Bi-weekly press briefing 21 July 2023
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48:33
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MP4
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295.4 MB

Press Conferences | WHO

Bi-weekly Press Briefing 21 July 2023

 

PRESS BRIEFING BY THE UNITED NATIONS INFORMATION SERVICE

21 July 2023

 

Update on Dengue Outbreaks

 

Raman Velayudhan, Head of the Unit coordinating the dengue and arbovirus initiative, Global Program on Control of Neglected Tropical Diseases, World Health Organization (WHO), said dengue was the most common viral infection that spread from mosquitoes to people. Most people who contracted dengue for the first time did not have symptoms, and most of those who did, recovered in one to two weeks. However, some people who contracted dengue repeated times had severe symptoms, and the death toll worldwide was high.

 

It was treated with medicines to lower the temperature and body pain, but there was no specific treatment. When there were outbreaks, dengue could draw precious resources from the health system, adding a further burden.

 

Dengue was spread by the Aedes species of mosquito. The disease was more common in tropical and subtropical climates. Its incidence had grown dramatically worldwide in recent decades. Cases reported to WHO had increased from half a million in 2000 to over 4.2 million in 2022, a more than eight-fold increase in two decades. The number of actual cases could be much higher. About half of the world's population was now at risk of dengue, with an estimated 100 to 400 million infections occurring each year.

 

The Americas region had reported 2.8 million cases and 1,280 deaths in 2022. This increasing trend was continuing in 2023, with already close to three million cases reported. The southern spread of cases in Bolivia, Paraguay and Peru was a growing concern.

 

In the European region, the Aedes mosquito was established in over 24 countries, which had reported dengue and chikungunya regularly since 2010.

 

In the Middle East, a high number of cases had been reported from Sudan, with 8,239 cases and 45 deaths since July 2022. In recent weeks, dengue cases had been reported in Egypt.  Trends in Asia were also worrying. Asia usually represented around 70 per cent of the global disease burden.

 

There are several factors driving this spread. These included increased movement of people and goods; urbanization and associated problems of water and sanitation; and continuing spread of the mosquitoes to more regions and countries. There were also issues linked to climate, such as high precipitation, increased temperature and water scarcity, which favoured mosquitoes' breeding. The virus and the vectors multiplied faster at higher temperature.

 

Several new tools were under development that provided greater hope in preventing and treating dengue, such as better diagnostics and antivirals under clinical trial.  One vaccine was in the market, and two were being trailed and reviewed.  Vector control tools included “Wolbachia” population replacement and population suppression models, the “sterile insect” technique and spatial repellents.

 

WHO was providing technical support to help countries respond to the outbreak and enhance cross-border exchange of information.  Community action was also needed for preventing mosquito breeding, raising awareness about dengue and encouraging those affected to seek medical care. WHO was also implementing an integrated strategy for control, with guidance for clinical management.

 

As the rainy season and El Niño commenced, there was a risk that Asian countries could experience a severe dengue outbreak. Dengue outbreaks usually happened around eight weeks after the monsoon season, so the next outbreak was coming soon. Health authorities were encouraging local agencies to reduce the breeding of mosquitoes.

 

WHO was working closely with countries in the Global Arbovirus Initiative to join forces to control some of the most burdensome diseases spread by mosquitoes. It was encouraging countries to focus on the most efficient actions to save lives and prevent disease.

 

In response to questions, Dr. Velayudhan said after the first wave of dengue in new areas, there was a possibility of 80 per cent of people having very mild symptoms. It was important to detect the first wave, as a few years down the line, there was a potential for more severe cases when future waves hit. Populations needed to be protected against those severe cases.

 

This was the beginning of the monsoon season, which had hit India as well as several other States. The stakes were high in India, with reports of dengue increasing. There was a need to prevent breeding by taking measures such as cleaning out stagnant water around houses. Such actions could reduce the number of cases.

 

Cases in Africa were a matter of concern.  The WHO Regional Committee for Africa had released the Framework for the Integrated Control, Elimination and Eradication of Tropical and Vector-Borne Diseases in the African Region. There were at least 200,000 cases per year reported in Africa. This year, there were already reports in countries such as Kenya and Sao Tome and Principe. Dengue in Africa had been masked by other diseases such as malaria in the past, but with the decrease in malaria, dengue cases were becoming more evident. There was a need to continue to improve detection mechanisms. 

 

Mosquitos with dengue bit during the day, so mosquito nets had limited effects. Other preventative measures such as spraying repellents needed to be taken in schools and homes. There was no direct drug intervention for dengue available yet, only medicines for reducing the effects of the disease. Tests needed to confirm the disease took two to three days. Governments needed to make rapid tests available and increase diagnostic capacities.

 

The vaccine for dengue on the market had been registered in 20 countries. It had three doses and worked well for people who had had the disease once. The vaccine had an average 65 per cent efficacy, varying depending on the variety of the disease.

 

On average, the highest number of confirmed deaths per year from dengue was around 6,000, but it was estimated that there the number was much higher, possibly around 40,000 to 70,000 deaths. The WHO hoped to reduce deaths further.

