Digital early warning systems essential as old diseases like cholera resurge in global crisis zones

(Toronto, March 18, 2026) JMIR Publications today released a critical analysis in its News and Perspectives section regarding the global resurgence of cholera and the vital role of digital surveillance in fragile settings. The article, "When Old Diseases Return: Cholera, Crisis, and Digital Surveillance in Fragile Settings," examines how the convergence of climate change, economic collapse, and conflict is bringing back a preventable disease once thought to be under control.

The report highlights the 2022 re-emergence of cholera in Lebanon, the country’s first outbreak in nearly 30 years, as a primary case study for how traditional surveillance systems fail during periods of instability. In Lebanon, the disease spread nationwide in a matter of weeks after initial cases went undetected, fueled by decaying water infrastructure and cross-border displacement.

Bridging the Gap with Digital Health

The article argues that in regions where laboratory capacity is limited and paper-based reporting causes fatal delays, digital tools are no longer optional; they are essential infrastructure. Key technological solutions highlighted include:

• Real-Time Mobile Reporting: Handheld technologies allow frontline workers to report suspected cases instantly, bypassing the delays of traditional facility-based systems.

• GIS and Predictive Mapping: By overlaying rainfall, flooding, and population movement data, health officials can pinpoint high-risk regions and pre-position medical supplies before an outbreak peaks.

• Genomic Surveillance: Integrating whole-genome sequencing into digital platforms allows researchers to track transmission routes across borders in real time, differentiating between local persistence and new viral introductions.

A Call for Predictive Preparedness

The analysis stresses that cholera outbreaks no longer follow predictable seasonal patterns but instead track crises and displacement. For policymakers and clinicians, this shifts the requirement from reactive treatment to predictive preparedness.

"Advances in infectious disease control can be swiftly reversed when social and environmental stability breaks down," the report notes. Isabelle Basbouss-Serhal urged global health authorities to invest in interoperable digital systems that integrate epidemiology with climate data to preempt the return of old diseases in an increasingly volatile world.

Please cite as:

Basbouss-Serhal I. When Old Diseases Return: Cholera, Crisis, and Digital Surveillance in Fragile Settings. J Med Internet Res 2026;28:e94818

URL: https://www.jmir.org/2026/1/e94818

DOI: 10.2196/94818

About JMIR Publications News and Perspectives

JMIR Publications is a leading open access publisher of digital health research. The News and Perspectives section is the newest addition to its portfolio, established to bring the rigor and integrity of academic publishing to scientific journalism. The section features well-researched, expert-driven content from the Scientific News Editor, Kayleigh-Ann Clegg, PhD, and a network of specialist JMIR Publications Correspondents to keep the digital health community informed, inspired, and ahead of the curve.

About JMIR Publications

JMIR Publications is a leading open access publisher of digital health research and a champion of open science. With a focus on author advocacy and research amplification, JMIR Publications apartners with researchers to advance their careers and maximize the impact of their work. As a technology organization with publishing at its core, we provide innovative tools and resources that go beyond traditional publishing, supporting researchers at every step of the dissemination process. Our portfolio features a range of peer-reviewed journals, including the renowned Journal of Medical Internet Research. 

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