Ravaged by cholera, Yemen faces scourge of diphtheria

Blockade by Saudi Arabia halts flow of emergency aid.

Diphtheria, a deadly infectious disease once thought to have been largely eradicated, has now joined cholera as a public-health scourge threatening war-torn Yemen, where a blockade by Saudi Arabia has impeded emergency aid.

Officials at the World Health Organization said Friday that at least 22 people in Yemen had died of diphtheria and nearly 200 had been sickened since it was detected three months ago.

The disease, which the medical charity Doctors Without Borders said had not been seen in Yemen for 25 years, has spread to 13 of Yemen’s 22 governorates.

Officials warned that young children were especially vulnerable to the disease, which spreads through the air and could escalate quickly into an epidemic in Yemen if health workers there lack the antitoxins and vaccine to control it. Currently they have little of either.

A military coalition led by Saudi Arabia, which has been battling Houthi rebels in Yemen since 2015, imposed a blockade on that country last month after a rebel missile was fired deep into Saudi territory. The Saudis said the missile had been supplied by Iran, their regional rival; Iran denied the accusation.

The blockade quickly worsened what was already one of the world’s worst humanitarian crises, denying deliveries of urgently needed food, fuel and medicine to Yemen, the poorest country in the Middle East.

The top relief official of the United Nations, Mark Lowcock, said on Nov. 8 that at least 7 million Yemenis could starve because of the Saudi blockade and that unless it were completely rescinded, the country would suffer “the largest famine the world has seen for many decades.”

Under intense international pressure, the Saudis partly eased the blockade this week. But U.N. officials said Friday that emergency aid deliveries still faced big problems, with many ships unable to unload.

“We’ve seen some progress in the right direction, but obviously we’re not at the level of unimpeded access we’d like to see,” Stéphane Dujarric, a spokesman for the U.N. in New York, told reporters.

Earlier Friday in Geneva, Christian Lindmeier, a spokesman for the World Health Organization, said that 1.9 million doses of diphtheria vaccine for children younger than 5, and 1,000 doses of diphtheria antitoxins needed to treat infected patients had arrived in Sanaa, the capital, in recent days.

Nonetheless, he said, “the recent border closings still have seriously impacted WHO’s operations and our ability to restock,” and the organization still lacks even “one dose of diphtheria vaccine for children above 5.”

Yemen’s diphtheria outbreak comes as the country is still struggling with the world’s worst epidemic of cholera, which can cause potentially fatal dehydration if untreated. Nearly 1 million Yemenis have been infected by cholera this year and more than 2,200 have died, according to the latest World Health Organization data.

Both diphtheria and cholera can thrive in regions suffering from poverty and war. But diphtheria, which once was a leading cause of child deaths in the world, was thought to have been largely vanquished through systematic vaccinations.

Symptoms include sore throat, loss of appetite, fever and difficulty breathing and swallowing.

More than 15,000 people in the United States died during a diphtheria outbreak in the 1920s, but infection rates then plummeted with the introduction of a vaccine.

Russia suffered a major diphtheria outbreak in the early 1990s, which public-health experts attributed to failings in its immunization system and the mass movement of people after the breakup of the Soviet Union.

Marc Poncin, emergency coordinator in Yemen for Doctors Without Borders, said in an email Friday that Yemen’s health care system, which has collapsed, could have once easily prevented and contained the diphtheria outbreak.

“With the last diphtheria case in Yemen recorded in 1992, and the last outbreak in 1982,” Poncin said, “the ongoing war is sending the Yemen health system decades back in time.”

‘The ongoing war is sending the Yemen health system decades back in time.’ Marc Poncin Emergency coordinator in Yemen for Doctors Without Borders