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CC BY-NC-ND 4.0 · Avicenna J Med 2018; 8(04): 147-152
DOI: 10.4103/ajm.AJM_130_18
ORIGINAL ARTICLE

Infectious diseases in the era of refugees: Hepatitis A outbreak in Lebanon

Abdul Rahman Bizri
Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center; Conflict Medicine Program, Office of Strategic Health Initiatives, American University of Beirut, Beirut, USA
,
Jawad Fares
Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
,
Umayya Musharrafieh
Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center; Department of Family Medicine, American University of Beirut Medical Center, Beirut, USA
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Background: The Syrian crisis has altered the epidemiology of infectious diseases in countries hosting large numbers of refugees. Lebanon witnessed several outbreaks linked to the presence of significant numbers of Syrian refugees, namely, Hepatitis A virus (HAV). We explore the epidemiology of HAV in Lebanon and the impact of the Syrian war during the 2014 outbreak and suggest solutions to prevent and minimize the HAV spread amid the current socioeconomic conditions. Methods: We reviewed all HAV cases reported to the Epidemiologic Surveillance Unit at the Ministry of Public Health between January 2001 and December 2017. Demographics and distribution of Syrian refugees in Lebanon were linked to reports of new HAV cases. Results: A sharp rise in the number of reported HAV cases was observed in Lebanon in 2013, concurrent with the Syrian crisis and influx of refugees. Most cases reported in 2013 and 2014 involved Syrian refugees and their relevant areas of settlement in the Beqaa and North governorates. Conclusion: The influx of refugees strained overburdened sanitary infrastructure and overstretched existing public health services in Lebanon, which led to an increase in the incidence of reported HAV cases. The Lebanese health authorities and the international community need to intensify their efforts in surveillance and prevention of communicable diseases. Providing proper sanitation and free vaccination for affected communities are effective solutions to contain the HAV outbreak. Yet, financial constraints and the need to prioritize in the health budget put HAV-immunization at a lower priority. The Lebanese scenario could be reflective to other countries hosting sizeable numbers of refugees.

Keywords

Hepatitis A - Middle East - Syrian crisis - Syrian refugees - vaccination


Publication History

Article published online:
12 August 2021

© 2018. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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