Iraq: 2015 Cholera

[Shiloh]

Source: http://www.reuters.com/article/2015/...11P0JY20150919

Sat Sep 19, 2015 2:05pm EDT
Iraq tries to contain cholera outbreak west of Baghdad

BAGHDAD, Sept 19

Iraqi Prime Minister Haider al-Abadi ordered daily water tests and other measures on Saturday to contain an outbreak of cholera that has killed at least six people in Baghdad's western outskirts.

The deaths were in the town of Abu Ghraib, about 25 km (15 miles) west of the capital, hospital sources said. At least 70 other cases were diagnosed in the area...

[alert]

Published Date: 2015-09-09 11:39:03
Subject: PRO/MENA> Gastroenteritis - Iraq: (Al-Anbar) contaminated water susp, RFI
Archive Number: 20150909.3633449
GASTROENTERITIS - IRAQ: (AL-ANBAR) CONTAMINATED WATER SUSPECTED, REQUEST FOR INFORMATION
************************************************** **************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 8 Sep 2015
Source: Alsumaria News [in Arabic, trans. Mod.NS, edited]

http://bit.ly/1EUXDWW

The head of Al-Baghdadi sub-district council in Al-Anbar governorate, Mal Allah al-Obeidi, revealed on [Tue 8 Sep 2015] that 250 persons have been infected with an "unknown" virus and warned of the possibility of occurrence of deaths among the infected people. Meanwhile, the Directorate of Health of Al-Anbar referred to treatment of 40 cases suffering from illness resulted from drinking unsafe water in the sub-district.

"250 persons from Al-Baghdadi sub-district (90 km [55 mi] west of Ramadi), have been infected with an unknown virus that has spread over the past 2 days," the head of the council, Mal Allah al-Obeidi, told Alsumaria News in an interview.

"The affected people are suffering from vomiting, fever, and hypotension, while many patients also suffered from body spasm, paralysis, and fainting," al-Obeidi said, warning of "occurrence of deaths of diseased people for lack of laboratories and doctors to diagnose the illness."

For his part, the general director of health of Al-Anbar, Khudair Khalaf Shalal, confirmed to Alsumaria News that "medical teams have been sent to Al-Baghdadi," noting that, "those teams have treated 40 cases suffering from fever, vomiting, and diarrhea."

"Patients were infected by drinking unsuitable water," Shalal added, noting that "the medical teams treated the sick and took control of the situation and the health centers in Al-Baghdadi district are operating."

Al-Baghdadi district is witnessing a severe embargo by the Islamic State (ISIS) since mid-2014 as the ISIS has cut off all supply routes of medicines, food, and other supplies to the people.

--
Communicated by:
ProMED-MENA


[Heavy and violent armed clashes that have taken place in and around Al-Baghdadi sub-district have left the area suffering from deteriorated humanitarian situation with a large number of displaced people, cutting off of the supply routes, and lack or poor availability of basic needs like drinking water and health services. All these factors might have contributed to occurrence of this outbreak of disease. These factors can also contribute to rapid spread of the disease and difficulty in controlling it.

Although the report has not mentioned the details of the disease and the responsible organism, it looks to be a water-borne diarrheal disease or gastroenteritis. Having this large number of cases within only two days calls for an epidemiological investigation supported by laboratory study.

Although the report mentions an "unknown virus" as the cause of this outbreak, there is no confirmation if it is actually a virus and what type of virus is causing this outbreak. Using the term virus is very common in the Iraqi context to describe any infectious agent. Exclusion of cholera should be considered in this cholera endemic country and in this particular season.

ProMED-mail would appreciate any information in this regard. -Mod.NS

[alert]

Cholera confirmed:

Published Date: 2015-09-13 14:37:48
Subject: PRO/MENA> Cholera – Iraq (04): (Baghdad, Al-Najaf) confirmed
Archive Number: 20150913.3642471
CHOLERA – IRAQ (04): (BAGHDAD, AL-NAJAF) CONFIRMED
************************************************** **
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Sun 13 Sep 2015
Source: Rudaw [in Arabic, trans. Mod.NS, edited]

http://rudaw.net/arabic/middleeast/iraq/1309201511

The Ministry of Health and Environment confirmed on Sunday [13 Sep 2015] that it recorded 12 cases of cholera, indicating that there were no deaths.

