Dengue has harmed human health since its first known cases among Spanish soldiers in the Philippines to its 21st-century outbreaks in Southeast Asia, the Pacific, and the Americas. In light of the current circumstances, it is imperative to investigate its origin and prevalence, enabling the implementation of effective interventions to curb the upsurge.

Methods

Our study examines the history of dengue outbreaks, and evolving impact on public health, aiming to offer valuable insights for a more resilient public health response worldwide. In this comprehensive review, we incorporated data from renowned databases such as PubMed, Google Scholar, and Scopus to provide a thorough analysis of dengue outbreaks.

Results

Recent dengue outbreaks are associated with rapid urbanization, international travel, climatic change, and socioeconomic factors. Rapid urbanization and poor urban design and sanitation have created mosquito breeding places for dengue vectors. Also, international travel and trade have spread the pathogen. Climate change in the past two decades has favored mosquito habitats and outbreaks. Socioeconomic differences have also amplified the impact of dengue outbreaks on vulnerable communities. Dengue mitigation requires vector control, community engagement, healthcare strengthening, and international cooperation.

Conclusion

Climate change adaptation and urban planning are crucial. Although problems remain, a comprehensive vector control and community involvement plan may reduce dengue epidemics and improve public health in our interconnected world.

Recent advances in the diagnosis and management of typhoid fever in Africa: A review

Typhoid fever, a classical disease of enteric origin caused by Salmonella species of bacteria, is among the most important diseases threatening public health in Africa. The African continent is a marker for both low resources within the healthcare system and poor disease control policy formulations in managing endemic infectious diseases. Since the colonial era, the Widal serological test has been used to confirm typhoid fever in Africa, however recent studies recommend blood culture, and when blood culture cannot be obtained, clinical findings, laboratory Widal test confirmation, and ruling out other febrile illnesses as confirmatory pathway to diagnose typhoid fever in Africa. Managing typhoid fever relies on antimicrobials. In 1980s chloramphenicol was the medication of choice. Years later, amoxicillin and co-trimoxazole were adopted. However, the instantaneous rise of resistant strains of Salmonella enterica confers an important challenge to treat the burdensome enteric fever. The current treatment algorithm of typhoid fever in Africa relies significantly on the use of fluoroquinolones, macrolides, and cephalosporins. Developed nations have successfully addressed and controlled typhoid fever via improvement in accessing safe water and food, better sanitary and hygienic behaviours, and vaccines development. Nevertheless, there is significant evidence to infer improvement in the diagnosis management of typhoid fever over the last few decades, and efforts are underway to control the disease spread in Africa. This review aims to provide an overview of the latest developments in typhoid fever diagnosis and management in Africa and provide key recommendations for a coordinated approach to mitigate typhoid in the continent.

Hepatitis A virus outbreak in Lebanon: Is it a matter of concern?

Lebanon has been grappling with hepatitis A virus (HAV) outbreaks for 3 decades, to an extent that it has been now termed an endemic zone for HAV. However, the rise in cases above the annual average concerns a potential outbreak in the North, and the Bekaa governorates of Lebanon must be highlighted. Although the Lebanese health authorities have ordered a probe into the possible causes of the outbreak, it has been speculated that the immigration of Syrian refugees has overburdened public health services. Reduced seroprevalence of HAV immunoglobulin G has also led to an epidemiological shift from child to adult populations. The current economic crisis affecting Lebanese society is another significant problem that could have contributed to the rise in incidents. This article examines Lebanon's current HAV outbreak and epidemiological status, offering suggestions for the future. In the event of an outbreak, the infrastructure for water sanitation and sewage is known to allow HAV to spread via the faecal-oral pathway. Maintaining personal hygiene, early detection, and vaccination have all been recommended as significant regional and individual control measures.

Measles outbreak in Zimbabwe: An urgent rising concern

Introduction

Measles, one of the most common infections in the world, accounts for more than over 100.000 deaths every year. Measles outbreaks are still ravaging the African continent, and the 2010 Measles outbreak in Zimbabwe is one to be noted, where more than 7754 infections and 517 deaths were reported, ultimately leading to the UN initiation of the vaccination program. COVID-19 could have been delaying the vaccination process in Africa. This article aims to shed the light on the current Measles outbreak in Zimbabwe and how global health organizations are taking measures to fight off this outbreak.

