Cholera in Iraq, World Health Organization Update

[Giuseppe]

[CHOLERA, IRAQ, WHO, UPDATES, EPIDEMICS SURVEILLANCE WHO] Cholera in Iraq (http://www.who.int/csr/don/2008_09_10a/en/index.html)

10 September 2008 --

On 20 August 2008, cases of acute watery diarrhoea from Baghdad and Misan Province were laboratory confirmed as cholera. They constitute the first cholera cases detected in Iraq in 2008.


By 28 August, seven cases had been laboratory confirmed, and a further 174 cases were suspected as cholera, bringing the total number of reported cases to 181 (128 in Missan and 53 in Baghdad).

In the first week of September, the outbreak spread to Babil Province, south of Baghdad, where 116 suspect cases have now been identified.

The presence of Vibrio cholerae, the bacterium causing the disease, has been confirmed in 21 cases.

To date there have been 10 fatalities, three of whom tested positive for Vibrio cholera.

The re-emergence of cholera this year is not unexpected: in September 2007, the country was affected by a large outbreak (4696 cases with 24 deaths). The outbreak occurred mainly in northern Iraq, but sporadic cases were also detected in other provinces.

The Government of Iraq has mobilized a multi-sectoral response to the outbreak.

Specific control measures have been reinforced and preventive measures to reduce the risk of transmission to unaffected areas have been put in place. Building on last year's experience, the Ministry of Health, together with WHO, have put in place an effective surveillance system that was able to capture the very first cases of cholera, enabling a timely response and facilitating the containment of the outbreak.

However, the overall quality of water and sanitation remains very poor, a factor known to greatly facilitate cholera contamination.

Experience has shown that long term-prevention of cholera depends on access to safe water and adequate sanitation to prevent exposure and interrupt transmission.

Improving water and sanitation infrastructures is therefore a long-term goal of WHO and its partners in Iraq and, in times of outbreaks, it is essential that immediate measures, such as water treatment at household level, health education and proper case management, are implemented rapidly.

To this end, the Government of Iraq is providing chlorine tablets to families and is intensifying social mobilization activities.

In response to a request from the Ministry of Health, WHO is providing technical support, particularly in the area of laboratory testing. A joint Ministry of Health/WHO mission will be deployed shortly.

WHO does not recommend any restrictions to travel or trade to or from affected areas, as a means of controlling cholera outbreaks. Neighboring countries are encouraged, however, to reinforce their active surveillance and preparedness.


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[Snowy Owl]

Re: Cholera in Iraq, World Health Organization Update

Cholera Outbreak Spreading in Iraq
By Kadhem Ali, Azzaman. Posted September 15, 2008.

http://www.alternet.org/waroniraq/98903/cholera_outbreak_spreading_in_iraq/

Contaminated water is believed to be the main cause of the spread of the deadly disease, which is estimated to have killed up to 1,000 people.

At least 1,000 people have died as a result of the recent outbreak of cholera in Iraq, Iraqi members of parliament said.

Nawzad Rifaat, chairman of parliament's Health Commission, accused the government of hiding the "the real figure of cholera cases" urging the Health Ministry to provide detailed statics on deaths and cases without delay.

Parliamentary sources said they feared the disease was already out of control and the government had failed in efforts to have it contained.

"Hospitals are crammed with the patients who may exceed 10,000 who have already been afflicted with the disease," said one member of parliament, who refused to be named.

MPs spoke of at least 1,000 deaths so far.

The outbreak of cholera, a bacterial infection causing severe diarrhea and vomiting, was initially said to have been confined to Babil Province, where at least six people had died.

Officials say thousands of cases have been reported in other provinces in addition to Babil. Hospitals in the provinces of Diyala, Najaf and Karbala were strapped for resources to treat patients.

The coverage of the diseases has terrified the country's population. Local newspapers quote unidentified Health Ministry officials as fearing that the disease had reached epidemic proportions.

Health Ministry officials disputed the figures, saying they were "exaggerated."

"The ministry is mulling the possibility of suing officials who have reported huge numbers of cases, the thing that has frightened citizens," said Ihasan Jaafar, the ministry's spokesman.

However, Jaafar declined to give figures on the number of deaths the disease has caused and the number of patients in Iraqi hospitals.

A severe form of the disease causes sudden diarrhea, leading to dehydration and death within minutes.

Contaminated water is believed to be the main cause for transmitting the disease due to rusty and broken pipes through which sometimes heavy water is carried to household taps.

Running water is very scarce in many provinces, forcing people to drink from rivers or stagnant ponds.

Last year there were more than 4,000 confirmed cholera cases in Iraq -- the vast majority in the Kurdish-controlled northern region.