Kőrösi: Cholera in Lebanon Won’t Become Epidemic

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

Mira, 18 months old, is one of the patients being treated for cholera in Lebanon (BBC)
Mira, 18 months old, is one of the patients being treated for cholera in Lebanon (BBC)
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Kőrösi: Cholera in Lebanon Won’t Become Epidemic

Mira, 18 months old, is one of the patients being treated for cholera in Lebanon (BBC)
Mira, 18 months old, is one of the patients being treated for cholera in Lebanon (BBC)

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.



The US Election by Numbers

Clark County Election Workers inspect mail-in ballots for the 2024 Election at the Clark County Election Department in North Las Vegas, Nevada, USA, 02 November 2024. (EPA)
Clark County Election Workers inspect mail-in ballots for the 2024 Election at the Clark County Election Department in North Las Vegas, Nevada, USA, 02 November 2024. (EPA)
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The US Election by Numbers

Clark County Election Workers inspect mail-in ballots for the 2024 Election at the Clark County Election Department in North Las Vegas, Nevada, USA, 02 November 2024. (EPA)
Clark County Election Workers inspect mail-in ballots for the 2024 Election at the Clark County Election Department in North Las Vegas, Nevada, USA, 02 November 2024. (EPA)

Swing states, electoral college votes, candidates up and down the ballot, and millions of potential voters: Here is the US election, broken down by numbers.

- Two -

Several independents ran -- and at least one, Robert F. Kennedy Jr, stumbled into a number of eyebrow-raising headlines.

But in the end, the presidential race comes down to a binary choice, with the two candidates from the major parties -- Democrat Kamala Harris and Republican Donald Trump -- seeking to lead a polarized America.

- Five -

November 5 -- Election Day, traditionally held on the Tuesday following the first Monday in November.

- Seven -

The number of swing states -- those which don't clearly favor one party over the other, meaning they are up for grabs.

Harris and Trump are courting voters in Arizona, Georgia, Michigan, Nevada, North Carolina, Pennsylvania and Wisconsin, concentrating their campaign efforts there in a push to ensure victory.

In a razor-tight election, just a handful of votes in any of those states could decide the outcome.

- 34 and 435 -

Voters won't just decide the White House occupant on Election Day -- they will also hit refresh on the US Congress.

Thirty-four Senate seats and all 435 spots in the House of Representatives are up for grabs.

In the House, members serve a two-year term. Republicans currently have the majority, and Harris's Democrats will be hoping for a turnaround.

In the Senate, 34 seats out of 100 are available, for a six-year term. Republicans are hoping to overturn the narrow Democratic majority.

- 538 -

Welcome to the Electoral College, the indirect system of universal suffrage that governs presidential elections in the United States.

Each state has a different number of electors -- calculated by adding the number of their elected representatives in the House, which varies according to population, to the number of senators (two per state).

Rural Vermont, for example, has just three electoral votes. Giant California, meanwhile, has 54.

There are 538 electors in total scattered across the 50 states and the District of Columbia. To take the White House, a candidate must win 270 votes.

- 774,000 -

The number of poll workers who made sure the 2020 election ran smoothly, according to the Pew Research Center.

There are three types of election staff in the United States.

The majority are poll workers -- recruited to do things like greet voters, help with languages, set up voting equipment, and verify voter IDs and registrations.

Election officials are elected, hired or appointed to carry out more specialized duties such as training poll workers, according to Pew.

Poll watchers are usually appointed by political parties to observe the ballot count -- expected to be particularly contentious this year, thanks to Trump's refusal to agree to unconditionally accept the result.

Many election workers have already spoken to AFP about the pressure and threats they are receiving ahead of the November 5 vote.

- 75 million -

As of November 2, more than 75 million Americans had voted early, according to a University of Florida database.

Most US states permit in-person voting or mail-in voting to allow people to deal with scheduling conflicts or an inability to cast their ballots on election day itself on November 5.

- 244 million -

The number of Americans who will be eligible to vote in 2024, according to the Bipartisan Policy Center.

How many of those will actually cast their ballot remains to be seen, of course. But the Pew Research Center says that the midterm elections of 2018 and 2022, and the presidential vote of 2020, produced three of the highest turnouts of their kind seen in the United States in decades.

"About two-thirds (66 percent) of the voting-eligible population turned out for the 2020 presidential election -- the highest rate for any national election since 1900," Pew says on its website.

That translated to nearly 155 million voters, according to the Census Bureau.