Methodology

Data was collected from online databases PubMed, Science Direct, and the Lancet, as well as news and conferences and press releases on the current measles outbreak. All articles and news related to the measles outbreak in Zimbabwe were taken into consideration.

Results

A measles outbreak was reported earlier in August of 2022, with more than 2000 confirmed cases out of which 157 were reported dead. Since the outbreak this year, cases of measles in Zimbabwe have been rapidly growing. The government in Zimbabwe started a massive vaccination campaign for children in and near the areas where the outbreak is present. Traditional and faith leaders are involved in the campaigns to encourage the public to volunteer to be vaccinated.

Conclusion

Efforts to control the measles outbreak in Zimbabwe are being mitigated by the government as well as the WHO and other global health organizations. With many people refusing the vaccination, this outbreak might not see an end, and more cases, as well as deaths, will increase by the end of the year.

Yellow fever outbreak in Kenya: A review

Yellow fever (YF) is a viral acute hemorrhagic illness caused by infected mosquitoes of the flavivirus family. The first yellow fever outbreak in Kenya was in 1992. Similar outbreaks were recorded in the western part of the country in 1993, 1995, and 2011, particularly in the Rift Valley province of Kenya. In early 2022, the viral acute illness resurfaced and hit Kenya. On January 12, 2022, the first case was discovered, with over 14 patients suffering from fever, jaundice, and joint and muscle pains. On March 4, 2022, a yellow fever outbreak re-emerged in Kenya, affecting 11 wards in Isiolo County. The fatality rate recorded was 11.3% (six deaths), with Chari accounting for 39.6% of the total 21 cases, Cherab 14 (26.4%), and 5 Garba Tulla (9.4%).

This has the potential to further endanger the nation's economic growth while also negatively impacting people's daily lives in a part of the world that is already dealing with the catastrophic impacts of the coronavirus pandemic. However, there is no curative therapy for yellow fever. The only options for curbing its spread are through vaccination and preventive measures.

Hence, Kenya's government must take responsibility for requiring vaccination of its citizens, implement an active national disease surveillance protocol, and set up anti-yellow fever campaigns in the country.

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Yellow fever (YF) is a viral acute hemorrhagic illness caused by infected mosquitoes of the flavivirus family.

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The first yellow fever outbreak in Kenya was in 1992. Similar outbreaks were recorded in the western part of the country in 1993, 1995, and 2011, particularly in the Rift Valley province of Kenya.

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In 2022, a yellow fever outbreak re-emerged in Kenya.

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The only options for curbing its spread are through vaccination and preventive measures.

Polio returns to the USA: An epidemiological alert

On July 21, 2022, the USA witnessed the first case of poliomyelitis after 3 decades of its eradication. Poliomyelitis is a crippling disease that results from infection with any one of the three related poliovirus types (referred to as types P1, P2, and P3), members of the enterovirus (picornavirus) family. The New York State Department of Health confirmed that a case of paralytic poliomyelitis was reported from a 20-year-old Hungarian traveller residing in Rockland County. The detected viral sequence has been found to have vaccine-derived poliovirus type 2 (VDPV2) suggesting an origin from the live attenuated oral polio vaccine (OPV). Since immunisation remains the only preventable measure, this article explores suggestions from the Centers for Disease Control and Prevention on reliable Inactivated (killed) polio vaccination in high-risk patients along with early case detection and treatment. In light of the above-mentioned findings, this research further details future recommendations like cessation of the OPV, encouragement of inactivated polio vaccine (IPV) in vaccination schedules, sensitive epidemiological surveillance system and appropriate training for healthcare providers. The affected countries have been further advised to have effective outbreak response strategy plans in place so that they can respond and stay prepared for such outbreaks in the future.

Poliovirus returns to the UK after nearly 40 years: current efforts and future recommendations

On 22 June 2022, the UK Health Security Agency declared a 'rare national incidence' after finding poliovirus in sewage in London for the first time in nearly 40 years. Although no cases of the disease or accompanying paralysis have been documented, the general public's risk is considered minimal. However, public health experts recommend that families are up to date on their polio vaccines to decrease the chance of harm. This article discusses the epidemiology of poliovirus by examining the aetiology of the disease and current mitigation policies implemented to prevent the spread of type 2 vaccine-deceived poliovirus in the UK. Finally, by examining the clinical features of polio, which range from mild gastroenteritis episodes, respiratory sickness, malaise and severe paralysis type, this article offers an advice on particular therapies and tactics to avoid poliovirus outbreaks and other future outbreaks.