The Director General of the Public Health Department in the Ministry of Health, Hassan Hadi Baqer, told a news conference that was observed by Rudaw Media Network that "Diarrhea cases occur increasingly in the summer season while respiratory infections occur increasingly in young and old people from different age groups in the winter season. Cholera is among the diseases that emerge when the high temperature of more than 50 degrees [C, or 122 deg F] drops below 42 degrees [C, or 107 deg F] in addition to drilling wells and lack of water sterilization, which are indicators for emergence of these cases."

"Three cases of cholera appeared in areas of Yusufiyah and Abu Ghraib in Baghdad and 9 cases in Al-Najaf governorate," Baqer continued.

He also pointed out that "the ministry has taken important and effective steps to prevent the spread of this disease," adding that "the situation is controlled and there is not any case of death."

"The laboratories, hospitals and health centers are fully prepared and equipped with intravenous fluids and antibiotics to receive any patient and to send samples to the Central Health Laboratory to confirm cholera cases," Baqer stressed.

"The health control teams have formed a crisis cell that has carried out monitoring and inspection campaigns to restaurants, swimming pools and has warned of occurrence of an epidemic in the case of non-compliance with the regulations, health education and public and personal hygiene," he added.

[Byline: Shirin Dawood]

--
Communicated by:
PROMED-MENA


[The Baghdad Governorate Council announced on Saturday [12 Sep 2015] the emergence of cholera cases in areas west of Baghdad that was mentioned in the 12 Sep 2015 post (Cholera - Iraq (03): (Baghdad) susp, RFI 20150912.3641065). Today [13 Sep 2015], the Iraqi Ministry of Health and Environment confirmed that 12 cholera cases have been recorded from Baghdad and Al-Najaf governorates.

Cholera is endemic in Iraq with outbreaks usually occur in summer-autumn seasons. The previous outbreaks of cholera have started in the north and spread later to the center and south of Iraq. This time the 1st recorded cases are from the center and upper south of the country.

While Baghdad governorate was affected by previous outbreaks, particularly in 2007, Al-Najaf governorates was only affected by have sporadic cases of cholera.

The current situation in Iraq with the ongoing ISIS-related conflict, displacement of a large population, poverty, poor availability of safe drinking water and poor sanitation and hygiene conditions in many provinces are factors that might contribute to emergence and even rapid spread of cholera outbreaks.

Therefore, immediate prevention and control measures should be enforced using a multidisciplinary approach with the involvement of all concerned authorities. – Mod.NS]

[sharon sanders]

Five deaths and more than a thousand infected with cholera in Baghdad Baghdad, September 20 (Petra) - demanded that Iraqi competent affairs of Health and Human Services international organizations, government agencies to help get rid of cholera. A source in the Iraqi Ministry of Health, said the victims of cholera, which has spread in Baghdad disease led to the death of five women and wounded a thousand others, most of them children in Abu Ghraib, west of Baghdad during the period Alhalah.ocd health source said health teams began to wander at Abu Ghraib for the distribution of clean water and provide vaccines, medical services and make people aware of the dangers of contaminated water. For his part, the governor of Baghdad, Ali al-Tamimi Sunday While we are making our efforts to provide health services and water pure to the people of the Abu Ghraib district of Baghdad and get rid of cholera, we need the help of international parties to eliminate this dreaded disease. - (Petra) AFP / o s 09/20/2015 - 14:19 http://www.petra.gov.jo/Public_News/Nws_NewsDetails.aspx?Site_Id=2&lang=1&NewsID=215353&CatID=19&Type=Home&GType=1 machine translation

[Pathfinder]

Health | Wed Sep 23, 2015 8:24am EDT Related: HEALTH

Cases in Iraq cholera outbreak rise to 121, but no new deaths: ministry

BAGHDAD

Iraq's first major cholera outbreak since 2012 has risen to at least 121 cases and spread to southern provinces along the Euphrates River, though no new deaths have been reported in days, the health ministry said on Wednesday.

