WHO assures risk of cholera outbreak to European countries low

The World Health Organization (WHO) said the risk to other countries from a possible cholera outbreak in Syria -where a massive refugee flow is underway- was low.

WHO officials did not confirm an outbreak but said the organization was aware of reports of a suspected death from cholera in Syria and a laboratory investigation was ongoing.

Head of a U.S.-based Syrian NGO had warned earlier this month that a cholera epidemic was spreading in Syria where a civil war has been raging on since 2011. Dr. Ahmad Tarakji of Syrian American Medical Association has told the media that one child in Syria's Aleppo had already been killed by the disease that could pose an international threat if not prevented. Tarajki had warned that the ongoing war left health infrastructure and healthcare services in Syria crippled and that would lead cholera to spread faster than thought across international borders.

Nedret Emiroglu, Director Communicable Diseases, Health Security, and Environment for WHO Regional Office for Europe, told Daily Sabah that although a risk of refugees bringing cholera to Europe exists, it was on the same level of a possible outbreak from travelers returning from cholera endemic countries.

She said the risk for importation of exotic and rare infectious agents into Europe such as Ebola was exceedingly low and importation of a disease into another country equally involves travelers, tourists or health care workers and refugees or migrants. "Refugees and migrants are exposed to the infectious diseases - diseases such as tuberculosis (TB), HIV/AIDS, hepatitis, measles and rubella - that are common in Europe, independently of migration. Countries where most of the refugees and migrants originate from often have lower incidence of vaccine preventable diseases such as measles compared to many European countries and higher levels of immunization," she said.

"Cholera is well-known in Europe and European countries are well equipped to address it," Emiroğlu said. "Cholera bacteria, when introduced in an unsanitary environment, can spread easily and the disease would not spread further if access to clean water and a safe sanitation is ensured."

Turkey, host of more than 2 million displaced people from Syria –and more estimated to come in the near future- is among countries that could be directly affected by a likely outbreak. A small fraction of refugees stay in refugee camps across Turkish-Syrian border while majority are scattered all around the country. Syrians who can afford stay in rental houses while impoverished ones are forced to live outdoors or in crumbling, abandoned buildings in squalid conditions.

Turkish authorities closely monitor refugees they admit into the country. Refugees are subject to medical examination and have free access to Turkish healthcare system. Refugee camps, praised for their state-of-art facilities also include clinics. Authorities had stepped up measures after polio cases were reported in Syrian refugees last year, mobilizing a vaccination program.

Emiroğlu noted that World Health Organization's Europe Office had a field presence in Gaziantep, a southern Turkish city bordering with Syria, since 2013, to help refugees in health issues. She said WHO provides support for technical and financial assistance for outbreak response and immunization campaigns as well as public health advice to refugees.