By Robert Herriman  @infectiousdiseasenews

Not only was Dec. 31, 2019 the end of the year, but it was also the end of the 2010s decade (Jan. 1, 2010-Dec. 31, 2019).

In this post, I list what I believe to be the top infectious disease news stories of the past decade.

9. First Naegleria fowleri survivors in the United States in 35 years

Primary amebic meningoencephalitis (PAM) is a nearly always lethal infection of the central nervous system.

Of the 145+ infections reported in the United States since 1962, only four have survived.

Prior to 2013, the last survivor was in 1978 (35 years earlier). In 2013, two patients survived the 98 percent fatal amoebic infection. The first one was 12-year-old Kali Hardig from Arkansas who made a full neurologic recovery and returned to school. Her recovery has been attributed to early diagnosis and treatment and novel therapeutics including miltefosine and hypothermia.

Naegleria: Fort Worth hospital 1st to house miltefosine in 2016, today it’s 21 hospitals

8. Cholera in Haiti

A magnitude-7.0 earthquake that struck Haiti on the afternoon of January 12, 2010, which killed and injured 100s of thousands of people.

Ten months after the catastrophic earthquake, a cholera outbreak was confirmed in Haiti. V. cholerae serogroup O1, biotype Ogawa was identified as the strain.

604,634 cases of infection, 329,697 hospitalizations, and 7436 deaths from cholera were reported in the first two years.

To date, nine years later, some 800,000 cases and nearly 10,000 deaths have been reported over the course of the decade since the outbreak started.

Fortunately, the numbers of cases reported in 2019 were few; however, as UN Special Envoy Josette Sheeran wrote in November 2019, “Although Haiti is in the “homestretch” of defeating a cholera outbreak first declared nine years ago, the battle is far from over before the country is free of the deadly disease.”

7. India is polio free

On January 13, 2011, a 2-year-old girl in the West Bengal state fell ill of the crippling disease polio. That was the last case of polio in India.

This was a milestone many thought they many see as India, as early as 1985, saw 150,000 polio cases that year. In fact, as recent as 2009, India had half of the reported cases of polio worldwide.

Thanks to the mobilization of millions across the country and the billions of dollars invested for a mass eradication program set out to give every child under five the oral polio vaccine, India did achieve polio-free certification in 2014.

6. H7N9 avian influenza in China

In March 2013, China reported the first human case of H7N9 avian influenza. The virus has seen 5 waves, or epidemics since that time resulting in more than 1,500 human cases, with approximate 40 percent resulting in death.

31 imported cases from China were reported in five countries, primarily in Hong Kong.

According to WHO’s assistant director-general for health, security and the environment, Keiji Fukuda, who said in 2013, ” This is definitely one of the most lethal influenza viruses we have seen so far.”

5. Middle East Respiratory Syndrome (MERS)

Middle East Respiratory Syndrome (MERS) was first reported in Saudi Arabia in 2012 and has since affected people in 27 countries–10 on the Arabian Peninsula and 17 (travel-associated) outside the Arabian Peninsula.

Since the first cases were reported in 2012 through November 2019, a total of 2494 laboratory-confirmed cases of MERS-CoV and 858 associated deaths were reported globally, mostly in Saudi Arabia.

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4. 2009-2010 H1N1 Pandemic

While this influenza pandemic began during the last decade (the spring of 2009), it did stretch into 2010 and the numbers were huge.

In the US alone, from April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases, 274,304 hospitalizations and 12,469 deaths.

Additionally, CDC estimated that 151,700-575,400 people worldwide died from (H1N1)pdm09 virus infection during the first year the virus circulated.

What was unusual about this pandemic, 80 percent of (H1N1)pdm09 virus-related deaths globally were estimated to have occurred in people younger than 65 years of age.

3. Zika virus epidemic in the Americas

In May 2015, the public health authorities of Brazil confirmed autochthonous transmission of Zika virus in the northeastern part of the country.

Incidence of Zika virus infection in the Americas peaked in 2016 and declined substantially throughout 2017 and 2018.

Zika virus transmission has been found in all countries in the Region of the Americas except mainland Chile, Uruguay, and Canada.

While Zika virus infection is typically mild, it was soon discovered that complications could be quite serious.

Zika history: A timeline to a public health crisis

Zika virus infection during pregnancy is a cause of microcephaly and other congenital abnormalities in the developing fetus and newborn. Zika infection in pregnancy also results in pregnancy complications such as fetal loss, stillbirth, and preterm birth.

Zika virus infection is also a trigger of Guillain-Barré syndrome, neuropathy and myelitis, particularly in adults and older children.

Research continues on Zika virus infection.


2. Yemen cholera outbreak

The cholera epidemic in Yemen became the largest and fastest-spreading outbreak of the disease in modern history during the past decade.

The outbreak surpassed Haiti as the biggest since modern records began in 1949.

The cumulative number of suspected cholera cases reported in Yemen since October 2016 to November 2019 is 2,236,570 including 3886 related deaths, with a case fatality rate of 0.17%.

The country experienced a second wave of this outbreak from 27 April 2017. The total number of
suspected cholera cases reported during the second wave were 2,210,743 including 3757 related deaths with a case fatality rate of 0.17%

Years of fighting between the Saudi-led coalition and Houthi rebels crippled the country, causing widespread internal displacement,  and the collapse of the public health and sanitation system, where 2/3s of the population did not have access to clean water and sanitation led to this massive outbreak.

1.West Africa Ebola Outbreak

In early 2014, the World Health Organization (WHO) reported cases of Ebola Virus Disease (EVD) in the forested rural region of southeastern Guinea.

Crowded urban areas, increased mobilization across borders, and conflicts between key infection control practices and prevailing cultural and traditional practices saw EVD spread to the bordering countries of Liberia, Sierra Leone and beyond, eventually seven other countries–Italy, Mali, Nigeria, Senegal, Spain, the United Kingdom, and the United States.

WHO declared a Public Health Emergency of International Concern (PHEIC) in Aug. 2014.

Liberia, Sierra Leone and Guinea were finally declared Ebola-free in June 2016, not after a record 28,600 cases and 11,325 deaths were reported making this outbreak by far the largest ever.

Honorable mention

2013-2014 Chikungunya outbreak in the Americas

2017 Madagascar plague outbreak

2019 Global measles outbreak

2018-2019 Ebola outbreak in DRC