Kőrösi: Cholera in Lebanon Won’t Become Epidemic

The number of cholera cases in Lebanon has exceeded 1,400 with over 17 deaths according to the latest official figures, while the President of the United Nations General Assembly, Csaba Kőrösi, said Wednesday in a statement to Asharq Al-Awsat he was very confident that cholera will not become a major epidemic in the country. Lebanon has recorded more than 1,400 cholera cases and 17 deaths as of Tuesday, since the first case appeared in the country on the fifth of October, according to the “World Health Organization” (WHO).

Commenting on this outbreak, Kőrösi expressed to Asharq Al-Awsat his confidence that despite the major crises that Lebanon is experiencing, cholera will be contained in the country. “I am very confident that cholera is not going to become a major epidemic in Lebanon, it should be contained,” he stated. He also pointed out that there might be some other very dangerous outbreaks that need to be prevented worldwide.

Concurrently, cholera continues to spread in Syria on a large scale, bringing the number of infections to about 25,000 cases, according to the latest figures, with more than 80 deaths.

Origins of Cholera

As reported by WHO, cholera transmission is closely linked to inadequate access to clean water and sanitation facilities. Menaced areas include outskirts slums, and camps for displaced persons or refugees, where clean water and sanitation lack the minimum requirements. The consequences of a humanitarian crisis, such as disruption of water and sanitation systems, or the displacement of populations to inadequate and overcrowded camps, can increase the risk of cholera transmission, should the bacteria be present or introduced.

Symptoms

According to WHO, cholera is an extremely virulent disease that can cause severe acute watery diarrhea. It takes between 12 hours and 5 days for a person to show symptoms after ingesting contaminated food or water. It affects both children and adults and can kill within hours if untreated. Most people infected with cholera do not develop any symptoms, although the bacteria are present in their body for 1-10 days after infection and are shed back into the environment, potentially infecting other people. Among people who develop symptoms, the majority have mild or moderate symptoms, while a minority develop acute watery diarrhea with severe dehydration. This can lead to death if left untreated.

Cholera spread in Syria and Lebanon

In Syria, the outbreak has likely started, according to the international NGO “Save the Children”, due to communities consuming contaminated water and food irrigated by the Euphrates River, which is experiencing historic low water levels mainly due to Syria’s worst drought in decades.

In Lebanon, cholera has been diagnosed firstly in rural areas bordering Syria, and is "probably due to population movements," according to the head of World Health Organization (WHO) technical team in Lebanon, Alissar Rady. “Most cholera cases in Lebanon have been in the camps, among the roughly 1 million Syrians who have taken refuge over the past decade from the conflict in their homeland”, according to Lebanese Health Minister Firass Abiad. While the outbreak was initially confined to northern districts, it has spread rapidly, said WHO’s office in Lebanon on Tuesday, with laboratory-confirmed cases reported from all eight governorates and 18 out of 26 districts.In Syria, cholera has already spread over the 14 Governorates of the country.

Tackling the disease

To contain the spread of the disease, the World Health Organization recommends improving access to proper and timely case management of cholera cases, prevention, and control in healthcare facilities, improving access to safe drinking water and sanitation infrastructure, as well as, improving hygiene practices and food safety in affected communities, with these counting as the most effective means of controlling cholera.

Oral cholera vaccine should be used in conjunction with improvements in water and sanitation to control cholera outbreaks and for prevention in targeted areas known to be at high risk for cholera. Key public health communication messages should be provided to the population.

Surveillance for early case detection, confirmation, and response in other provinces and regions of Lebanon should be reinforced especially at the district level while expanding community-based surveillance.

According to information provided by Hala Habib, the communications officer of WHO Lebanon, the long-term solution for Cholera control lies in economic development and universal access to safe drinking water and adequate sanitation. Actions targeting environmental conditions include the implementation of adapted long-term sustainable WASH solutions to ensure the use of safe water, basic sanitation, and good hygiene practices in cholera hotspots.

In addition to cholera, such interventions prevent a wide range of other water-borne illnesses, as well as contribute to achieving goals related to poverty, malnutrition, and education. The WASH solutions for cholera are aligned with those of the Sustainable Development Goals (SDG) number 6.

Vaccination

WHO recently announced that the standard two-dose vaccination for cholera will be suspended temporarily to allow for the available doses to be used in more countries, although Lebanon took delivery on Monday of its first vaccines to combat the worsening cholera outbreak from donor nation France. However, despite global shortages in cholera vaccines, WHO is supporting the Lebanese Ministry of Public Health to secure 600,000 doses for those most at risk, including frontline workers, prisoners, refugees, and their host communities.

Humanitarian Aids

In Lebanon, WHO is joining with the Ministry of Public Health and other health partners to curb the evolving cholera outbreak. For instance, WHO and other humanitarian partners have supported the Ministry to develop a national cholera preparedness and response plan, outlining the most urgent response interventions required, while scaling up surveillance and active case-finding in hotspot areas. UNICEF distributed thousands of liters of fuel to water pumping stations and waste-water treatment stations in locations with confirmed and suspected cholera cases. It has procured emergency medical supplies to support the treatment of several thousands of cholera cases and symptoms including moderate to severe diarrhea. It delivered Chlorinated Trucked water, wastewater desludging, and ensured disinfection in informal settlements with suspected or confirmed cases.