 

Climate change created excess rainfall, which led to more stagnant water in which mosquitos could breed.  This was a major challenge. Rainfall levels needed to be monitored and stagnant water removed. Mosquitos were able to hide in cooler areas to escape the heat during heatwaves. After the current heatwave, there would be rainfall, which would create more breeding sites for mosquitos. In communities where water was being stored, it needed to be covered well to prevent breeding.

 

Dengue had four closely related viruses. If you contracted one virus, you were immune from that virus for your lifetime. However, if you subsequently contracted other dengue viruses, you could potentially develop serious symptoms.

 

Body and clothing repellents, electronic mats, coils and long-sleeved clothing were effective in preventing mosquito bites. Mosquitos usually did not enter air-conditioned areas, and shutting windows and doors was also effective.

 

Historically, dengue started in 1953, with seven or nine Asian countries reporting dengue.  Since then, numbers had increased, with around 2.5 million cases reported in 2019.  More and more regions were now being affected, and WHO predicted around four million cases for this year. However, the number of cases would depend on what happened in the next six months.

 

There were plant-based repellents available, some of which were effective. Users needed to follow labels’ instructions for such products. Their effects lasted for shorter periods than chemical-based products.

 

Announcements

 

Alessandra Vellucci, Director of the United Nations Information Service (UNIS) in Geneva, said the UN Special Envoy for Syria, Mr. Geir O. Pedersen, would brief the Security Council on Monday, 24 July at 4 p.m. The briefing was currently scheduled as open, and a transcript would be delivered after the conclusion of the briefing.

 

The UN Food Systems Summit +2 Stocktaking Moment would also open on Monday, 24 July at 2:30 p.m. The high-level event would build on the momentum of the 2021 Food Systems Summit and create a conducive space for countries to review progress on commitments to action and identify successes, enduring bottlenecks and priorities in order to close the implementation gap for food systems transformation.

 

The three-day meeting in Rome would further highlight the central role of food systems transformations in overall advancement of the Sustainable Development Goals ahead of the SDG Summit in September 2023. The meeting would advocate for urgent action at scale, building on the latest evidence that sustainable food systems contribute to better and more sustainable outcomes for people, planet and prosperity, leaving no one behind.

 

The high-level opening ceremony would see the participation of the Prime Minister of Italy, the Director-General of the Food and Agriculture Organization, the President of the International Fund for Agricultural Development and the Executive Director of the World Food Programme.

 

More than 1,200 participants from 161 countries, including 19 Heads of States and Governments, 100 minister-level delegates and more than 450 Non-state Actor (NSA) delegates would attend the event. The main sessions would be broadcast on UN Web TV.

 

Ms Vellucci added that the Secretary-General held a briefing on 20 July to present to Member States a “New Agenda for Peace”. The briefing gave States a vision of multilateral efforts for peace and security, based on international law, for a world in transition.

 

The UN Office at Geneva had just published its annual report for 2022, which could be viewed on the UN Geneva website. The report presented an overview of activities occurring at UN Geneva in 2022. There was a chapter on communicating UN work and values. Ms. Vellucci thanked all journalists accredited to UN Geneva for their coverage of the Office’s activities last year.

 

Fionnuala Ní Aoláin, the UN Special Rapporteur on the promotion and protection of human rights and fundamental freedoms while countering terrorism, would hold a hybrid press conference on Friday, 21 July 2023 at 12 p.m. on returns and repatriations from conflict zones. Joining her would be Anne Charbord, Senior Legal Advisor of the Special Rapporteur.

 

The Committee against Torture was continuing its 77th session in Geneva, and would conclude its review of the report submitted by Spain this afternoon at 3 p.m.  Next Monday starting at 11 a.m., the Committee would hold a short, public meeting to discuss reports on follow-up to its concluding observations, on individual communications (complaints) and on reprisals against persons having collaborated with the Committee.  

 

The Human Rights Committee would meet on Monday, at 3 p.m., to adopt reports on the follow-up to it concluding observations regarding countries reviewed during previous sessions.

 

Also, on Wednesday, 26 July 2023 at 1:30 p.m., the Human Rights Committee would hold a hybrid press conference to present its findings on the reports of Brazil, Burundi, Colombia, Cyprus, Lesotho, State of Palestine and Uganda, which it has reviewed this session.  Speaking would be Committee Chair Tania María Abdo Rocholl and other Committee members.