A review on acute, severe hepatitis of unknown origin in children: A call for concern

Hepatitis is defined as the inflammatory reaction of the liver parenchyma. It is either acute, which resolves within six months or may be chronic. An outbreak of severe, acute hepatitis of unknown origin in children was reported in nearly all World Health Organisation (WHO) regions except in the Africa. As per the recent update on the 26th of May, approximately 650 cases have met the WHO's probable criteria. While some are yet to be confirmed, the WHO warns that the figure may be underestimating the real situation. The observed clinical presentation includes outstanding immoderate levels of transaminases, vomiting from the previous presentation, pale/mild stools, and jaundice. So far, the viruses which can cause viral hepatitides, like Hepatitis A, B, C, D, and E, have not been detected in any of the identified cases. Some literature reported human enteric adenovirus type 41F in the majority of cases aged sixteen or younger, with few cases of co-infection with SARS-CoV-2. Currently, only several hypotheses have discussed the causality of the outbreak. However, no consensus has been reached. During this outbreak, it is important to adhere to both hand and body hygiene, general infection and control prevention strategies, and lastly, case presentation matching the criteria of case definition set by the WHO. Said identified cases should be reported to concerned health authorities on an urgent basis and must be kept under proper surveillance.

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Hepatitis is defined as the inflammatory reaction of the liver parenchyma. It is either acute, which resolves within six months or may be chronic.

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An outbreak of severe, acute hepatitis of unknown origin in children was reported in nearly all World Health Organisation (WHO) regions except in the Africa.

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Although extensive research has not been conducted on the rapidly-progressing AHUO in children, current literature has reported human enteric adenovirus type-41F in most cases aged sixteen or younger.

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Potential confounding coronavirus infection is one of several theories currently being considered in acute non-hepatitis A–E viral hepatitis origin.

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During this outbreak, it is important to adhere to both hand and body hygiene, general infection and control prevention strategies, and lastly, case presentation matching the criteria of case definition set by the WHO.

Leishmaniasis control in the light of the COVID-19 pandemic in Africa

Leishmaniasis is a parasitic disease, endemic to Africa, Asia, and South America due to inadequate access to medication and underreporting of leishmaniasis cases. Leishmaniasis has two forms: cutaneous and visceral. The fight against leishmaniasis has been greatly affected by the coronavirus disease 2019 (COVID-19) pandemic that impacted resource distribution and access to medication. Continuous effort in vaccine development and affordable therapeutics are necessary to eliminate leishmaniasis in low-income countries. Further research is necessary to determine molecular drug resistance markers in leishmaniasis patients. In this analysis, we focus on the effect of COVID-19 on leishmaniasis in Africa.

Ukraine - Russia crisis and its impacts on the mental health of Ukrainian young people during the COVID-19 pandemic

The Russia-Ukraine crisis has been at the center of international talks since early 2022. This conflict, bursting after the sanitary crisis of the covid 19 pandemic, creates an atmosphere of uncertainty and instability, which negatively impacts many aspects, including mental health. Young Ukrainians have been suffering from socio-political instability for decades, and the current war, together with the Covid 19 pandemic, shatters hopes of brighter days. This commentary covers the challenges facing the younger generation in Ukraine and the impact of this situation on their mental health.

The use of Ivermectin for the treatment of COVID-19: Panacea or enigma?

The outbreak of SARS-CoV-2 pandemic has triggered unprecedented social, economic and health challenges. To control and reduce the infection rate, countries employed non-pharmaceutical measures such as social distancing, isolation, quarantine, and the use of masks, hand and surface sanitisation. Since 2021 a global race for COVID-19 vaccination ensued, mainly due to a lack of equitable vaccine production and distribution. To date, no treatments have been demonstrated to cure COVID-19. The scientific World is now considering the potential use of Ivermectin as a prophylactic and treatment for COVID-19. Against this background, the objective of this study is to review the literature to demystify the enigma or panacea in the use of Ivermectin. This paper intends to investigate literature which supports the existence or shows the nonexistence of a causal link between Ivermectin, COVID-19 mortality and recovery. There are inconsistent results on the effectiveness of Ivermectin in the treatment of COVID-19 patients. Some studies have asserted that in a bid to slow down the transmission of COVID-19, ivermectin can be used to inhibit the in vitro replication of SARS-CoV-2. The pre-existing health system burdens can be alleviated as patients treated prophylactically would reduce hospital admissions and stem the spread of COVID-19. On a global scale, Ivermectin is currently used by about 28% of the world's population, and its adoption is presently about 44% of countries. However, the full administration of this drug would require further tests to establish its clinical effectiveness and efficacy.