The illness was detected last week in the town of Abu Ghraib, about 25 km (15 miles) west of the capital, where at least four deaths were recorded. Most of the new cases are in Babel province south of Baghdad.
...

http://www.reuters.com/article/2015/09/23/us-iraq-cholera-idUSKCN0RN1DL20150923

[sharon sanders]

Samarra hospital denies cholera epidemic in city.....................




Samarra hospital put "the arrival of the cholera epidemic of the city."

Sunday 27-09-2015 | 3:19:17







P u / h d
Twilight News / Samarra hospital denied the existence of casualties in the city, a cholera epidemic. Recently it deployed dozens of cholera cases in the country, raising fears of an outbreak of the epidemic, especially in camps for displaced people. A spokesman of the hospital for Twilight News "There is not any infection in Samarra, a cholera epidemic." The local media have reported the existence of cholera infections in Samarra, which includes a number of camps for displaced people that lack safety features.

http://www.ara.shafaaq.com/30681

machine translation

[Shiloh]

Source: http://www.who.int/csr/don/28-septem...15-cholera/en/

Cholera – Iraq
Disease Outbreak News
28 September 2015

On 15 September 2015, WHO received a notification from the IHR National Focal Point of Iraq of laboratory-confirmation of cholera in at least five governorates.
As of 23 September 2015, a total of 120 stool samples have been tested positive at the Central Public Health Laboratory of Baghdad for Vibrio cholerae 01 Inaba. Laboratory-confirmed cases have so far been reported from at-least five Governorates of the country- Baghdad Babylon, Najaf, Qadisiyyah, and Muthanna. The preliminary investigation revealed contaminated water source as the cause of this current outbreak.
Public health response

The Ministry of Health (MoH) has stepped up its response to contain the current situation and prevent further spread of cholera in close collaboration with WHO.
WHO risk assessment

WHO does not recommend any travel or trade restrictions on any country affected by cholera outbreak.

[Shiloh]

Source: http://www.presstv.ir/Detail/2015/10...aniyah-Baghdad


Cases of cholera infection in Iraq near 1,000: Health Ministry
Mon Oct 5, 2015 4:41PM

Iraqi medical authorities say the number of recorded cases of cholera in the embattled Arab country now stands at approximately 1,000, though the waterborne disease has claimed no new lives in days.

Director General of Planning and Development at Iraq?s Health Ministry Hassan Hadi Baqer told the Arabic-language al-Sumaria satellite television network on Monday that 101 new cases have been diagnosed, bringing the number of people affected in the current cholera outbreak to 979.

Baqer added as many as 60 new people have contracted the disease in the central province of Babil, 17 in the city of Diwaniyah, located 130 kilometers (80 miles) south of the capital, Baghdad, 16 in Baghdad?s al-Rusafa district, which lies on the eastern side of the river Tigris, and eight in Karkh on the western sector of the river...

[Gert van der Hoek]

Cholera cases in Iraq top 1,200: ministry

October 7, 2015


Baghdad (AFP) - The number of confirmed cases of cholera in Iraq has risen to 1,201, the health ministry said Wednesday of an outbreak that started along the Euphrates river last month.

"There are 1,201 confirmed cases as of October 7, 2015," the health ministry said in a statement, adding that most patients had recovered.

It said there had been only one confirmed death from the disease, in Babil province south of Baghdad. Health officials had reported four suspected deaths west of the capital last month.