 

Teleprompter
[Other language spoken]
Welcome to the briefing of the Information Service of the UN in Geneva.
Today is Friday, 21st of July.
We have a very short briefing which changes a little bit from the latest editions.
And we are very happy to welcome Doctor Rahman Velayudan, who is The Who Unit Head on Global Programme on Control of Neglected Tropical Diseases.
And so you coordinate dengue and Arbogir virus initiatives.
So we're going to hear from you about outbreaks of the dengue disease.
I'll give you the floor now.
Thank you very much for this opportunity and to brief you on the situation on dengue after our previous briefing in in May.
So as most of you know, dengue is a a serious illness which is most commonly A viral infection spread with through the bites of mosquitoes from one person to the other.
Most people who get dengue do not have much of symptom because 80% of the cases are asymptomatic and but they get well within a week or two.
But in some cases, especially when you get the the infection for the second time, which we call a secondary infection, there can this can lead to severe dengue and can it can be fatal too.
So a few, a large number of deaths are recorded in countries where severe dengue is getting increasingly reported.
It can be only treated.
There's really no treatment for dengue and all we do is to manage the fever as well as the body pain with simple medicines.
And these outbreaks can draw a huge amount of resources from countries when severe dengue cases gets reported and which needs hospital admission.
As I had said in the first, in the beginning, the dengue is spread by AD species of mosquitoes and there are two species actually spreading it around the world.
And the disease is most common in the tropical and subtropical region.
And its incidence has grown dramatically worldwide since 2000.
And if you really look at the picture of the trends, in 2000 we had about half a million cases and today we in 2022 recorded over 4.2 million cases, which really shows an 8 fold increase.
And actually this can be much higher as we get more and more accurate figures.
About half of the world population is at risk of dengue and dengue effects approximately 129 countries about.
We estimate that about 100 to 400 million cases are reported every year.
You know, this is basically an estimate.
And the American region alone, for example, has reported about 2.8 million cases and 100 and 1280 deaths in 2222.
But right now they have almost touched the same figure, maybe have nearly 3,000,000 cases there.
And almost equal number of deaths are covering a large number of countries.
And the southern spread of the disease, especially in parts of Bolivia, Paraguay and Peru, is a matter of concern now.
[Other language spoken]
The European countries are also on alert because Europe had recorded a dysbourne transmission of either dengue or chikungunya since 2000 and 2010.
Have we had more outbreaks since then?
And it is estimated that the the the the mosquito is present in about 22 European countries.
The in the Middle East, for example, recently there has been reports of dengue in in Sudan with well over 2000 cases and 45 deaths.
And even in the last week or so we have got reports of dengue being reported in Egypt.
At present, it is relatively early to report cases from Asia but the trends are worrying and actually the there are more than 50,000 cases reported in Malaysia and Philippines while more than 20,000 cases have been reported in Thailand, Vietnam and so on.
So the the the trend is there.
Asian countries are also increasingly reporting **** number of cases and Asia accounts for about 70% of the global burden of dengue.
There are several factors to this.
One, this disease increases with the movement of people and goods and naturally the that is an increasing trend today.
Urbanisation and associated problems with water and its storage practises again increases the habitat of the mosquito.
The continuous spread of the mosquito has gone unnoticed for a long time and it has spread, as I said, to over 129 countries and it is continuing to move.
And this is a matter of concern because we are being affected by these mosquitoes and the ****** of the disease is really increasing continentally.
There are several issues linked to climate also the **** precipitation, increased temperature and even the mosquito manages to survive even when there is water scarcity.
So both during a flood situation as well as a drought situation, dengue can increase the virus and the vector multiplies faster at a higher temperature.
This is a well known fact.
We are of course at a period where there is several new developments in dengue.
Right now there are several tools under development and there is greater hope in preventing this disease, but we still have a lot more work to be done.
There is a lot of effort being done to develop better diagnostics and we hope this will be available soon.
There are very few antiviral research working on and actually two or three of these candidates are going through phase two trials and we'll move on to the phase three which is very promising.
There is also one dengue vaccine in the market which has which has got certain limitations and two other candidates are actually in the pipeline and are under review especially with their phase three studies.
So these this is also something promising as we will get probably more of these tools soon.
In terms of mosquito control also we have very good developments.
There are new technologies coming through which includes the use of a symbiotic bacteria called Wolbachia and there are two versions of it and then there is also the sterile insect technique and spatial repellents which are under trial phase three trials.
So these there are promising tools and it is really we hope that these tools will enable us to bring down this global spread of the disease.
From The Who point of view, we provide support to countries again to respond to these outbreak and enhance more cross-border exchange of information.
Community Action in prevention, awareness and seeking medical care is very, very important and we encourage the implementation of an integrated strategy for control based on the guidance provided by WHO to to various countries in the region.
And this includes both clinical management as well as control of the mosquito.
As the rainy season and the El Nino phenomenon has commenced, there is a increasing risk in Asian countries to experience more severe dengue outbreaks and thus health authorities are encouraging local agencies to reduce the breeding ground for these mosquitoes.
