SEOUL, South Korea (AP) — North Korea reported a new “epidemic” of an intestinal disease on Thursday, an unusual announcement from the secretive country that is already contending with a COVID-19 outbreak and severe economic turmoil.

It’s unclear how many people are infected in what the official Korean Central News Agency said was “an acute enteric epidemic” in southwestern Haeju city.

The agency didn’t name the disease, but enteric refers to intestinal illnesses, such as typhoid, dysentery and cholera, which are caused by germs in contaminated food or water or contact with the feces of infected people. Such diseases routinely occur in North Korea, where there is a shortage of water treatment facilities and the public health system has been largely broken for decades.

Some observers said the purpose of the announcement was not so much to report the infections themselves as to mention that leader Kim Jong Un donated medicine from his personal stock — an apparent effort to burnish his image at a moment of extreme hardship.

The official Korean Central News Agency reported that Kim donated medicine from what it referred to as his family’s reserves. The country’s main Rodong Sinmun newspaper carried a front-page photo showing Kim and his wife, Ri Sol Ju, looking at saline solutions and medicine that the paper said they donated.

In a country where power is concentrated is the hands of a small ruling elite and hospitals often lack even basic supplies, defectors say it’s common for anyone who can to keep stocks of medicine in their homes — and senior officials are typically able to stockpile more than ordinary citizens. Observers also said the donated medicine may have simply come from state storage facilities but was distributed in Kim’s name.

“The outbreak of measles or typhoid isn’t uncommon in North Korea. I think it’s true there is an outbreak of an infectious disease there, but North Korea is using it as an opportunity to emphasize that Kim is caring for his people,” said Ahn Kyung-su, head of DPRKHEALTH.ORG, a website focusing on health issues in North Korea. “So it’s more like a political message than medical one.”

Last month, North Korea reported a rising number of patients with fever. At the time, South Korea’s spy agency said that “a considerable number” of the cases included those sick with measles, typhoid and whooping cough.

KCNA said Thursday more than 4.5 million out of the country’s 26 million people have fallen ill due to an unidentified fever and 73 died. The country, which apparently lacks coronavirus test kits, has identified only a fraction of those as confirmed COVID-19 cases. Many foreign experts question the North’s death toll, saying that’s likely underreported to protect Kim from any political damage.

North Korea recently claimed progress in slowing the spread of COVID-19 across the unvaccinated population, though a top World Health Organization official said this month the agency believes the outbreak is worsening.

During a ruling party conference last week, Kim claimed the pandemic situation has passed the stage of “serious crisis.” But the country still maintains elevated restrictions. Some outside experts have said the measures will further strain the country’s already troubled economy hit by long-running pandemic-related border shutdowns and U.N. sanctions.

Late Thursday, South Korea’s Unification Ministry renewed its offer of help on health issues. After the North first announced the COVID-19 outbreak, South Korea and the United States offered to ship vaccines and other medical supplies, but the North hasn’t responded.

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