Escalation of Infectious Diseases Amidst Gaza's Ongoing Crisis: A Alarming Rise in Bloody Diarrhea, Jaundice, and Hepatitis Cases

The Gaza Strip is currently experiencing a spread of diseases such as bloody diarrhea, jaundice, acute hepatitis, and respiratory infections. The World Health Organization has described the health system in the region as "on its knees and collapsing." As the conflict between Israel and Hamas continues for the third month, medics and aid groups are raising concerns about the dire humanitarian situation in the besieged enclave. The United Nations has expressed worry that more people may perish from diseases than from bombs and missiles.

Palestinian families, forced to leave their homes as a result of Israeli airstrikes, seek refuge in tents at Nasser hospital during the continued hostilities between Israel and the Palestinian Islamist organization Hamas in Khan Younis, located in the southern Gaza Strip on November 19, 2023. REUTERS/Saleh Salem

Saleh Salem/Reuters

In Gaza, disease could be even deadlier than airstrikes, WHO says

The coastal territory, controlled by the Hamas militant group, has been completely besieged by Israel since the start of the war with Hamas. The Palestinian group initiated an attack on October 7, killing 1,200 people and kidnapping 240 others, according to Israeli authorities.

Due to the ongoing conflict, most of the Strip has depleted its food, drinkable water, electricity, and medical supplies. Hundreds of thousands of displaced Palestinians are crowded into small spaces to seek shelter from Israel's bombings.

Almost no one has been able to leave Gaza, except for foreign nationals and a few injured Palestinians, leaving over 2 million people trapped in the region. According to the Hamas-controlled health ministry in the enclave, the fighting has resulted in over 18,000 deaths since it began.

Heres what we know about the potential for disease to spread in the territory.

How has the healthcare system been affected by the war?

The UN and local doctors have been issuing repeated warnings about the dangerous spread of disease in Gaza. The WHO has described the situation as a breeding ground for epidemics. During a meeting with WHO member countries, Director-General Tedros Adhanom Ghebreyesus stated that only 14 out of 36 hospitals in Gaza are operating, and the two main hospitals in the south are overwhelmed, operating at three times their normal capacity.

He stated that only two are still functioning in the north of Wadi Gaza, following Israel's request for approximately 1.1 million people to evacuate south of the area when it initiated its ground operation on October 13. He further added that there are only 1,400 hospital beds remaining, with medical facilities running low on supplies and serving as makeshift shelters for the displaced.

Palestinians flock to a truck carrying drinkable water amid growing hunger and thirst in Rafah, southern Gaza on December 11.

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What diseases are medics worried about?

The head of WHO expressed concern about the presence of alarming signs of epidemic illnesses "such as bloody diarrhea and jaundice," and also noted the existence of instances of elevated occurrences of diarrheal illnesses and respiratory infections.

The Palestinian Ministry of Health in Gaza has reported cases of measles, meningitis, chickenpox, and acute viral hepatitis. According to Richard Peeperkorn, WHO Representative in the Occupied Palestinian Territory, there are between 160,000 to 165,000 cases of diarrhea among children under the age of five, which is significantly higher than usual.

Diarrheal diseases are considered the second most common cause of death among children under five years old. If left untreated, diarrhea can persist for multiple days, depriving the body of essential water and salts necessary for survival.

A Palestinian boy carrying a baby stands at a destroyed building in Rafah, in southern Gaza, December 4, 2023.

Mohammed Salem/Reuters

Israel's military campaign has extended to southern Gaza, despite the UN's warning of a severe lack of regard for basic human rights. In addition, the Palestinian Ministry of Health has documented over 133,000 cases of upper respiratory tract infections, 17,000 cases of lice and nits, 35,000 cases of skin rashes, and over 1,900 cases of food poisoning.

The ministry has not officially documented any instances of cholera, however, Doctors Without Borders has issued multiple warnings about the possibility of a cholera outbreak due to the shortage of clean water in densely populated areas. "Many individuals are consuming salty or polluted water, which has the potential to cause illness," MSF stated in October.

Cholera has been spreading in recent years during the wars in Yemen, Syria, and Sudan. Euro-Med Human Rights Monitor issued a warning last month that the presence of bodies near or in water sources could also contaminate the water, thereby increasing the risk of cholera and other gastrointestinal diseases.

Whats causing the diseases and why are they spreading?

The prolonged decomposition of dead bodies in public spaces, a frequent consequence of the war in Gaza, may lead to the spread of other diseases such as blood-borne viruses and tuberculosis.

Following the imposition of a blockade by Israel on October 9, Gaza faced a rapid depletion of food and water supplies. The diminishing fuel stocks have resulted in severe electricity shortages, impacting medical facilities, food storage, and the handling of casualties. Israel's military operation has now extended further into southern Gaza, prompting civilians to relocate from previously designated safe areas.

Almost all of Gaza's 2 million population is now displaced, with 1.9 million having been forced to leave their homes, as reported by the WHO on Sunday.

Due to limited options, many of the displaced residents are relocating to already overcrowded areas. The UN has estimated that as of November 24, at least 60% of Gaza's housing has been either destroyed or damaged.

Medical aid from the International Committee of the Red Cross (ICRC) arrives at the Nasser Medical Hospital in Khan Younis, southern Gaza, on December 9.

Ahmad Salem/Bloomberg/Getty Images

How is the international community reacting?

The emergency session on the situation in Gaza will be resumed by the UN General Assembly on Tuesday, following the recent veto by the United States of a UN Security Council resolution calling for a humanitarian ceasefire. According to Philippe Lazzarini, the head of the UN Relief and Works Agency for Palestinian refugees (UNRWA), UN staff in Gaza feel abandoned after the US veto. Lazzarini expressed their confusion and frustration over the lack of a ceasefire agreement despite the significant loss of life and displacement in the region. He made these remarks in the Egyptian city of Arish, near the Rafah crossing with Gaza.

Amid the temporary truce between Israel and the Palestinian Islamist group Hamas, Palestinian children are seen walking among the houses destroyed in Israeli strikes during the conflict, at Khan Younis refugee camp, in the southern Gaza Strip, November 29, 2023. The photo was taken by REUTERS/Mohammed Salem.

Mohammed Salem/Reuters

US pressing Israel to move civilians out of way if Israel attacks in southern Gaza

Gaza is on the brink of a collapse in civil order, which will make it impossible for the agency to continue operating. Desperation has led some civilians in Gaza to resort to looting warehouses. Aid groups have criticized the insufficient volume of 60 to 100 trucks entering Gaza through the Rafah crossing in recent days, stating that it is not enough to alleviate the humanitarian crisis in the territory.

The timing of when additional aid will reach Gaza remains uncertain. Israeli authorities announced on Monday that two crossings, Kerem Shalom and Nitzana, will be utilized to inspect humanitarian aid bound for Gaza. However, they stated that no aid will be permitted to enter Gaza directly from these Israeli crossings. Instead, the aid will be inspected at both crossings and then transferred to international aid organizations in Gaza via Rafah in Egypt, according to Israel.

CNNs Kareem Khadder, Niamh Kennedy, Clarissa Ward, Catherine Nicholls, Tamar Michaelis and Tim Lister contributed to this report.