Background: Countries in the World Health Organization (WHO) Eastern Mediterranean Region (EMR) are predisposed to highly contagious, severe and fatal, emerging infectious diseases (EIDs), and re-emerging infectious diseases (RIDs). This paper reviews the epidemiological situation of EIDs and RIDs of global concern in the EMR between 2001 and 2018. Methods: To do a narrative review, a complete list of studies in the field was we prepared following a systematic search approach. Studies that were purposively reviewed were identified to summarize the epidemiological situation of each targeted disease. A comprehensive search of all published studies on EIDs and RIDs between 2001 and 2018 was carried out through search engines including Medline, Web of Science, Scopus, Google Scholar, and ScienceDirect. Results: Leishmaniasis, hepatitis A virus (HAV) and hepatitis E virus (HEV) are reported from all countries in the region. Chikungunya, Crimean Congo hemorrhagic fever (CCHF), dengue fever, and H5N1 have been increasing in number, frequency, and expanding in their geographic distribution. Middle East respiratory syndrome (MERS), which was reported in this region in 2012 is still a public health concern. There are challenges to control cholera, diphtheria, leishmaniasis, measles, and poliomyelitis in some of the countries. Moreover, Alkhurma hemorrhagic fever (AHF), and Rift Valley fever (RVF) are limited to some countries in the region. Also, there is little information about the real situation of the plague, Q fever, and tularemia. Conclusion: EIDs and RIDs are prevalent in most countries in the region and could further spread within the region. It is crucial to improve regional capacities and capabilities in preventing and responding to disease outbreaks with adequate resources and expertise.

This study aims to provide descriptive epidemiology of human CCHF cases in Afghanistan by demographic, geographical, and seasonal characteristics. This paper's findings are based on the retrospective analysis of the National Surveillance System's collected data from 2016 to 2018. Weekly cases exceeding the 90th percentile of the expected number of cases were considered to be exceptional and above normal. The National Surveillance System detected 1,284 CCHF cases from 2007 to 2018, of which 163 cases were in 2016, 245 cases in 2017 and 483 cases in 2018. A total of 891 suspected and confirmed cases were reported between 2016 and 2018, 293 (33%) of these cases were confirmed by detecting IgM antibody using ELISA and RT-PCR. Among confirmed cases, the three-year case fatality ratio (CFR) was 43.3%. Among the reported cases, 68.5% were males and 31.5% females. The frequent reported occupational groups were housewives (15%), health staff (13%), shepherds (11%), butchers (6%), students (6%), animal dealers and farmers (both 2%) respectively, 19% were unemployed, and occupation was not recorded for 26% of cases. Recently, CCHF has significantly increased in Afghanistan. Despite the increased frequency of cases, the laboratory capacity to test specimens and overall knowledge of CCHF management remains limited.

This paper aims to describe the epidemiological characteristics and clinical manifestations of the first 15 dengue fever cases reported in Afghanistan. A retrospective descriptive analysis of the data on confirmed dengue cases detected by the national disease surveillance system was conducted. Epidemiological, socio-demographic, clinical, laboratory and outcome data from the cases were analyzed. Between May and December 2019, 62 samples were tested for DENV, among which 15 (24.2%) were positive. Seven of the cases were probable autochthonous with no travel history, the other seven cases had a travel history to dengue-endemic countries (five Pakistan, two India) and the travel history for one of the cases was not known. The 15 confirmed cases were reported from six provinces, seven cases (46.7%) were reported from Nangarhar Province, two (13%) from Paktya, and one (6.7%) from Paktika province, bordering with Pakistan, three (20%) were reported from Kabul, and one each (each 6.7%) from Faryab and Laghman provinces. All of the cases manifested fever, headache, myalgia, and arthralgia. Other clinical features were low platelet count (50%), pain behind eyes (36%), rash, and nausea/vomiting (each 21%). For the first time, the surveillance system detected and reported locally acquired DENV cases in Afghanistan, mostly in provinces bordering with Pakistan. Population movements between Afghanistan and Pakistan facilitate the cross-border spread of DENV between two countries.

Access to reliable and timely information is key for healthcare decision-making at the regional, national and sub-national levels. However, lack of access to such information hampers to progress towards achievement of the Sustainable Development Goals (SDGs) in the Eastern Mediterranean Region (EMR), as indicated in the Regional Progress Report on Health-Related Sustainable Development Goals.

Background: Measles and rubella remain key indicators of immunization system performance and are central to the Immunization Agenda 2030 (IA2030). Disruptions caused by the COVID-19 pandemic have widened immunity gaps and accelerated resurgence of vaccine-preventable diseases across multiple regions. This study assesses progress toward measles and rubella elimination in the WHO Eastern Mediterranean Region (EMR) during 2023–2024. Methods: We conducted a retrospective descriptive analysis of measles and rubella surveillance data, WHO/UNICEF Estimates of National Immunization Coverage (WUENIC), and Joint Reporting Form (eJRF) data for all 22 EMR countries and territories. Key indicators included disease incidence, MCV1 and MCV2 coverage, surveillance performance metrics, and verified elimination status. Results: Regional measles incidence increased from 110.8 to 116.3 per million population, while rubella incidence more than doubled from 1.9 to 4.3 per million. Large outbreaks in Yemen, Iraq, and Afghanistan disproportionally drove regional trends. MCV1 coverage remained stable at approximately 80%, while MCV2 coverage increased marginally from 73% to 75%. Only nine of 22 countries achieved ≥95% coverage for both doses in 2024. Persistent zero-dose populations, high dropout rates, and ongoing immunity gaps sustained transmission across multiple settings. Conclusions: The EMR remains off track to achieve measles and rubella elimination by 2030. Accelerated, equity-focused efforts are urgently needed to strengthen routine immunization systems, reduce zero-dose population, enhance surveillance capacity, and improve outbreak response—particularly in fragile and conflicted-affected settings.

Objective This paper aims to provide information on epidemiology and virology of seasonal influenza for the 2018-19 season, and build upon limited information for developing influenza vaccination policy for risk groups in Afghanistan. Methods This paper is based on a retrospective analysis of Afghanistan influenza surveillance data, both from influenza-like illness (ILI) and severe acute respiratory infection (SARI) cases during the 2018-19 season. The data for 2018-19 has also been compared to the data of the previous two seasons (2016-2017 and 2017-2018). Results During the 2018-19 season, a total number of 10,604 ILI and 5,261 SARI cases were reported to the national influenza sentinel surveillance system. From week 48 2018 to week 14 2019, a total of 713 ILI specimens were tested for influenza virus, and 10.7% were positive with majority influenza A(H1N1)pdm09 virus (57%). Similarly, a total of 1,004 SARI specimens were tested for influenza virus during this period, and 11% were positive for influenza with the majority caused by influenza A(H1N1) pdm09. Almost two-thirds (62%) of the ILI-influenza positive cases and 46% SARI-influenza positive cases aged less than five years. Also, over 50 years old patient was reported to have the second-highest proportion of SARI associated influenza (30%). Conclusion The findings indicate that the seasonal influenza virus results in considerable hospital visits, admissions, and deaths in Afghanistan. The data from this study will inform and guide policymakers in developing national influenza vaccination policies.