We work closely with countries to implement the Global Arbovirus Initiative and to join forces with some of the most countries who are interested in full implementation to reduce the burden of this disease and the spread of the mosquitoes.
We encourage countries to focus on the most efficient action to have the greatest impact, save life as well as the and and prevent the disease wherever possible.
[Other language spoken]
This is just a brief update of the dengue situation.
We are in the midst of a monsoon, especially hitting Southeast Asia.
So this is a, a right time to be on the alert because the dengue usually happens, dengue outbreaks usually happen 6 to 8 weeks after the monsoon season because that gives the mosquito time to, to multiply and spread the disease.
So it is, it gives us a, an opportunity window of opportunity to be better prepared and to reduce the spread of the disease.
Thank you very much.
Thank you very much, Doctor Vela Yudan.
I'll now turn to the journalist for questions.
[Other language spoken]
Hi, thanks for taking my question.
[Other language spoken]
Wondering you mentioned.
The the geographical spread that is spreading more with the warmer climate.
I was wondering what specific increased dangers there might be when when dengue.
Arrives in places.
[Other language spoken]
Previously, if it's if there are.
Increased dangers, I guess.
With people, not.
Realising what it is or if the disease itself when it it meets a population that hasn't had dengue.
[Other language spoken]
[Other language spoken]
[Other language spoken]
[Other language spoken]
[Other language spoken]
[Other language spoken]
And this is exactly the point where we wish to highlight that the first wave of dengue in in areas where it has never affected, there is a possibility that almost 80% of them may be asymptomatic.
In other words, you may have a, a very slight body pain or a mild temperature and you you really do not seek health advice.
You may take paracetamol or some of these drugs and then get on with your work because it's a very mild symptom.
In some people there may not be even a symptom.
So the first wave, it is important that from a from the ministry or the government's point of view, it would be good to detect that wave.
Even if there are few people coming to the health centre with some symptoms, it would be very important to to really say that this is potential outbreak of dengue here and we really need to be on the vigil.
Because as I said, a two years or so down the line if you get another wave of dengue with another dengue virus, we have 4 viruses, then there is a potential to have more severe cases.
So the first wave could be mild.
But there is potential that if you at least 20% of the people may seek help, intervention or help from the doctors.
But we really need to detect it quickly so that we can be better prepared if this wave continues to expand to newer areas.
[Other language spoken]
[Other language spoken]
So I'll go now to the platform.
[Other language spoken]
You have to.
[Other language spoken]
[Other language spoken]
[Other language spoken]
[Other language spoken]
Thank you, Alexandra.
Doctor Valathem, my question is very simple.
You have not mentioned India and India is experiencing heavy monsoon rains, particularly in pockets of Northern India.
And how serious or senior is the intensity of dengue, dengue in India, particularly in North as well as in North East or across the country?
[Other language spoken]
Indeed, on India.
[Other language spoken]
So as I said, why we are having this webinar is really to alert the governments because this is the beginning of the monsoon season.
And as you rightly pointed out, I'm fully aware of the monsoon hitting the Indian subcontinent and has spread to the north and this this year in particular, the monsoon has been affecting more number of States and regions.
So the issue is how are you?
India definitely is a dengue prone.
It's dengue endemic area and the number of places could get quite ****, 6 to 8 weeks down.
So we really need to take preventive measures.
There is already records of dengue in India right now and I know that our reports have come from Kerala for example, where dengue outbreak has been already reported and it is increasing.
So we really need to be better prepared and make sure that all our health facilities are well alerted.
And as the water recedes, we need to prevent breeding.
And this is the key message.
And communities can do a great help by just going round in and round their houses to clean whatever stagnant water is there and to make sure that mosquitoes are not breeding in and round their house.
And if that sort of cooperative action could be done, we could definitely reduce the number of cases.
Thank you very much, Catherine Cianco, Franz Wancake.
Thank you, Alexandra.
Thank you, Doctor.
I I have a couple of questions #1.
Could you please briefly?
Tell us about the.
Situation in Africa, you've mentioned Sudan, I know that the cases in.
[Other language spoken]
[Other language spoken]
Africa, where you have an increase of floods the last couple of years.
[Other language spoken]
Is regarding prevention in order to.
Prevent these kind of cases.
I suppose that you have indoor spreading and this mosquito the use of mosquito Nets As for malaria, but what kind of product are you using?
Is it also based on?
Art Artemisanin, because we know that.
There's a resistance against Artemisanin.
And about the diagnostics, are you using test kits?
[Other language spoken]
[Other language spoken]
And is it as?
[Other language spoken]
That you have to make the test the moment that you hit, that you have the symptoms and that after it's too late.
And thank you so much.
Thank you very much.
[Other language spoken]
To be honest, and the cases in Africa is a matter of concern and the African region as a whole, last year during their regional committee meeting in Togo, they passed a framework of action against tropical and vector borne disease, which is extremely useful because that framework document really highlights that in a single year there are more than 200,000 cases of dengue reported in Africa.
Now the countries you have mentioned dengue at present effect Sudan, Ethiopia, parts of Senegal, it is already reported in Kenya, Nigeria and few other S Tomo for example.
So these are areas we are tracking right now of cases of dengue being reported.
Now Africa is right.
Now one of the reasons why Africa is very important to us and our work is to record dengue cases more because we know it is there but it has been masked by other diseases.