MORE:

[Shiloh]

Source: http://www.who.int/csr/don/12-october-2015-cholera/en/
Cholera ? Iraq

Disease Outbreak News
12 October 2015

WHO has received notification from the National IHR Focal Point of Iraq of additional laboratory-confirmed cases of cholera.
As of 8 October, a total of 1,263 laboratory-confirmed cases of Vibrio cholerae 01 Inaba were reported. These cases were reported from at least 15 governorates of the country ? These are Babylon (469 cases), Baghdad (304 cases), Qadisiyyah (146 cases), Muthanna (155 cases), Basra (61 cases), Wassit (41 cases), Karbala (33 case), Najaf (32 cases), Thi-qar (6 cases), Maysan (6 cases), Diyala (2 cases), Duhok (2 cases), Erbil (2 cases), Kirkuk (2 cases), Salah al-din (1 case) and Suleimaniyah (1 case).
Public health response

The Cholera task force led by the Ministry of Health (MoH) has established a Cholera Command and Control Centre to enhance multisectoral coordination for effective response to the outbreak. In the affected governorates, active surveillance has been stepped up for case findings in the community and case management has been standardized across all health facilities currently admitting the cholera cases.
In cholera affected areas, and particularly in the camps hosting the internally displaced people and refugees, preparedness activities have been geared up as well. These include distribution of bottled water, water kits, hygiene kits, bleaching powder and chlorine tablets; establishment of water distribution points; sanitation activities, such as disinfecting septic tanks at health facilities, conducting targeted sanitation improvements including for the water treatment plant, as well as regular cleaning of latrines and bathing facilities and proper solid waste collection, disposal and management; and dissemination of key messages on cholera prevention through several networks including social media, national radio channels, SMS messages and door to door campaigns.
Furthermore, discussions are ongoing with the International Coordinating Group to release oral cholera vaccine from the global stock. A risk assessment to identify priority groups for vaccination and a vaccination plan is being developed.
WHO has deployed a team of international experts under the Global Outbreak Alert and Response Network (GOARN) to support MoH respond to this outbreak. Additional requests have also been sent out to the technical partners in GOARN in case of request for additional international support for cholera response.
WHO advice

WHO does not recommend any travel or trade restrictions on any country affected by cholera outbreak.

[Pathfinder]

Health | Wed Oct 21, 2015 1:55pm BST Related: HEALTH

Iraq's cholera outbreak exceeds 1,800 cases: health ministry

BAGHDAD

Iraq?s first major cholera outbreak since 2012 has risen to more than 1,800 cases, including six deaths, and spread to the northern Kurdistan region, a health ministry spokesmen said on Wednesday.

The illness, which can lead to death by dehydration and kidney failure within hours if left untreated, was detected last month west of Baghdad.

Most of the new cases are there and in Babel province south of the capital, spokesman Ahmed al-Rudaini said by phone from Baghdad.

...

http://uk.reuters.com/article/2015/10/21/us-iraq-cholera-idUKKCN0SF1N620151021

[Pathfinder]

Cholera spreading in Iraq, suspected case reported in Syria ? UN health agency

27 October 2015 ? The World Health Organization (WHO) announced today that it would start vaccine treatments for cholera beginning this weekend to prevent further outbreaks in Iraq, where the disease has now been confirmed in 15 out of 18 governorates, while the agency also reported a suspected case was also found in northern Syria.

WHO spokesperson Christian Lindmeier told the regular press briefing in Geneva, Switzerland, that the latest laboratory tests had confirmed 1,942 cases and two deaths in 15 out of 18 governorates in Iraq.

?On 31 October, WHO will begin, in conjunction with the Ministry of Health, the oral cholera vaccine treatment, and will use 510,000 of the global stock pile to ensure that 255,000 internally displaced persons and refugees in the affected areas will receive two doses,? the spokesperson said.

Mr. Lindmeier said ?while this number of vaccines was not enough to vaccinate everyone, it should, however, be a strategic vaccination to block the path of the disease and prevent further outbreaks.?

In addition to the vaccine campaign, diarrhoeal disease kits and 600,000 chlorine tablets had been distributed in the infected areas, 48 national health staff had been trained in cholera and laboratory procedures, and a team of international experts have been deployed to assist the Iraqi?s Ministry of Health, he said.
...

http://www.un.org/apps/news/story.asp?NewsID=52388#.Vi_qtberQ2w

[Pathfinder]

WHO mobilizes 510 000 doses of oral cholera vaccine to help control the cholera outbreak in Iraq

1 November 2015 | Erbil, Iraq - An estimated 250 000 displaced persons will be targeted during the oral cholera vaccine (OCV) campaigns to help control cholera outbreak in Iraq. The World Health Organization (WHO) has mobilized 510 000 doses of OCV, and the 2-dose campaign is part of a strategy to prevent cholera transmission in high-risk areas and avert a potentially large-scale cholera outbreak in the 62 camps for refugees and internally displaced people.

