Panic and anticipation dominate the Lebanese city of Tripoli, following an unprecedented outbreak of “jaundice” or “hepatitis A”, affecting dozens of residents from different neighborhoods and areas in the city, including a large number of children, without knowing the causes or the source of the pollution that led to it , which further complicated the matter and exacerbated the fears of the city’s residents.
On Monday, the Lebanese woke up to demands to declare a state of health emergency in the country, the most prominent of which came from the head of the Pharmacists Syndicate, Joe Salloum, who indicated the extent of the disease outbreak in Tripoli and its spread in several areas of the city and its vicinity, calling on hospitals to remain on alert to receive patients.
Salloum’s statements came following a visit to Trabulson, who he undertook to inspect the situation in the field following the spread of injuries, and then issued a statement in which he indicated that the preventive vaccines for the disease are missing, and there is a great delay in importing them, while the vaccine is the only way to prevent it, and accordingly he appealed to those concerned in the authority as well Importing companies expedite the provision of vaccines to pharmacies and launch the largest vaccination process (Preventive medicine) to limit its spread and preserve the health of citizens.
What is “yellow disease”?
Jaundice, or what is called “whistoric” or “yellow disease” popularly, is a disease caused by the formation of an excessive amount of a substance called “bilirubin” that acquires a yellowish color in the blood, as a result of a defect in the work of the liver, so that it collects under the skin and in the whites of the eyes In turn, it turns pale yellow.
Jaundice may affect anyone of any age, but the percentage usually rises in newborns. In cases of epidemic outbreaks resulting from pollution, the disease may affect all age groups exposed to the source of pollution, and it also affects people who have previously received vaccination in Young or old, as well as those who have had the disease in previous periods.
Hepatitis A is highly contagious and affects the liver’s ability to perform its vital functions. It is transmitted to the body through contaminated food or water, or through direct contact with an infected person or an object contaminated with the virus, and most people with infection recover completely without permanent liver damage or defect, while the recovery period from the disease sometimes extends for months, especially if the patient does not receive Necessary treatment of the causes of the disease.
In this context, the Lebanese Ministry of Health has clarified that “Alpha hepatitis is caused by a virus that is transmitted to humans through eating contaminated and undercooked foods, or drinking contaminated water or beverages, and the incubation period extends from 15 to 50 days.”
The most prominent symptoms of the disease are: fever, feeling tired, vomiting, nausea, and yellowing of the skin (wheezing). Therefore, the Lebanese Ministry of Health advised “not to eat uncooked foods, and not to drink water of unknown source or suspected of contamination, in addition to refraining from using this water to wash vegetables and fruits.”
The ministry urged citizens to “observe the conditions of personal hygiene, in terms of washing hands well following using the toilet, and before preparing food or eating it with hands, as the virus can be transmitted orally when hands are contaminated with stool carrying the virus.”
Early onset of the disease
The emergence of the disease in Tripoli and its spread came in stages, as the monitoring of cases began on the first of last May, coinciding with Eid Al-Fitr, according to what the Director of Medical Care at the Ministry of Public Health, Joseph Al-Helou, confirms, who visited the neighborhoods that recorded high infections, and inspected the conditions The health and social status of patients, and the status of their families.
Al-Helou explained, in his interview with Al-Hurra website, that, according to what people reported to the epidemiological surveillance group of the ministry, which examined the places of the outbreak and conducted a field examination, it was found that monitoring of these cases began on the second of last May, “and this is the incubation period of the virus, which extends from 7 to 50.” Day, so the numbers are low and then rose simultaneously in the past days and reached their peak.”
The Ministry of Health began investigating the monitored cases following they reached 49 cases, as it turned out that they are distributed in the neighborhoods of “Dahr Al-Maghar / Al-Qubba”, which is the area that recorded the highest percentage of injuries, in addition to neighborhoods in “Bab Al-Tabbaneh, Al-Mina, Al-Badawi and Bab Al-Raml”. However, the number of injuries rose to 174, according to a statement issued by the Ministry of Health on Monday.
The ministry stated that it has kept up with this issue since its appearance, and is still taking samples and conducting the necessary investigations to clarify the cause of the spread of infection, which “has not been resolved definitively yet.”
The ministry’s teams communicated with the injured in order to determine how they were exposed to the injuries and the pathological and epidemiological characteristics of the cases, and samples were collected to examine drinking water in cooperation with the North Water Authority.