But now that malaria in particular has made great strides and has reduced in Africa, we are seeing increasing presence of dengue.
And this is something we really encourage the governments and we are trying to build capacities to make sure that the recording system begins to report dengue cases and it is happening.
Now on to prevention.
First of all, this mosquito bites during the day and it's not a night biter.
So bed Nets have got very limited value and only people who are sick with dengue can sleep under a net or people who are elderly and who have the habit of taking a nap during the daytime.
[Other language spoken]
But other preventive measures are mainly self protection measures like using repellents, mosquito coils, they can work and we are also encouraging some programmes to who are already working for malaria to use that method of spraying in and around houses which also is helpful in reducing the bites of a this mosquito.
So this is the challenge we face.
We have a mosquito which bites during the day and how do we manage.
So dengue prevention has to be both not only at home but also at your place of work and even in schools.
We have to make sure these measures are taken in case there is a dengue outbreak in that area.
Now artemisinin is of course is a drug which is used in malaria and we've as I said in the beginning, dengue does not have any treatment.
We do, we do, we don't have any drug which is effective against dengue virus and studies are in progress for developing antivirals for it.
All we can do is to manage fever and body pain with simple paracetamol and such medicines.
But otherwise there's no direct drug intervention for dengue available yet.
In terms of diagnostics, we have rapid tests but it is the duty of the government to procure good quality rapid test which uses mostly the plasma or the blood but the results can be available in 15 minutes.
But the problem with dengue is that unlike malaria where you can get a confirmatory test within 15 to 30 minutes, in dengue the confirmatory test takes two to three days because it needs APCR level test for confirmation.
So what we do, we encourages for governments to have few good quality rapid test for the rapid detection, but at the same time to send the samples for PCR confirmation.
And this is very important.
And most of the cases for example, in in the American region, almost 40% of the cases have been confirmed while the others are clinically diagnosed.
And the the treatment is given to patient on the on based on clinical signs and symptoms.
So these are the challenges we face with dengue diagnosis.
Dengue diagnosis is also very much in our priority because we better, we need better diagnosis to manage this this virus.
Thank you very much, Doctor John Zaracostas, Also to France Van Katter, English Channel and Rancid.
Yes, good morning, doctor.
I was just wondering, Sir, you just mentioned that there is one vaccine, but there are some problems related to it.
Can you elaborate what is the current efficacy of the vaccine that is on the market and if the price is affordable for people in low middle income countries?
Thank you very much, Sir.
Thank you very much.
The vaccine which is currently in the market is the Sanofi Pasteur vaccine.
And this vaccine has been registered in approximately 20 countries for use.
And the price varies from country to country.
And frankly, I really do not know the exact price, but in some countries I know it ranges from around $40 to 60.
Dollars per per dose, you need to take 3 doses.
But the limitation of this vaccine is this vaccine works well in people who had dengue once.
So you need to do a test to make sure that you have the antibodies against the one, at least one virus of dengue, in which case you can take this vaccine and it will give you protection.
The efficacy of this vaccine against the there are four viruses of dengue, Dengue 1234.
It is on an average around 6065% efficacious, but there is variation between each of these viruses.
So some viruses it is effective, for example, dengue 1 and dengue 3, it is effective up to 80%.
Dengue 2 is it's less effective and it is effective by around 50% in the case of dengue 4.
So this is the challenge we face.
We have 4 viruses and vaccines have various levels of efficacy against it.
So I think I have answered your question.
This vaccine works better in people who had dengue ones.
Thank you very much.
[Other language spoken]
And I see Catherine on the chart that is asking Carla to share the document the doctor referred to after that was issued after the Africa regional meeting with the information on on dengue.
[Other language spoken]
Lisa Schlein, Voice of America Morning Doctor, You mentioned that dengue kills many people.
Do you have a number on that?
That is globally.
How many people do you think die every year from this?
And are adults or children most affected by the disease?
Or does the mosquito not care who who it bites and who it who it kills?
And then if you would expand a bit upon the role that climate change plays in dengue, you just mentioned it in passing and I'm the world is getting hotter.
[Other language spoken]
And so I'm wondering whether you're very concerned that there might be an exponential increase in the disease because of climate change and what people can do about this?
[Other language spoken]
Thank you very much.
[Other language spoken]
In terms of dengue mortality, we're on an average WHO gets data from about 104 countries globally and the highest number of bets reported so far is around 6000 cases from these countries.
But these are really confirmed cases.
So what we do is really we need to do estimation, burden estimation and the mortality figures.
We, we collaborate with other partners in burden estimation and the estimation on dengue debts ranges between 40,000 to 70,000 per year.
This is the estimate.
But again, we we really need more accurate data to come from countries and there are many countries who still do not report them.
So this is this is the challenge we face.
So, dengue debts, overall the case fatality rate is around less than 1% in majority of the country countries and we are hoping to reduce it still further.
Now in terms of climate change, as I said, the warmer the climate, it helps the mosquitoes to multiply faster and it also helps the virus to multiply within the body of the mosquito.
So this is definitely favourable factors.
The other aspect of climate change is in case there is excess rainfall, we are creating more homes for the mosquitoes in and around your house.
