In the Syrian capital Damascus, Typhoid has broken out among Palestinian refugees from the besieged Yarmuk camp, a UN agency said.
The UN agency for Palestinian refugees UNRWA (United Nations Relief and Works Agency for Palestine Refugees in the Near East) said it had been able to confirm the outbreak after gaining access to residents of the camp sheltering in the nearby Yalda neighborhood.
"UNRWA has had its first access to civilians from the besieged Palestinian refugee camp of Yarmuk, Damascus, since 8th June," UNRWA spokesman Chris Gunness said in a statement.
"We can now confirm a typhoid outbreak among this UN-assisted population with at least six confirmed cases," he added. UNRWA later said another five cases were detected on August 19, raising the total to at least 11. Gunness said the detected cases could be only "the tip of the iceberg".
According to the World Health Organization (WHO), about 21 million people are infected with typhoid every year, and an estimated 216,000 to 600,000 die.
The disease is caused mainly by Salmonella typhi bacteria in food or water contaminated with the feces or urine of infected people.
UNRWA said the visit to Yalda was its first since access was suspended to areas sheltering displaced Yarmuk residents on June 8. It has not had access to Yarmuk itself since March.
Yarmuk was once a thriving neighborhood of Damascus, home to both Palestinian refugees but also Syrians. But after fighting erupted in the camp, the government in 2013 imposed a blockade and the area's population shrank from 160,000 to just 18,000.
The siege prompted a major humanitarian crisis, with people dying for lack of food or access to medical care. The situation in Yarmuk has worsened in recent months, with Islamic State group militants entering in April, prompting fierce clashes.
Several thousand civilians have been able to leave the camp but the Syrian Observatory for Human Rights monitoring group and a Yarmuk resident told AFP that up to 14,000 people are still living inside.
Despite that, the UN has removed Yarmuk from its list of besieged areas in Syria, reducing the number of Syrians under siege by 18,000 in its May 22 report on people under blockade.
Gunness repeated UNRWA's longstanding call for humanitarian access to the Yarmuk camp. "Never has the imperative for sustained humanitarian access been greater," he said. "UNRWA's priority remains the delivery of humanitarian aid to civilians within Yarmuk itself."