2022 was a banner year for infectious diseases, due to a wide web of complex factors.
Mpox, cholera, polio, and the measles all turned up in places where they hadn't been seen in years — or, ever.
Some of the outbreaks were short lived, while others will likely continue well into 2023.
Polio re-emerged in the UK and the US after nearly a decade of no cases, paralyzing at least one unvaccinated New Yorker.
Polio, a deadly virus that used to disable hundreds of thousands of children a year in the early 20th century, only circulates in Pakistan and Afghanistan these days, thanks to near-universal vaccination that extends to almost every corner of the world.
Health workers and security guards in those two countries still risk their lives and are routinely gunned down traveling to remote areas and battling outlandish anti-vaccine conspiracy theories to deliver oral polio vaccines to children.
"If we do not manage to eradicate polio, it is not going to stay in Pakistan, Afghanistan — it will always come out," Oliver Rosenbauer, a communications officer with the World Health Organization's Global Polio Eradication Initiative, recently told Insider, alluding to the modern pace of global travel and how infectious diseases spread irrespective of borders.
"Countries will always run the risk of being reinfected, and that is what we're seeing with New York and London," where unvaccinated people now run the risk of infection and paralysis," Rosenbauer added.
"That's one thing that keeps surprising me, actually, is how good this virus is at finding unvaccinated individuals."
He expects polio "will continue to spread" until the virus is eliminated.
"The goal of achieving a polio-free world is not going to be won or lost in New York or London, it's going to be won or lost in Pakistan," he said.
Scarlet fever killed at least 25 children in the UK, who had a nasty version of strep.
In the US, too, cases of invasive group A strep, the infection that causes scarlet fever, are up according to the Centers for Disease Control and Prevention — but no deaths have been recorded stateside.
Fortunately, group A strep is a bacterial illness, which means it can be easily treated with one of many different antibiotics, including amoxicillin or cephalexin.
Dr. Anthony Flores, chief of pediatric infectious diseases with Memorial Hermann Hospital and UTHealth Houston, recently told Insider that "we still have a long winter respiratory virus season to go," so it's likely that the hefty load of strep cases we're seeing now could continue into the first months of 2023.
Measles is spreading fast among unvaccinated children in Ohio — at least 32 have been hospitalized.
No measles deaths have been reported in Ohio this year, but 82 measles cases have been recorded, and nearly half of those patients (32) were hospitalized.
So far, only unvaccinated kids have been infected (though four patients have an "unknown" vaccination status.) The CDC says measles vaccine coverage has "steadily declined since the beginning of the COVID-19 pandemic," both in the US, and around the globe.
In Minnesota, a few states further west, at least 22 measles infections have been recorded in 2022 — after three years of no cases — all in families with unvaccinated children. Seven of those patients have been hospitalized.
Because measles is one of the most contagious viruses humans get, "even a small drop in the immunization coverage rate means there are thousands more children who could be vulnerable to disease," Jennifer Heath, the immunizations program coordinator for the Minnesota Department of Health, said in September.
Heath recently told the Washington Post that a big part of the reason why more parents are shifting their stance on routine MMR vaccines for their kids is because of "a disconnection to the primary care provider — the human being who's telling you that vaccines are important."
The World Health Organization and UNICEF say a "perfect storm" has been brewing for more measles outbreaks around the world, spurred on by both pandemic declines in vaccination, and more vaccine hesitancy. Disease experts expect areas of the world without 95% of their population vaccinated against measles may see more outbreaks in 2023.
Mpox, a virus which had rarely spread outside of endemic countries in central and west Africa before, roared across the globe, with thousands of infections diagnosed across six continents.
In a span of less than six months starting in May, more than 83,500 cases were confirmed, and at least 25 people died worldwide.
The virus, which was called monkeypox before the World Health Organization recently renamed it, appears to be in retreat, after layered interventions including vaccines, treatments, and community prevention measures were quickly adopted and embraced.
After surveying more than 800 men who had sex with men, the Centers for Disease Control and Prevention found around 48% reported reducing their number of sexual partners over the summer of 2022, when the outbreak was peaking, and 50% said they slowed down on one-off "sexual encounters."
"Given the low number of cases today, HHS does not expect that it needs to renew the emergency declaration when it ends on January 31, 2023," US Health Secretary Xavier Becerra announced December 2.
Babies and toddlers have been bearing the brunt of a nasty respiratory illness season, with skyrocketing cases of RSV, parechovirus, and other infectious diseases.
Doctors, nurses, and epidemiologists say there are several things at play contributing to the big viral soup — and they are wary of dismissing it with any one simple explanation, like a so-called "immunity debt" spawned by social isolation during the COVID-19 pandemic.
Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center, says there is more of an "exposure debt" at work, not an immunity debt, meaning lots of kids who didn't get many common childhood illnesses for two years are all getting infected with them now.
"Childrens' immune systems are just fine," Schaffner said during a recent Infectious Diseases Society of America press briefing. "Now that they're exposed, they're having to deal with this virus, and the virus has many more opportunities to spread."
"It happens every respiratory virus season," Dr.Flores said. "But this season has been a little more intense."
Infectious disease experts like Flores are notoriously wary of making specific predictions about what seasonal viruses will do in 2023, but it's likely we'll continue to see more wintery illnesses popping up over at least the next few months. Most viral illness, including flu and RSV, peak annually between December and February.
Flores also said drug shortages for medicines like children's Tylenol and amoxicillin could last until the spring.
An out-of-nowhere outbreak of Cholera has killed more than 280 people in Haiti.
For the first time in three years, cholera is spreading in Haiti, with at least 13,672 cases and 283 deaths recorded since early October.
Insider's Sarah Braner reported it's possible that the currently circulating strain may be a descendant of one brought into the country over a decade ago by UN troops providing earthquake disaster relief.
Cholera is also on the rise this year in Syria, Malawi, and more than 25 other countries, a global increase prompted by more flooding, conflict, migration, and "other factors that limit access to clean water," the World Health Organization said in a recent dispatch.
A group of concerned doctors wrote in the New England Journal of Medicine last week that this "resurgence of cholera in several parts of the world despite available tools to fight it" means "cholera control and prevention efforts must be redoubled," with the WHO specifying that "urgent action is needed to increase global vaccine production."
Though disease experts can't yet say for sure what the cholera situation will be in 2023, cholera vaccines are being rationed — to one dose per person, instead of the usual two — in order to provide more people with "protection in the near term, should the global cholera situation continue deteriorating," the WHO said.
More than three years in, COVID-19 is continuing to infect and kill millions of people — with various versions of Omicron dominating, for now.
Disease experts expect anywhere between 500,000 and 1.8 million people in China will die from COVID-19 by the end of April 2023, as the country quickly disbands its longstanding "zero-COVID" policy, in the face of widespread citizen protests.
For now, the coronavirus variants that are circulating in China, the US, and elsewhere are almost all some version of Omicron, but federal health officials in the US are worried about the possibility that the virus could morph again into another new variant that could potentially circumvent current vaccines or treatment options, as millions more people will continue to get infected in the new year.
Updated booster shots from Moderna and Pfizer fight back against Omicron specifically, and help stave off severe disease and death. The US has offered some of its vaccines to China, but the country has instead focused on trialing its own booster shots. While China's overall COVID-19 vaccination rate is above 90%, only about two-thirds of the elderly adults over age 80 in China, who are by far the most vulnerable to severe disease and death from the disease, have been vaccinated.
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