Palestinians are facing the epidemic while they are the only occupied country globally, with around 2 million inhabitants under siege in the Gaza Strip (GS) for the last 14 years and have no control over the health of the Palestinians in East-Jerusalem (EJ). Such catastrophic situations created a variety in the spread of the COVID-19 pandemic in different territories. This study aimed to explore variation in COVID-19 spread, risk factors, and intervention activities in the three Palestinian territories: West Bank (WB), EJ, and GS to learn from the current gaps to overcome this pandemic and be prepared for future emergencies. Epidemiological data regarding COVID-19 were obtained from online websites, Palestinian national reports, WHO reports, and scientific publications. Morbidity and mortality indicators in Palestine are higher than the global level with rate variation in the three territories. COVID-19 incidence and mortality rates are higher in EJ and lowest in GS, while case fatalities are around 1% all over the country. Social gathering and lack of readiness of the fragmented health systems (there are two systems; Palestinian serves the WB and GS and Israeli serves the EJ) are risk factors in the three Palestinian territories. The most prominent risk in GS is overcrowding, while the movement of the workers inside Israel and travel are more prevalent in the WB and EJ. The WHO and international organizations play an active role in responding to a community spread, mainly national coordination, risk communication and community engagement, laboratory support, surveillance and procurement, and supply management. Recommendations include restructuring the national committees, reviewing and standardization of the national protocols, expanding infections prevention training, supporting and developing the capacity of laboratories, and setting the role of NGOs besides community engagement and participation.

The emergence of the coronavirus pandemic led to the implementation of several precautionary measures across the globe. For densely populated regions in the world, this may have been challenging given the proximity of people to one other. Thus, this brief report sought to compare the measures across 2 densely populated locations, Hong Kong and Gaza. Epidemiological data was obtained from governmental online repositories and was compared with the data presented by the Johns Hopkins coronavirus map to ensure consistency. Descriptive statistics were used to interpret the data obtained over the period of the study. The data suggested that although Hong Kong and Gaza implemented similar strategies, Gaza recorded marginally higher cases compared with Hong Kong in the same timeframe. The strategies implemented in both settings included border closures, social distancing, proper hand hygiene, and mask usage. Cultural and socio-demographic differences may have played a part in this variation in case numbers, in addition to lessons Hong Kong had previously learned from a similar outbreak. As the pandemic is ongoing it is essential that public sensitization to adherence to precautionary measures at the personal/family level does not occur.

Phenylketonruia (PKU) is an inherited metabolic disorder that results in progressive mental retardation. PKU is a paradigm of a disease that can be identified by proper screening of newborns and medical follow-up in order to prevent serious complications. The present study was designed to evaluate the Palestinian national screening programme for PKU in the Gaza Strip. Data about the screening of PKU in the Gaza Strip were obtained from the records of the healthcare centers of the Palestinian Ministry of Health (MOH) during the year 2000. In addition, PKU patients and families were interviewed. The results showed that the prevalence of PKU in the Gaza Strip varied considerably between the different regions with an overall prevalence of 6.35/100,000, while the maximum prevalence of 28.3/100,000 occurred in the rural areas. Coverage of PKU testing in the Gaza Strip is limited to about 35.3 per cent of the total newborns, who are delivered and receive health care at the government clinics. Among those newborns delivered at the government clinics, the percentage of PKU screening is about 87.8 per cent. However, PKU testing is not carried out at UNRWA clinics where about two-thirds of newborn deliveries take place. On average, 61 per cent of PKU testing is made in the infant's second week, ranging between 11 and 17 days, and the remaining (39 per cent) are tested thereafter. Approximately 60 per cent of PKU patients had consanguine parents (first cousins), while 7.7 per cent had no consanguinity. Only 43.1 per cent of PKU patients were fed on the specialized low phenylalanine milk. An inverse correlation was reported between the use of low phenylalanine milk and age. A total of 35.4 per cent of the PKU patients were regularly monitored by blood tests each month, 47.7 per cent had not been tested for the previous year. It was concluded that the PKU screening programme has to be improved, the screening methods should be reviewed, and the screening coverage should include all the newborns in the Gaza Strip.

An outbreak of cholera involving 161 culture-positive cases of biotype El-Tor Serotype Ogawa occurred in the Gaza Strip in the summer and autumn of 1981. The signs and symptoms of the disease were mild to moderate in two thirds of the cases. In many of them the disease was so mild that the patients did not realize they had cholera. Another outstanding feature of the disease was the high percentage of family clustering. From constant monitoring of water, sewage, and vegetables we were unable to show that they played any part in the transmission. A case control study which specifically investigated these items showed no differences between cases and controls. Epidemiological investigation indicated that the disease was probably introduced into the area by a visitor from Jordan, where an epidemic was in progress. The first spread followed a wedding party and seems to have been caused by ingestion of contaminated soft drinks. Subsequent spread was probably caused mainly by carriers who were either asymptomatic or very mild cases. The actual transmission seems to have occurred from person to person, by food contamination, or by both. The authors believe, therefore, that the transmission of El-Tor cholera has many features in common with other bacterial diseases that are transmitted by the faecal-oral route.

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