According to a WHO statement on 6 December, diphtheria is rapidly spreading in the refugee camps in Cox's Bazaar, with the epicentre of the outbreak being located in Kutupalong, Balukali and Jamtoli refugee camps. As of 8 December, over 110 people have contracted the disease, including six fatalities. The majority of people affected are between 5 and 15 years old. This airborne disease is highly contagious in congested environments. Immediate relocation of populations and additional sites and land are required to limit the spread of the outbreak.
WHO, together with the Ministry of Health and health partners, is rapidly scaling up prevention and treatment response, as currently only one agency has the capacity and available medicines to admit and treat patients. Routine immunization with all antigens has been instructed to start as of 9 December and will target children up to six years old. Lack of vaccines does not permit vaccination of older age groups for the moment. Dipthteria Antitoxin is being procured by WHO and is expected to arrive next week. Humanitarian agencies are assessing capacity to set up additional isolation tents. Additional human resources, isolation capacity, vaccines and supplies are urgently needed (PCV, TD and Pentavalent) to respond to the epidemic.
Meanwhile, UNHCR is scaling up its presence in the country, with the arrival of additional 80 staff members expected in the coming weeks. This follows a decision by the UN chiefs to put the refugee agency in the lead of the operations. This comes at a time when preparations are underway for a revision of the humanitarian response plan following the current one, coming to an end by February 2018.