Communicable Disease Surveillance in Lebanon during the Syrian Humanitarian Crisis, 2013–2019

Abstract

Lebanon has been one of the most affected countries by the Syrian humanitarian crisis. The national communicable disease surveillance was enhanced to detect outbreaks among Syrians. In this study, we aim to describe the findings of the communicable disease surveillance among Syrians in Lebanon, compare it to residents’ data, and describe the implemented surveillance activities between 2013 and 2019. During the study period, data on communicable diseases was mainly collected through the routine national surveillance system and an enhanced syndromic surveillance system. Predefined case definitions and standard operating procedures were in place. Data collection included both case-based and disease-specific reporting forms. Descriptive data and incidence rates were generated. Information was disseminated through weekly reports. Activities were conducted in close collaboration with different partners. The most commonly reported diseases were: viral hepatitis A, cutaneous leishmaniasis, mumps, and measles. Hepatitis A incidence increased in 2013 and 2014 among Syrians as well as residents. For leishmaniasis, the incidence increased only among Syrians in 2013 and decreased after that. An outbreak of mumps was reported among Syrians between 2014 and 2016, with a peak in 2015 concomitant with a national outbreak. Outbreaks of measles were reported among Syrians and residents in 2013, 2018, and 2019. The infrastructure of the well-implemented surveillance system in Lebanon has been utilized to monitor the health status of Syrians in Lebanon, early detect communicable diseases among this population, and guide needed preventive and control measures. This highlights the importance of having a flexible surveillance system that can be adapted to emergencies and the importance of sharing results with involved partners.

Measles Outbreak in Lebanon: July 2023

“…A World Health Organization (WHO) assessment mission was conducted in 2016 to assess the national surveillance system in Lebanon, results showed compliance of 93%. 3 It is essential to keep active surveillance even in these difficult times to control this outbreak. Awareness should be created and invested in to target different audiences and inform them of the importance of vaccination.…”

“…The lack of vaccination among children is a major cause of the outbreak. 3 Socioeconomic factors play a major role in vaccination compliance, and contracting measles is itself associated with a significant economic burden. A recent study found several factors that hinder vaccination, including socio-demographics, knowledge, beliefs, and practices associated with age-appropriate vaccination.…”

“…After the beginning of the Syrian crisis, increased rates of infectious diseases were reported in Syria and other neighboring countries hosting displaced refugees from Syria. [1][2][3][4] The emergence of tuberculosis, measles, mumps, hepatitis A, leishmaniosis, cholera, and polio were observed. [1][2][3][4] Lebanon has the largest immigration rate per capita in the Mediterranean region.…”

“…[1][2][3][4] The emergence of tuberculosis, measles, mumps, hepatitis A, leishmaniosis, cholera, and polio were observed. [1][2][3][4] Lebanon has the largest immigration rate per capita in the Mediterranean region. Just after the Syrian migration, studies reported simultaneous increase in infectious diseases in Lebanon.…”

“…Just after the Syrian migration, studies reported simultaneous increase in infectious diseases in Lebanon. 1,3,4 In the year 2012, Tuberculosis cases increased by 27% with a total of 630 cases reported, the numbers kept on increasing until the year 2014. 4 Measles cases were very low in the years 2011 and 2012 with 10 cases reported every year, then went up to 1760 cases in the year 2013.…”