Infectious disease outbreaks in the World Health Organization Eastern Mediterranean Region in 2019

The World Health Organization's (WHO) Eastern Mediterranean Region (EMR) continues to face emerging and re-emerging infectious disease outbreaks that result in high morbidity and mortality. Some countries in the region also continue to experience acute or protracted humanitarian emergencies that have resulted in the breakdown of already fragile health systems. We analysed data from epidemiological reports produced by countries and the WHO regional office (WHO EMRO). We describe the disease outbreaks that occurred in 2019 and the mitigation support provided by WHO. Ten countries reported 24 new or ongoing infectious disease outbreaks caused by 13 different pathogens. They include cholera, Crimean-Congo hemorrhagic fever (CCHF), chikungunya, chickenpox (varicella), dengue fever, diphtheria, extensively drug-resistant (XDR) typhoid fever, human immunodeficiency virus (HIV), hepatitis A, measles, Middle East respiratory syndrome (MERS), poliomyelitis, and Rift Valley fever. These resulted in more than one million cases (suspected and laboratory-confirmed) and more than 1500 deaths with an overall case-fatality ratio (CFR) of 0.17%. While WHO continues to support preparedness and response activities in the EMR, more countries continue to face repeated outbreaks coupled with data gaps due to inconsistent reporting. While some countries have reduced cases following enhanced surveillance and response systems, strengthening of country-level health systems is needed.