There will be stagnant water on your rooftops, on your in your garden, in any material you may have thrown aside because any stagnant body of water can breed a dis mosquito and they they prefer to live in and around human habitation.
So this is a major challenge and so poster, I mean post rainy season, you can anticipate dengue outbreak and multiplication of the mosquito and this needs to be monitored.
The second scenario is in terms of climate change, we also have droughts and the drought situation there.
Naturally the water supply is going to be erratic and when water is erratic, water supply is erratic.
People tend to store more water in and round the house in various containers, be it drums, be it underground tanks and so many other containers.
So when these are stored and if the stir, the containers are not well covered.
Mosquitoes utilise them very well to breed.
So in both scenarios we have seen both in the case of floods and droughts, dengue outbreaks have potential to increase and we really need to take action.
[Other language spoken]
Thank you very much, Sir.
[Other language spoken]
You mentioned.
That you wanted to warn governments?
Do you think this could be the worst year or or season yet for dengue and.
Are you seeing an increase in cases with the heat?
Waves around the world.
[Other language spoken]
Well, we, we really need to see what happens during this.
I agree, heat waves, as I said in cases there, there are very **** heat waves.
The temperature goes beyond 40 and above.
Usually it should **** the mosquito more than breeding it.
But the mosquito is a very clever insect and it can breed in water storage containers where the temperature doesn't rise that ****.
So we really don't know whether heat wave is going to swing the dengue or break this way or that way.
The second thing is I cannot say whether this is going to be the worst year.
In 2019 was by far a very bad year where large number of were affected and since then we have we had a lull and probably in 2022 we recorded about 4 million plus cases and we are anticipating the same trend to continue this year.
We, we, it is too early for me to say whether this is going to be a bad year, but it is.
The trends in the American region certainly shows it is bad.
And we hope the Asian region may be able to control it even better because already governments have started issuing warnings to citizens to take precautionary action.
And this is very good and we hope this message will help in bringing down the burden.
Thank you very much.
Isabel Sacco, Spanish News Agency.
[Other language spoken]
Thank you very much.
I would like to to ask on 2 days ago when we received the epidemiology report on dengue, I read that in The Who expect, expect that in the second-half of this year we can, we may see an increase of dengue cases.
And I would like to know firstly is if this assumption is related to the to the of El Nino and I secondly, I also I would like if to know if you can elaborate on how concerning is the situation in Europe with the spread of cases.
And if you mentioned, you mentioned already that the heat wave doesn't necessarily increase the, the risk, but that you really don't know.
But in Europe, where the, the, the, the, it is, the dengue was not common and now it, it begins to be common.
What is the situation that you expect?
And certainly, please, I would like to know on the immunity.
So that does it means that when people get the the the the disease, the the person doesn't develop any immunicity on the against the a new contact with the with the Arbour virus.
[Other language spoken]
Thank you very much for these questions.
First of all, El Nino, El Nino phenomenon we have in terms of certainty of evidence, we have a weak level of evidence to prove that El Nino does have an impact on dengue outbreaks, especially in parts of Asia and the Latin American countries.
We we are still hoping that there are many studies going on and we hope to get more evidences on this.
The recent outbreak in Peru, for example, has been attributed to a cyclone which really battered the country, flooding large amount of areas and naturally the disease has spread further South.
And this is this is a matter of concern.
But we we right now our evidence is rather on the weak level, but we hope the evidence rate will increase as more studies results are published.
In terms of Europe, Europe, the ECDC and other partners have already taken measures and have informed the countries of the potential ****** of Aedes borne diseases and arboviruses in general.
The heat wave say what is sweeping right now, as I said, over 45° actually it will reduce the breeding sites because water dries up.
But the issue is after this heat wave, we are probably going to experience some rainfall and that is something which we really need to think about because if there is rain after that already UK is experiencing rain and this this sort of environment can trigger more breeding sites for the mosquito.
So this is a a period we really need to watch out.
And I assume that water storage practises in European countries are better.
And naturally people don't store much, I hope because there is still a regular supply of water.
But in case there are communities where the supply is erratic due to the current situation and water is being stored, we really need to make sure that they are stored and covered well.
So mosquitoes don't breed.
But having said that, the mosquito is there in almost 21 countries and if you are careful, you can see it flying around.
And in this condition, of course, heat wave, they may not fly, but post heat wave, this is a period where we need to watch about.
Now in terms of immunity, even if it is a mild dengue, you as the challenge we have with dengue is we have four more or less closely related viruses, Dengue 1234.
Now if you get one virus, you get immunity against that virus for your lifetime.
However, the cross immunity, there's really very limited cross immunity from one virus to the other three.
So the case is in case after a few years you get a second virus that is when you may fall sick and may need medical attention in case you end up with a severe case.
So this is this is the challenge we face.
It is not each virus has provides immunity for that particular virus alone while it does not provide cross immunity for the other three for a longer period.
So this is this is the challenge.
Thank you very much.
And I see that Isabel has a follow up.
[Other language spoken]
[Other language spoken]
Also 2 days ago W show advice to the use of repellents to avoid the bite of the mosquito.
