Emerging or Newly Detected? Rethinking Infectious Disease Outbreaks in North Africa

Abstract

North Africa sits where climate change, armed conflict and cross-border mobility meet, and each of these moves pathogens. Yet outbreaks in the region are often recognized late, through travel surveillance abroad, single-hospital studies or reference laboratories rather than routine national reporting. This editorial, which opens the special issue on emerging and re-emerging infectious disease outbreaks in North Africa, reviews three microbial fronts: arboviruses such as West Nile, dengue and chikungunya viruses; antimicrobial resistance and conflict-driven cholera; and fungal pathogens, including Candida auris. It summarizes eleven outbreaks reported in the region since 2012 and how each came to light. The gap between reported and actual burden can be large: in eastern Sudan in 2018, surveillance counted 13,978 chikungunya cases, whereas the epidemic was later estimated to have affected about 487,600 people. The editorial argues that many infections called emerging in North Africa are newly detected rather than new, and that the main gap lies in laboratory and surveillance capacity. It calls for integrated One Health surveillance and wider access to molecular and fungal diagnostics.