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8 Disease Outbreaks From 2018 That You Should Know About

Ebola, measles, and monkeypox are just a few of the infectious diseases that caused severe outbreaks in 2018. Here's what you need to know.

Posted on December 16, 2018, at 10:00 a.m. ET

Measles cases hit a record high in Europe.

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Measles is a highly contagious disease that causes respiratory symptoms and a whole-body skin rash. Since the introduction of the measles vaccine in 1963, global measles deaths have decreased significantly, according to the World Health Organization (WHO), but outbreaks remain a problem in many parts of the world. And in 2018, measles cases hit a record high in Europe.

More people in Europe were infected with measles during the first six months of 2018 than during any other year in the past decade, according to the WHO regional office for Europe. Over 41,000 children and adults have been infected with measles since January, and 37 people have died. Previously, the highest total number of cases in Europe was 23,927 in 2017, BuzzFeed News previously reported.

Seven countries reported over 1,000 cases, including travel hotspots like France and Italy. Ukraine was hit the hardest, with over 23,000 measles cases, and Serbia reported the highest number of measles-related deaths (14) out of any country. Measles is spread through contact with an infected person or their respiratory secretions, which are produced through coughing and sneezing. It can be prevented with the MMR vaccine.

A drop in vaccination rates is behind many measles outbreaks. About 40% of people in France incorrectly believe vaccinations are unsafe, as do 25% of people in the Ukraine, BuzzFeed News previously reported.

The deadly, bat-borne Nipah virus spread in India.

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The Nipah virus (NiV) is a rare infectious disease with no vaccine or cure, and a case fatality rate of up to 75%. Early symptoms include a fever, vomiting, and mental confusion. Nipah can cause a respiratory infection that leads to pneumonia, or it can cause inflammation of the brain (encephalitis), which may lead to seizures, a coma, or death.

In May of 2018, a deadly outbreak of Nipah virus was reported in the Kozhikode district of Kerala, a state on India's Malabar coast. It was the first outbreak of Nipah virus in south India, according to the WHO, and there were a total of 19 cases and 17 deaths reported, including a young nurse who had cared for infected patients at a hospital. Following a robust public health response, the outbreak was contained and no new cases have been reported since June.

Nipah virus is a zoonotic infection, meaning it is transmitted to humans from animals. It's thought to spread through the saliva and respiratory secretions of infected bats or direct contact with infected pigs or their tissues, BuzzFeed News previously reported. The virus can also spread from human to human, often in health care settings or to caregivers.

Ebola spread in the Democratic Republic of Congo, causing the second-largest outbreak in history.

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Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a rare infectious disease that's often fatal if left untreated. It is caused by a virus that's transmitted to people through blood and bodily fluids from infected people or animals. It can cause flu-like symptoms that lead to vomiting, kidney impairment, and both external and internal bleeding.

The Democratic Republic of Congo (DRC) is facing its worst Ebola outbreak to date, sparking concern among global health officials. According to the most recent data from the WHO, there have been 505 Ebola cases (457 confirmed, 48 probable), and 296 deaths reported in the northeastern provinces of North Kivu and Ituri, which share borders with Uganda, Rwanda, and South Sudan.

The Ebola case fatality rate is around 50%, but it can be as high as 90%, according to the WHO. Supportive care can improve the chances of survival. There is currently no licensed vaccine to protect against Ebola, but an investigative vaccine, rVSV-ZEBOV, is being offered to those considered high-risk — as of Dec. 10, over 44,000 doses had been administered, according to the WHO.

The 2014–2016 Ebola outbreak in West Africa was the largest in history and the first-ever epidemic affecting multiple countries and infecting some US travelers. There were 28,616 cases and 11,310 deaths reported overall.

Norovirus sickened security staff and some athletes at the 2018 Winter Olympics in Pyeongchang, South Korea.

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In February, millions of people arrived in Pyeongchang, South Korea, for the 2018 Winter Olympic Games. Among those was one very unwelcome guest: norovirus.

Norovirus is the most common cause of gastroenteritis, which is an inflammation and irritation of the stomach and intestines. This can lead to nausea, abdominal pain, vomiting, and diarrhea — lots of diarrhea. Treatment usually involves supportive care, or getting plenty of rest and fluids.

People typically contract norovirus by consuming food or beverages contaminated with fecal matter from an infected person, or from touching their mouth after coming into contact with a contaminated surface. It spreads quickly in crowded conditions and can spread directly from person to person through close contact.

The outbreak during the winter Olympics began among members of security hired to work the event — as a result, 1,200 members of the security detail were quarantined during the games and members of the South Korean army were drafted to fill in, BuzzFeed News previously reported. The outbreak eventually spread to athletes, including two freestyle skiers on the Swiss team. There were a total of 324 confirmed cases of norovirus in this outbreak, according to the Korea Centers for Disease Control and Prevention.

