BAMAKO, Mali (AP) — Authorities say dengue fever is on the rise in Mali, posing a new threat to the West African nation struggling with extremist attacks and political turbulence.

The director general of health and public hygiene, Dr. Cheick Amadou Tidiane Traore, told The Associated Press in an interview Wednesday that his department had counted 21 deaths and 600 cases of the disease as of Monday.

Dengue is a viral infection spread by mosquitoes that mostly causes flu-like illness. In severe cases, it can cause joint pain, swollen glands, bleeding and death. There is no specific treatment, but two vaccines have been recommended by the World Health Organization for countries that suffer regular outbreaks.

Mali’s government has not officially released any figures on the disease to the public, nor has it announced whether it has requested aid from the WHO.

With the country in political transition and facing the threat of fighters linked to al-Qaida and the Islamic State group, a new epidemic of dengue fever risks worsening the humanitarian situation especially among the large population of displaced people.

“Dengue fever is also present in Burkina Faso and Senegal, and we need to raise public awareness,” Traore said.

The virus typically emerges in more tropical environments but was first detected in comparatively arid Mali in 2008. Reports of the virus reemerged in 2017 and 2019. There is little long-term data on its prevalence.

In August, the government of Chad reported the country’s first-ever outbreak of dengue, with dozens of confirmed cases in the nation that, like Mali, is located in the vast Sahel region south of the Sahara desert.

Elsewhere, the WHO has reported record cases of dengue this year in Bangladesh and the Americas, which have seen more than 300,000 cases and 4 million infections respectively.

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Associated Press writer Sam Metz contributed from Rabat, Morocco.