In times of conflict, the devastation extends far beyond the immediate impact of violence. One of the most insidious consequences of war is the breeding ground it creates for infectious diseases.
As health systems crumble and populations are displaced, the stage is set for disease outbreaks that can ravage communities already struggling to survive.
Diseases that Thrive in War Zones
According to the Centers for Disease Control and Prevention (CDC), an outbreak is defined as an increase, often sudden, in the number of cases of a disease above what is normally expected in a limited geographic area.Â
War-torn regions often see a resurgence of diseases that were previously under control. Among the most prevalent and dangerous are:
An acute diarrheal illness is caused by an infection of the intestine with the bacterium Vibrio cholerae. This spreads through contaminated water or food, particularly in areas with inadequate sanitation and lack of clean water.
A bacterial infection caused by Salmonella Typhi, which leads to high fever, abdominal pain, and severe complications if left untreated. Typically, it spreads through contaminated food and water or close contact with infected individuals.
A highly infectious viral disease that invades the central nervous system and motor neurons, and can cause total paralysis in a matter of hours. This is transmitted through person-to-person, primarily through the fecal-oral route or, less frequently, through contaminated water or food.
Other common infectious diseases that proliferate during wartime include measles, tuberculosis, and various forms of hepatitis.
War creates a perfect storm for disease outbreaks:
Destruction of Infrastructure: Bombing and shelling often target critical infrastructure, including hospitals, water treatment facilities, and sewage systems.
Displacement of Populations: Refugee camps and overcrowded shelters become hotspots for disease transmission.
Breakdown of Health Services: As medical personnel flee or become casualties themselves, healthcare systems collapse, leaving populations vulnerable.
Lack of Resources: Essential medicines, vaccines, and medical equipment become scarce, hampering disease prevention and treatment efforts.
How Disease Has Spread in War-torn Gaza and Yemen
The conflicts in Gaza and Yemen provide stark illustrations of how war creates ideal conditions for the spread of infectious diseases.Â
These examples demonstrate the devastating impact of prolonged warfare on public health infrastructure and the subsequent rise of disease outbreaks.
The Gaza Conflict
The 7-month-long Israeli military operation in Gaza has had devastating effects on the territory's healthcare infrastructure and public health:
Destruction of Healthcare Facilities Only 16 out of 36 hospitals in Gaza remain even partially functional, severely limiting the territory's ability to provide medical care and manage disease outbreaks.
Resurgence of Polio In July, the World Health Organization (WHO) reported that sewage samples collected from two areas in Gaza tested positive for polio. Dr. Hamed Jafari, a WHO polio specialist, noted that the genetic nature of the samples suggested the virus had been circulating "for some time, maybe as early as since September of 2023.
More recently, a child in Gaza was confirmed to have contracted polio, prompting urgent action. In response to this alarming development, a temporary pause in the fighting has been declared to allow for a vaccination campaign targeting children in the area
Ideal Conditions for Disease Transmission Dr. Jafari highlighted that Gaza offers "ideal conditions" for polio transmission due to "displacement, overcrowding, sewage contamination, lack of clean water" - all direct consequences of the ongoing conflict.
Decline in Immunization Rates While immunization rates in Gaza and the occupied West Bank were optimal before the conflict (with polio vaccine coverage estimated at 99% in 2022), they had declined to 89% by 2023, according to the latest WHO data.
Infrastructure Destruction Oxfam International reports that as many as 70% of sewage pumps in Gaza have been destroyed, and not a single wastewater treatment plant is operational. This creates a "perfect breeding ground" for disease spread.
Detection in Wastewater The presence of the polio virus in wastewater is a clear indicator of its circulation within the population, highlighting the urgent need for intervention.
The Yemen Conflict
Cholera Outbreak: Yemen is facing a rapidly escalating cholera outbreak, with over 40,000 suspected cases reported. This water-borne disease has seen a dramatic resurgence due to the destruction of water and sanitation infrastructure during the conflict.
Daily New Infections: In Houthi-controlled areas, hundreds of new cholera infections are being reported daily, indicating the rapid spread of the disease in conflict-affected regions.
Compromised Healthcare System: The ongoing war has severely damaged Yemen's healthcare system, limiting its capacity to respond effectively to the cholera outbreak.
Malnutrition and Disease: The conflict has also led to widespread malnutrition, making the population more susceptible to infectious diseases like cholera.
Limited Access to Clean Water: The destruction of water treatment facilities has left millions without access to clean water, exacerbating the spread of water-borne diseases.
Vaccination is Key to Disease Prevention
The link between war and infectious diseases is clear and devastating. As conflicts continue to rage in various parts of the world, the threat of disease outbreaks looms large. The international community must recognize this connection and prioritize health interventions as part of broader peacekeeping and humanitarian efforts.
For those planning to visit areas with existing outbreaks of cholera, typhoid, or polio, vaccination is essential. Travelers should seek professional medical advice before their journey.
Residents of Arizona can receive tailored travel health advice and necessary vaccinations at Away Clinic, ensuring they are protected against potential infectious diseases in high-risk areas.
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