A monkeypox outbreak in Nigeria ended up spreading to the United Kingdom.

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Monkeypox is a rare disease that causes symptoms that are similar to but milder than those caused by smallpox, according to the WHO. It's endemic to West and Central Africa, but it has spread outside the continent and there was a monkeypox outbreak in the midwestern US in 2003.

The outbreak in Nigeria started in September of 2017, and between then and September 2018 there were 115 confirmed cases and seven deaths, the WHO reported. Of those, 37 cases and two deaths occurred in 2018. But there's something else notable about this year's outbreak: Monkeypox spread to a country where it's never been diagnosed before.

In September, three individuals were diagnosed with monkeypox in the United Kingdom, according to Public Health England, which were the first cases ever diagnosed in the UK. Two of the patients were believed to have contracted the disease in Nigeria before traveling back to the UK, and the third patient was a health care worker.

Monkeypox is a zoonotic infection caused by the monkeypox virus (MPXV), and symptoms include a fever, muscle aches, swollen lymph nodes, and small fluid-filled lesions or "pox" that develop all over the body. Transmission of monkeypox occurs when a human comes into contact with an infected animal or human, or materials contaminated with the virus, according to the CDC. The animal reservoir or main carrier of the disease is still unknown, but African rodents may be a potential source. Hunting and handling live or dead animals is a possible risk factor.

E. coli linked to romaine lettuce caused two multi-state outbreaks in the US, which left five people dead.

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Overall, 2018 was a bad year for romaine lettuce in the US. The CDC warned consumers not to eat the salad staple two separate times after it was linked to E. coli outbreaks making people sick in multiple states.

In the most recent outbreak, which began in October, 52 people have been infected from 15 states so far, according to the CDC. No one has died yet, but five people died in a similar, larger outbreak of E. coli linked to romaine lettuce that sickened over 200 people earlier this year, BuzzFeed News previously reported.

Escherichia coli are bacteria that are commonly found in the digestive tracts of humans and animals. Most strains of E. coli are harmless, but some can cause serious food poisoning and other illnesses. The strain in the outbreaks linked to romaine lettuce is called E. coli O157:H7, which is particularly bad because the bacteria produce a potentially life-threatening Shiga toxin.

E. coli infections typically cause severe diarrhea and cramping, but some can lead to urinary tract infections, pneumonia, or kidney problems. People usually get exposed to E. coli through contaminated water or food, or through contact with sick people or their fecal matter.

There was a massive outbreak of Lassa fever, which is spread by rats, in Nigeria.

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Lassa fever is a hemorrhagic virus, or one that has the potential to cause severe bleeding, that's endemic to West Africa. Outbreaks typically occur each year in Nigeria. However, the 2018 outbreak was one of the worst the country has ever seen, according to the WHO.

There were more confirmed cases of Lassa fever in the first two months of 2018 than there have been in the last two years combined, BuzzFeed News previously reported. Since Jan. 1, there have been a total of 562 confirmed cases and 144 deaths, according to the Nigeria Centre for Disease Control.

Of those who are infected with the Lassa virus, about 80% will have no symptoms and only 1 in 5 will develop severe disease, according WHO. Symptoms include a fever, sore throat, diarrhea, abdominal pain, and weakness. In severe cases, people may develop fluid in the lungs and bleeding of the mouth, nose, vagina, or intestines which can lead to seizures or death in the later stages, according to the WHO.

Humans usually get the virus from contact with infected rats or their urine and feces, for example through contaminated food. Less commonly, it can spread from person to person — which typically occurs in health care settings — and there's evidence that it can be transmitted sexually.

Influenza was widespread and deadly in the US, killing an estimated 80,000 people.

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The flu is an extremely contagious upper respiratory illness caused by influenza A and B viruses. Symptoms include a fever, runny nose, chills, fatigue, and body aches. In severe cases, the flu can lead to viral or bacterial pneumonia or sepsis, which is a life-threatening complication of an infection. The flu is especially dangerous for high-risk individuals such as elderly people, very young people, and those with weak immune systems.

The 2017–2018 flu season was one of the deadliest in the last 40 years. According to the CDC, an estimated 80,000 people died, including 180 children, from the flu and its complications. The flu season started to peak early, in November. It reached high levels of activity nationwide in January and February, and remained elevated through the end of March. The predominant circulating strain, H3N2, is known for being particularly nasty and causing severe flu seasons.

The flu is transmitted through respiratory droplets that are produced when a person coughs or sneezes. These can be inhaled or enter the body through direct contact, such as kissing, or when someone puts their hands in their mouth or eyes after touching a contaminated surface. The best way to protect yourself from getting sick is by getting the seasonal flu vaccine.

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