Global Infectious Diseases in June 2023: Monthly Analysis

coro-navirus 2 (SARS-CoV-2)


INTRODUCTION
Infectious diseases have threatened humanity throughout history. For example, the epidemic of severe acute respiratory syndrome coronavirus (SARS) in 2003, the prevalence of swine f lu in 2009, the pandemic of Middle East respiratory syndrome coronavirus (MERS) in 2012, the outbreak of Ebola virus disease in 2013-2016, and the current pandemic of coronavirus disease 2019 (COVID-19) all resulted in severe morbidity and mortality and led to a devastating impact on global economy [1]. The increased international mobility, high-density urbanization, climate change, poor public health systems, and microbial adaptations are some of the main drivers for the emergence and spread of infectious diseases. Self-distancing, wearing masks, travel restrictions, avoiding gatherings, and vaccine administration are the common measures we have adopted to control the pandemic diseases nowadays; however, the natural diversity of pathogens make the production of efficacious vaccines against diseases a large challenge. Therefore, monitoring the growing trends of global infectious diseases is particularly significant and necessary to control the pandemic.
In this review, data from epidemiologic websites were mined to predict the global outbreak trends of infectious diseases. We used the Shusi Tech Global Epidemic Information Monitoring System to analyze the global distribution of infectious diseases which have occurred between 24 May 2023 to 23 June 2023 (Fig 1).

COVID-19
The outbreak of the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has clearly caused a major public health emergency # Shuqiong Zhang and Xin Fu have contributed equally to this work. *Corresponding authors: worldwide. The reason for this threat is the infectious nature of the virus and the ability of the virus to rapidly evolve and mutate, thus leading to the emergence of new, less common strains. According to the World Health Organization, from 24 May to 23 June 2023, there were 1,222,682 new cases of COVID-19 worldwide, and 6,973 new deaths, both down approximately 40% from the previous month. Among the 6 WHO regions, the Western Pacific region still has the largest proportion of new cases (approximately 60%), but the greatest number of new deaths occur in the European region (Fig 2). Although the status of the epidemic in some areas has improved, the epidemic still needs continuous attention, prevention, and control.

MONKEYPOX
Monkeypox is a zoonotic disease caused by the monkeypox virus [2]. According to an analysis of WHO data, the number of monkeypox cases reported weekly has declined significantly in recent months from the global peak of 7576 cases observed in the week of 8 August 2022. In the past month, the number of new monkeypox cases mainly occurred in the Americas and western Pacific, where the number of new cases exceeded 150 (Fig 3). The main prevention of monkeypox involves avoiding contact with infected individuals, including not only the patient, but also the patient's clothing and household items.

CHOLERA
Cholera, caused by Vibrio cholerae, can result in hypovolemic shock due to the rapid loss of f luids and electrolytes [3]. During June 2023, cholera outbreaks occurred in several countries, including Afghanistan and Zimbabwe, as shown in Table 1. Local medical workers are taking active measures to contain the spread of the epidemic. A combination of surveillance, water, sanitation and hygiene, social mobilization, treatment, and oral cholera vaccines are used to control the spread of cholera.

DENGUE
Dengue is transmitted by mosquitoes of the genus Aedes. Virus amplification occurs during the viremia phase when mosquitoes become infected by biting humans [4]. Tens of thousands of people in Indonesia, Peru, the Philippines, Sri Lanka, and Thailand have been infected with dengue this year (Table 2). Nearly 2000 people are infected in Malaysia every week. Dengue continues to spread rapidly due to climate change, rapid urbanization, and population growth. Dengue outbreaks are usually seasonal, peaking during and after the rainy season, thus dengue is one of the infectious disease to watch closely during the hot and rainy summer months.

MEASLES
Measles, an acute respiratory infection caused by the measles virus, is easily transmitted between humans [5]. Since the development of the measles vaccine, measles deaths have declined worldwide and measles has been eliminated in some countries and territories, but measles remains one of the leading causes of death among young children worldwide. In June, new infections and deaths were reported in several countries, including Afghanistan and Nigeria (Table 3).

INFLUENZA
Inf luenza, caused by a negative-strand RNA virus of the Orthomyxoviridae family, is an acute respiratory infection that affects millions of people around the world annually [6]. The incidence of human inf luenza is seasonal because the viral survival and transmission is largely driven by climate conditions. As reported, the inf luenza cases in USA decreased at the beginning of summer compared to the past few months (Table 4). In contrast, the burden of f lu infection remains high in Australia, where the inf luenza seasonal activity occurs in the winter months ( June to August). To prevent an inf luenza epidemic, surveillance measures should be carried out continuously to monitor the directions of antigenic changes in the inf luenza virus.

MALARIA
The data in Table 5 shows that approximately 3000 residents in Ethiopia are at risk of malaria within one week. Malaria remains a serious public health threat in Ethiopia. Widespread insecticide resistance in mosquito vectors, weaknesses in malaria surveillance, and a lack of high-quality healthcare are some of the major factors that hinder progressive steps toward elimination of the disease [7].

TUBERCULOSIS
Tuberculosis (TB), caused by bacteria of the Mycobacterium tuberculosis complex, is one of the major killers of the human population after HIV/AIDS [8]. Data from Table 6 demonstrate that the prevalence of TB infection is higher in Japan and Korea than other countries with similar economic power. A global program, "End TB Campaign," which is managed by the WHO, has the goal of reducing the incidence of TB by 90% to 10 per 100,000 population by 2035. Continued efforts are necessary in Japan and Korea to eradicate TB.

OTHER INFECTIOUS DISEASES
In addition to the above-mentioned diseases, other global infectious diseases that occurred during the last month are listed in Table 7

CONCLUSION
Infectious diseases affecting humans are ever-present, whether the common cold, cholera, and a plague, which adversely affect human society. With globalization, emerging infectious disease quickly spread widely around the world. To control the global spread of infectious diseases and ensure the safety of people's lives, it is necessary to regularly analyze global infectious disease cases. The COVID-19 pandemic and other recent large-scale disease outbreaks have highlighted how healthcare facilities can contribute to the spread of infection if insufficient attention is paid to infection prevention and control. In the past month, new COVID-19 cases and deaths have decreased compared to the previous month, but because SARS-CoV-2 is highly variable and contagious, we still need continuous attention and prevention and control. The emergence of SARS-CoV-2 variants, such as XBB.1.5 and XBB.1.16, over the past few months highlights one of the major challenges facing this pandemic.
At the same time, seasonal outbreaks of inf luenza, dengue fever, and malaria remain public health concerns around the world. The number of inf luenza cases in the United States decreased in early summer compared to past months. In contrast, Australia, which is in winter, has had a marked increase in inf luenza infections. In addition, we should be vigilant for sporadic infectious diseases, such as chikungunya, legionellosis, polio, scarlet fever, and Hantavirus, to avoid a global pandemic.