So but in some countries, we in some communities, we know that the use of repellent is very difficult.
So what is really the other way apart of repellents to to avoid, to to have contact, to be bite by the mosquito?
Well, if repellents are a challenge, then the other issues are they, we could have electronic mats or even the coils which you could burn the electronic ones.
You you light it up in the room and naturally that will prevent mosquito bite.
The second method is of course you wear a little longer sleeves so you don't expose your skin to mosquito bite.
Instead of even even the repellent, instead of applying on your body, you can even apply on your clothes that if the repellent is not advisable, you can apply it on top of your clothes because that will repellent the mosquitoes.
The third important category is of course in an in a situation in Europe for example, where you you are more or less in because of the heat wave, you may be in air conditioned unit or in an area where there's there is good circulation.
Usually mosquitoes don't enter air conditioned areas and your doors and windows are closed naturally they have no chance of entering.
So this is, these are the preventive measures you have to take.
And yeah, it very much depends on the mosquito density as well because usually outbreak is happens only when the mosquito presence is all significantly higher than normal.
And we we can monitor that and control the mosquito breeding.
[Other language spoken]
[Other language spoken]
Just a quick follow up, you mentioned probably.
4,000,000 cases this year, similar to last year.
Can you put that in?
Historical context for me, please.
[Other language spoken]
Historically, as I said, in 2019, we had say basically in dengue started in the 1953 with the most of the Asian countries, about 7 or 9 Asian countries reporting dengue outbreak.
And since 1953, this disease has spread to more and more countries.
Now in 2000 here as I said, we had recorded about half a million cases reported from about 80 odd countries.
Now at present in 2019, for example, we had 5.2 million cases reported from 129 countries.
Now it is almost a similar situation.
We are, we are having though that many countries affected, more regions of the countries getting affected and the number of cases, Yeah, right.
We anticipate around 4 million plus, but we can't predict because we really don't know what is going to happen in the next 6 months, especially post monsoon season in in the Asian subcontinent.
[Other language spoken]
[Other language spoken]
Check an info.
With you regarding what you said about the African report, the framework, was it the meeting that took place in August 2020?
2 Is that the?
[Other language spoken]
[Other language spoken]
Figures and if you have.
The info.
Could you kindly share it with with us, maybe through Alessandra?
Or WH Carla, yeah, it's OK that Carla was writing that she was going to look for the document, but just to confirm doctor is the is that.
Meeting, right.
It is that meeting.
It is place to place in Togo and it is a regional committee meeting.
I think it was August last year and this framework is available on the African Regional Office website, but we can download it and send it to you.
Thank you very much, John.
Yes, yes, Hi, it's John once again.
I was wondering Sir, besides spraying with toxic pesticides, are there any natural repellent plants?
Plants that are act as repellents against dengue or or other mosquitoes?
There are plans and this varies from country to country and we unfortunately none of these are produced on a large scale and have not been pre qualified within WHO Only the repellents commercially available ones have approached WHO pre qualification but in in each country you will find plant based repellents being available.
Some of them may be good as into.
Our main advice is to follow the label provided in such repellents.
So there are natural plants which are available as repellents in some countries, but please follow the label on the product in in both in application and it's durability.
I would assume that a plant based repellent could be effective for three to four hours, while the commercial ones we are which are which are more recognised, they are effective for about 8 to 10 hours.
[Other language spoken]
Yes, a bit of a misunderstanding in my question.
I'll rephrase it.
What I meant are the bushes or plants that you can have in your garden that act as a repellent against dengue or other vectors.
And I understand there are that have been used in Central America for instance successfully in many parts.
So in, in the case of dengue, do we know a list of plants that would act as a repellent that someone can have in their garden or their terrace?
Well, honestly, these are evidences we really want.
We, we don't have any clear evidence of this.
There are, I, I agree there are communities who say that this plant repels or that plant repels, but in reality, it is not fully proven.
And if that is the case, we would really like these sort of evidences to come by because I, I know even in parts of India, there are plants which they claim can repel mosquitoes, but it is not fully proven.
And we really want, because the mosquitoes, they are very clever.
They, they, they feel that one plant is repelling them.
They, they, they go on to the other one.
But the most important thing is they are within their, your house, house area.
They are breeding in and around your house.
And it is very challenging to really repel them away from the house.
And this is this is the main challenge.
They know to hide and breed in very cryptic conditions.
Indeed, thank you very much, Doctor.
This has been, we've asked you so many questions.
I really would like to thank you for having come in and, and brief us and give us updates on this dangerous illness.
Thank you very much.
And come back in a while if you have any news on the dengue.
And Carla, please, I, I understand Carla has already sent you the notes, but she will follow up anyway.
Thank you very much.
I have quite a few announcements for you.
I will start with one on behalf of the office of this Special Envoy for Syria, Mr Gayle O Pedersen.
Who will brief the Security Council Monday, 24th of July at 10 AM New York Times at 4:00 here.
The briefing is currently scheduled as open and the transcript will be delivered when Mr Peterson concluded as usual by Jennifer and our office.
So please stay tuned with this briefing also on Monday.
Also on Monday, I'd like to call your attention on the opening of the UN Food System Summit +2 stock taking moments.