Prospect of acute hepatitis E virus outbreak in the context of the COVID-19 Pandemic in Africa: A contingency plan

Hepatitis E virus (HEV) is the primary cause of acute viral hepatitis in Sub-Saharan Africa (SSA). It is transmitted by oral-faecal route via contaminated water or animal products, which is more pronounced in SSA, where inadequate hygiene measures, low socioeconomic situation, and frail healthcare system increase HEV susceptibility. During the coronavirus disease-19 (COVID-19), numerous initiatives concerning viral hepatitis relief in SSA are implemented. However, national programs do not support most services and are neglected when national and local attention rests on the COVID-19 pandemic. Furthermore, during the COVID-19 pandemic, hepatitis E prevention and control programs were affected in low-income countries due to economic losses. Therefore, an interdisciplinary approach should be adopted to mitigate HEV infections during COVID-19.

Russia-Ukraine conflict and COVID-19: a double burden for Ukraine's healthcare system and a concern for global citizens

The conflict between Ukraine and Russia significantly influences the healthcare sector. The ongoing COVID-19 pandemic and the armed conflict have badly devastated the established healthcare system. Only 36.08% of the Ukrainian population has received the COVID-19 vaccination, with the majority receiving two doses, and currently, Ukraine records the highest mortality rate in the world. In addition to the conflict injuries, increased susceptible deaths to COVID-19 can be found due to inadequate vaccination rates for the disease. To save their lives and for their well-being, many individuals have been relocating to the underground metro stations, other cities, nearby towns and countries. In these settings, social distancing, hand sanitation and wearing masks are not prioritised. In the current circumstances, the broken healthcare system needs to be rebuilt, and the Non-Governmental Organizations (NGOs), doctors and all the front-line workers should extend their humanitarian support to the Ukrainian population. Conclusion: It is an arduous task for healthcare organisations to supply vaccines and medicines in this ‘armed conflict’ between Russia and Ukraine. This can only happen when both parties extend their support to rebuild the shattered healthcare infrastructure.

Poliomyelitis amidst the COVID-19 pandemic in Africa: Efforts, challenges and recommendations

Poliomyelitis is the leading infectious cause of acute flaccid paralysis among children under five years of age, caused by the Wild Poliovirus, with no medical cure other than prevention through vaccination. The advent of mass vaccination campaigns against polio disease worldwide has greatly decreased the number of global cases and limited the rate of transmission. However, the emergence of Vaccine-derived Poliovirus due to genetic reversions in the live attenuated oral polio vaccine has posed a significant impediment to global polio eradication efforts. Therefore, There is a need to modify the vaccination regimen by utilizing more doses of inactivated poliovirus vaccine or adopting the bivalent oral polio vaccine in order to eliminate the transmission of Vaccine-derived Poliovirus. In addition, collective efforts from governments, health policymakers, vaccination groups and health-related bodies are required to improve vaccine coverage and suppress the circulation of Vaccine-derived Poliovirus.

Rift Valley fever during the COVID-19 pandemic in Africa: A double burden for Africa's healthcare system

A new rising incidence of Rift Valley fever (RVF) among livestock and humans in the African continent during the COVID‐19 pandemic has become of increasing concern. We analyzed the different ways COVID‐19 has contributed to the increase in RVF cases and how it has impacted the interventions allocated to the disease by comparing it with the status of the disease before the pandemic. There is enough evidence to conclude that the COVID‐19 pandemic has impacted the efforts being taken to prevent outbreaks of RVF. Therefore, with no definitive treatment in place and inadequate preventive measures and disease control, RVF may potentially lead to a future epidemic unless addressed urgently.

Threats and outbreaks of cholera in Africa amidst COVID-19 pandemic: a double burden on Africa's health systems

Every year, about 4 million cases and 143,000 deaths due to cholera are recorded globally, of which 54% were from Africa, reported in 2016. The outbreak and spread of cholera have risen exponentially particularly in Africa. Coupled with the recent emergence of the Coronavirus Pandemic (COVID-19) in Africa, the local health systems are facing a double burden of these infectious diseases due to their cumulative impact. In this paper, we evaluate the dual impact of cholera and COVID-19 in Africa and suggest plausible interventions that can be put in place to cushion its impact.