UNICEF trained over 4000 frontline workers and partners on cholera awareness, including transmission, symptoms, treatment, prevention, and referral mechanisms, scaled up safe water deliveries, and increased desludging to over 250,000 people living in informal settlements. In Lebanon also, the “Save the Children” organization is responding with partners through the interagency cholera prevention, preparedness, and response Plan. “Save the Children” will be working to ensure children in schools and communities are protected from possible water-related outbreaks, have access to safe water, sanitation, and hygiene, and affirm that their well-being is maintained. This includes awareness messaging, health hygiene promotion in schools, and distribution of soap, hygiene kits, and chlorination tablets for supported communities, as well as providing support for sustainable solutions such as UV solar-powered systems for cleaning water.

In Syria, UNICEF is distributing millions of water treatment tablets to more than 350,000 people in affected governorates. It distributed over 400 tons of sodium hypochlorite during the first two weeks of October to increase chlorine dosages and concentration, as chlorine is often distributed in cholera response because it effectively inactivates the Vibrio cholerae bacteria, that causes cholera. Since the beginning of the cholera response, more than a ton of sodium hypochlorite has been distributed, providing more than 13 million people with safe and clean water. UNICEF delivered acute watery diarrhea (AWD) kits to support treating thousands of moderate and severe Cholera cases. UNICEF also trained hundreds of healthcare workers and hygiene promotion teams across Syria.

Save the Children’s response to cholera in Syria, is helping the restoration of basic services, including water and sanitation, as key to helping communities recover from the impact of conflict. Save the Children’s response plan includes chlorination of restored water, water quality monitoring, distribution of hygiene and cleaning kits, as well as hygiene promotion.

Vice President Kamala Harris, the likely Democratic nominee for president, is attempting to bridge divides within the party over the war in Gaza, emphasizing Israel's right to defend itself while also focusing on alleviating Palestinian suffering.

She delivered remarks after meeting with Israeli Prime Minister Benjamin Netanyahu on Thursday that reflected a delicate balancing act on one of the country's most divisive political issues. Some Democrats have been critical of President Joe Biden's steadfast support for Israel despite the increasing death toll among Palestinians, and Harris is trying to unite her party for the election battle with Republican candidate Donald Trump.

"We cannot look away in the face of these tragedies," she said. "We cannot allow ourselves to become numb to the suffering. And I will not be silent."

Harris did not deviate from the administration's approach to the conflict, including grueling negotiations aimed at ending the fighting, releasing hostages held by Hamas and eventually rebuilding Gaza. She also said nothing about military assistance for Israel, which some Democrats want to cut.

Instead, she tried to refocus the conversation around mitigating the calamity in Gaza, and she used language intended to nudge Americans toward an elusive middle ground.

"The war in Gaza is not a binary issue," she said. "But too often, the conversation is binary when the reality is anything but."

In addition, Harris made a more explicit appeal to voters who have been frustrated by the ceaseless bloodshed, which began when Hamas attacked Israel on Oct. 7.

"To everyone who has been calling for a ceasefire, and to everyone who yearns for peace, I see you, and I hear you," she said.

Harris' meeting with Netanyahu was private, and she described it as "frank and constructive." She also emphasized her longtime support for Israel, which includes raising money to plant trees in the country when she was a young girl.

Jewish Americans traditionally lean Democratic, but Republicans have tried to make inroads. Trump claimed this week that Harris "is totally against the Jewish people" because she didn't attend Netanyahu's address to a joint meeting of Congress. The vice president was traveling in Indiana during the speech.

Harris is married to a Jewish man, Doug Emhoff, who has played an outspoken role in the administration's efforts to combat antisemitism.

Netanyahu did not speak publicly after his meeting with Harris. His trip was scheduled before Biden dropped his reelection bid, but the meeting with Harris was watched closely for clues to her views on Israel.

"She is in a tricky situation and walking a tightrope where she’s still the vice president and the president really is the one who leads on the foreign policy agenda," said Dearborn Mayor Abdullah Hammoud, a Democrat whose city is home to one of the largest Arab American communities in the nation. "But as the candidate, the presumptive nominee, she has to now create the space to differentiate in order for her to chart a new course."

Protesters gathered outside Union Station on the day of Netanyahu's speech, ripping down American flags and spray painting "Hamas is coming."

Harris sharply criticized those actions, saying there were "despicable acts by unpatriotic protesters and dangerous hate-fueled rhetoric. "

"I support the right to peacefully protest, but let’s be clear: Antisemitism, hate and violence of any kind have no place in our nation," she said in a statement.

As vice president, Harris has tried to show little daylight between herself and Biden. But David Rothkopf, a foreign policy writer who has met with her, said there's been "a noticeable difference in tone, particularly in regards to concern for the plight of innocent Palestinians."

The difference was on display in Selma, Alabama, in March, when Harris commemorated the anniversary of the Bloody Sunday march for voting rights in 1965.

During her speech, Harris said that "given the immense scale of suffering in Gaza, there must be an immediate ceasefire."

The audience broke out in applause. A few sentences later, Harris emphasized that it was up to Hamas to accept the deal that had been offered. But her demand for a ceasefire still resonated in ways that Biden's comments had not.

An AP-NORC poll conducted in June found that about 6 in 10 Democrats disapproved of the way Biden is handling the conflict between the Israelis and the Palestinians. Roughly the same number said Israel's military response in Gaza had gone too far.

Israeli analysts said they doubted that Harris would present a dramatic shift in policies toward their country.

Chuck Freilich, a former Israeli deputy national security adviser and senior fellow at the Institute for National Security Studies, a Tel Aviv think tank, said Harris was from a generation of American politicians who felt they could both support Israel and publicly criticize its policies.

"The question is as president, what would she do?" Freilich said. "I think she would put considerably more pressure on Israel on the Palestinian issue overall."

Kőrösi: Cholera in Lebanon Won’t Become Epidemic

Cases exceeded 1,400 with over 17 deaths in the country