As you know, this is a follow up two years after to the 2021 Food System Summit.
It will build on that summit and will create a conducive space for countries to review progress on commitments to action and identify successes and during bottlenecks and priorities in order to close the implementation gap for food systems transformation.
It's a three day meeting.
It will happen in Rome, and it will further highlight the central role of food systems transformations in overall advancement of the Sustainable Development Goal.
Of course, ahead of the SDG Summit in September, the meeting will also advocate for urgent action at scale, building on the latest evidence that sustainable food systems contribute to better and more sustainable outcomes for people, planets and prosperity, leaving no one behind.
So now on the practicalities.
The **** level opening ceremony will take place at 2:30 Central European time, as I said in Rome, with the participation of the Prime Minister of Italy, the Director General FAO, the President of IPHAD, the Executive Director of the World Food Programme and a group of Heads of States and government.
We've sent you this information at the beginning of the week in details.
The opening ceremony and the main sessions will be webcast on UNTV, so you are invited to follow them.
There will be more than 1200 participants from 161 countries, including, as I said, heads of States and governments for the moment in the number of 19 and 100 minister level delegates, including also more than 415 on state actor delegates that would be in person at the FAU headquarters in Roman.
As I said, our only Kelly who is actually at the moment in room.
As you know, we'll make sure that you can follow this.
This the main sessions on UN Web TV.
If you need the information again, we're happy.
We are happy to send it to you on things that we have already sent you.
That was yesterday.
I'd like to call your attention on the new agenda for peace that the Secretary General as presented yesterday afternoon, New York time to Member States.
That briefing gave the Secretary General's vision for multilateral efforts for peace and security based on international law for a world in transition.
We have shared with you the remarks of the Secretary General and the briefing if you need it, just let us know.
I would also like to remind you, as we have told you yesterday, that we have just published the annual report of the UN Office of Geneva for 2022.
I think it's interesting to have a look at this report that we've also made available in few copies in, in hard copies, but it's on the website of UN Geneva as it shows all the activities to that, that were taken place here and of which you've been witness and that you've spread and, and promoted through your work.
And in fact, there is a whole chapter, chapter 3 on communicating our works and values.
And I would like to take this opportunity to thank all the journalists accredited to the UN Geneva for their coverage of our activities last year.
And, and it's nice to have a look at the report.
There are plenty of pictures.
I'm pretty sure you will recognise yourself in some of them.
And please have a look look and, and, and see how much we've achieved last year in terms of press conferences.
We have one in 45 minutes here.
That's the UN Special Rapporteur on the promotion and protection of human rights and fundamental freedoms while countering terrorism.
This press conference would be on returns and repatriations from conflict zones, given of course by the Special Rapporteur, Fiona Latni.
Our lane, I'm not sure, pronounced from it and the senior legal advisor of the Special Rapporteur and Sharborg.
And then on Wednesday, 26th of July at 1:30, also hybridly, the OHCHR will hold another press conference.
That's going to be the UN Human Rights Committee.
Members will present findings on Brazil, Burundi, Colombia, Cyprus, Risotto, State of Palestine and Uganda.
And the speakers will be the members of the committee, including the Chair, the I think that's for the press conferences.
And then just to remind you that today at 3:00 PM, the Committee against Torture will end the review of the report submitted by Spain.
And next Monday, they will hold a short public meeting to discuss reports on follow up to its concluding observation on individual communication and complaints and on reprisal, reprisal against personally collaborated with the committee.
Sorry for this long list of things.
I just wanted to remind you of all these points.
[Other language spoken]
Yes, thank you, Alessandra.
It's concerning the food summer in Rome.
I was wondering if it's possible to get from FAOI, Don't see the press officer in the briefing list.
That was on Wednesday.
It happened to clash exactly at the same time that Doctor Tedros was briefing.
So many of us missed it.
If it's available, Mckelly maybe could send it to us on.
I think it was embargoed, but it gave the whole overview of what was going to happen.
It would be very useful.
And just secondly, you mentioned multilateral solutions here in in the temporary building where we are, we've had no lift for 9 days.
I was wondering if it's possible to have admin services look into it.
And no lights in the staircase going down at night, it's completely dark.
[Other language spoken]
Thank you very much.
I guess you refer to the background briefing that was given on Wednesday, indeed at 3:00 in the afternoon.
I'm sorry if it clashed with with some other activities here.
[Other language spoken]
So I will ask our colleagues of the FAO if there is any recording that can be shared under embargo, of course, because it was a background briefing, as the title says.
So I will ask you if they have any recording of that and and eventually ask her to to share it with you.
On the issue of the lift, it has been brought already to our attention and our from the very first day it broke, our colleague are looking into it.
In fact more than looking into it because there is already a request for a quote for repairing it and we hope really that it will happen.
It will happen as soon as possible on the lights.
We take note we didn't have that information.
So thank you for sharing with us.
And we will follow up with the central support services here at UNOC.
And I see the key is writing in the chat that she could get back to you on the issue of the background briefing.
But I really invite you to follow the opening ceremony on the 24th if there are no other questions.
I don't see any.
So I thank you very much.
I wish you a very good weekend and to to Tuesday.
[Other language spoken]