Water..the first suspect
Focusing on water as the most likely possibility to be the source of pollution came following almost all the cases monitored by the Ministry of Health agreed on the same story, according to El-Helou, “They all bear responsibility for the quality of water. ”
This theory is consistent with the opinion of the attending physician at Tripoli Governmental Hospital, Helmy Shamroukh, that the known cause of this disease is water pollution in general, “But in the case of Tripoli, the question is which water is that polluted? Drinking water, tanks, or the water network for domestic use, or even of irrigation water for crops?
This is the real problem for the Director of Medical Care in the Ministry of Health, “Until today, we did not know the true source of pollution, whether it was a sewage leak in the water network for domestic use, or contamination in water collection tanks, or even private water tanks. Until now, all the tests that it conducted The Ministry of Health and the North Water Authority, the result was negative and did not show any source of pollution.
The statements of the mayor of Tripoli, Riyad Yamaq, contributed to directing attention to water, as the most likely source of pollution, especially since “the popular areas of Kabab al-Tabbaneh and others, over the years, have been witnessing cases of diarrhea, due to the overlap of well water with sewage, so that there is no water network. modern in these areas,” he said.
Yamaq pointed out that the electricity had been cut off from Tripoli for regarding 10 consecutive days, with it the water pumps stopped working in Tripoli, which prompted people to consume water tanks, especially in the al-Qubba area, until the last drop with its sediments and pollutants, then people were forced to buy water from tanks later.”
Hence, the hypothesis that the problem occurred during that time period increases, according to Al-Helou, who confirmed that the Ministry of Health teams were able to count regarding 5 tanks whose water was also tested, “We also noticed that most of the old buildings have a private water well in the building, amid talk regarding inside sewage water with well water in some areas.”
However, the Water Authority asserts that, with French support, the water network was modernized and repaired regarding two years ago, and there has been no maintenance or excavation work on this network recently that may lead to water leakage on each other, according to El-Helou.
In turn, the North Lebanon Water Corporation announced, in a statement addressed to water subscribers in and around Tripoli, that “following receiving news of the spread of hepatitis A, the corporation’s teams inspected the area last Sunday morning and took water samples in several places, and examined them in The institution’s central laboratory, and the examination result showed that the institution’s water is free of any microbial contaminants, and it is clean and suitable for drinking and domestic use.
The outbreak is confined
Most areas in Tripoli depend on two springs of drinking water that feed the entire city, and here the question arises as to why the disease did not spread widely if it came from water. However, the Director of Medical Care at the Ministry of Health conveys from his observations that there are families of whom 3 or 4 were infected. People, while one or more individuals remain uninfected, despite their presence in one house with more than one infected person, and they share food, drink and the same bathroom, “and all of this is one of the most important causes of infection, yet they did not contract it, and here I think that the biggest influencing factor is the immune system of each person.” one by one.”
Al-Helou added, “We also contacted a large number of doctors, who drink from the same water that reaches the various neighborhoods of Tripoli, yet no infection or infection was recorded among them.”
For his part, Shamroukh told Al-Hurra that the number of infections that reached the government hospital is not large, “but it is a big difference from the annual figures recorded for this disease, while the number of infections with this disease was one or two throughout the month, we arrived this month to regarding 17 cases.
According to the current results, the outbreak is small and confined to specific popular neighborhoods in the city, according to the doctor, who records symptoms ranging from high body temperature, diarrhea and vomiting, to yellowing of the face and eyes, while the treatment of cases is carried out in a simple way through the serum and the necessary medications.
Vaccines are missing
Attention is currently turning to the most important element in combating the outbreak of the epidemic, which is the vaccine for the virus, which the head of the Pharmacists Syndicate confirmed that it was cut off from Lebanon.
For his part, Al-Helou confirms that vaccination once morest “jaundice” was never compulsory in Lebanon, so it was not available in the Lebanese markets in the necessary quantities, “Now, in this case, I hope that the Lebanese authorities, through the Ministry of Health, will be able to secure this vaccine to cut the way for investors in crises, as we may witness in the coming period laboratories, dispensaries and doctors who secure this taste for a high price.”
In addition to monitoring and tracking, the Ministry of Health also ensures complete and completely free treatment for patients, as Al-Helou confirms that all primary care centers receive patients and provide them with the necessary treatments with the doctor’s detection and provision of the necessary medicines, and so far there is no case in hospitals and all cases have received the necessary treatments And they followed the stone themselves in their homes.
Both Al-Helou and Shamroukh agree that the issue is not as dangerous as it is being portrayed and is given more than its size, so that the biggest goal remains to reach the source of pollution and control the spread.
