Scientists have found an increase in botulism and salmonellosis in Ukraine compared to before the invasion by Russia.
To analyze the war’s effects on infectious disease epidemiology, researchers used open-source data on eight diseases from EPIWATCH, an artificial intelligence early-warning system.
They looked at patterns of infectious diseases before and during the conflict. Before was defined as from November 2021 to Feb. 23, 2022, and during was classed as Feb. 24 to July 31, 2022. Findings were published in the journal Emerging Infectious Diseases.
Conflict situations increase the risk of epidemics, and the disruption or halting of public health surveillance creates challenges for tracking them.
Water supplies in cities such as Mariupol are unsafe to drink because of damaged sewage systems and raw sewage leakage into rivers and streams, yet many people still consume contaminated water. A lack of regular housing and shelter reduced caloric intake, and poor hygiene and sanitation increased the risk for infectious diseases.
After February 2022, formal surveillance for most infectious diseases ceased, and reporting of notifiable diseases was reduced. While formal systems continued to report cases of botulism, the analysis showed that numbers were probably underestimated.
Data from the Ukrainian Ministry of Health shows that 39 cases of botulism have been registered from the beginning of 2024 until mid-July, compared to 45 cases in the same period last year. In June, 15 people were admitted to hospitals with a diagnosis of botulism, mostly after eating dried fish and homemade canned meat.
More botulism and Salmonella reports
Open-source data can help overcome the lack of formal disease surveillance by using information from news media, medical organizations, and social media sources. Scientists say artificial intelligence (AI) can generate early warning signals from open-source data and provide epidemiologic information on infectious diseases in the absence of formal surveillance in a war zone.
Researchers identified 805 outbreak reports in EPIWATCH from Feb. 24 to July 31, 2022. In comparison, 259 reports were collected three months before the conflict. From Feb. 24 to July 31, 2021, there were 180 reports. This indicates a large increase during the conflict.
In the during-conflict period, botulism increased from 22 to 122 reports and salmonellosis from four to 39 reports. For botulism, the number of cases identified through EPIWATCH was lower than that found through formal surveillance.
Researchers said they could identify epidemics such as botulism during the conflict.
“We have demonstrated the value of using open-source epidemic intelligence to gain information about unfolding epidemics and public health priorities in a conflict zone where formal surveillance is reduced or lacking.
“The increases in cholera and gastroenteritis reflect declining hygiene and sanitation during the conflict, including lack of access to safe drinking water and toilets and subsequent improper disposal of fecal waste.”
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