Preparation for the campaign is now on its final stage in fourteen governorates. The campaign begins with an initial round of vaccinations during the first week of November followed by ? after a required, minimum 14 days interval ? a second round of doses, which will complete the vaccination. For such a campaign to be effective, it is vital that a second dose is administered. Targeted social mobilization, campaign logistics and health education are key components to ensure the successful implementation of OCV. In order to achieve herd immunity all members of a family above one year of age will be vaccinated.
Cholera outbreak

The cholera outbreak in Iraq continues to pose a threat inside the country as well as among its neighbouring countries. Since the start of the outbreak on 15 September 2015, the Ministry of Health has reported 2173 laboratory confirmed cholera with 2 deaths from 15 out of 19 governorates.

The trend of cholera cases has been declining in the last 2 weeks, however, some of the central and southern governorates namely are still reporting confirmed cholera cases. Over the last 7 days, only one confirmed cholera case was reported from the northern governorates which comprise Kirkuk, Erbil, Dahuk and Suleimaniyah.
Oral cholera vaccine

An OCV is proven to be effective and can protect individuals by 85% in short-term and 65% over 5 years with a good safety profile. Evidence shows that high coverage of OCV in the target population can results in significance reduction of disease transmission in the vaccinated communities.

The pre-emptive use of OCVs in emergency situations was recommended by WHO in 1999, and the use of OCV is not regarded as a replacement for proven public health interventions such as improving the water, sanitation, and hygiene situation in the target areas.

In early October 2015, the Ministry of Health of Iraq decided to use OCV to prevent a potential cholera outbreak in the camps and to supplement the existing preventive measures implemented by the Ministry of Health and health partners. WHO, in collaboration with the Ministry of Health, conducted comprehensive cholera risk assessment to identify the high-risk groups and priority areas to be used the cholera vaccination. The assessment team used the WHO?s risk assessment matrix and decision-making tool for the use of OCV in complex emergencies and concluded a high risk of cholera existed in the internally displaced person and refugee camps.
WHO?s response

WHO has been supporting the Ministry of Health and partners to scale up the cholera response interventions, including the establishment of C4 coordination mechanism, enhanced early warning surveillance, improved case management practices, water quality monitoring and chlorination, improved sanitation and hygiene practices in high-risk areas, risk communications and prepositioning cholera supplies in strategic places.

To ensure that effective surveillance, case management and infection control and laboratory support are in place, WHO has deployed epidemiologists from the headquarters and regional office, as well as experts from International Centre for Diarrhoeal Disease Research, Bangladesh through the Global Outbreak Alert and Response Network to Iraq since the outbreak was confirmed. Further, WHO donated adequate medical supplies to MoH and facilitated the distribution of these supplies to treatment facilities across the country.

http://www.emro.who.int/fr/surveillance-prevision-et-action/surveillance-news/510-000-doses-oral-cholera-vaccine-help-control-cholera-outbreak.html

[Shiloh]

Source: http://www.who.int/csr/don/26-novemb...aq-cholera/en/
Cholera ? Iraq

Disease Outbreak News
26 November 2015

WHO received notification from the National IHR Focal Point of Iraq of additional laboratory-confirmed cases of cholera.
As of 22 November, a total of 2,810 laboratory-confirmed cases of Vibrio cholerae 01 Inaba had been confirmed at the Central Public Health Laboratory in Baghdad, and only 2 deaths related to cholera were reported. These cases were reported from 17 Governorates of the country, namely Baghdad (940 cases), Babylon (675 cases), Qadisiyyah (442 cases), Muthanna (287 cases), Karbala (157 cases), Basra (102 cases), Wassit (68 cases), Najaf (46 cases), Thyqar (20 cases), Missan (21 cases), Dahuk (16 cases), Kirkuk (19 cases), Erbil (10 cases) Diyala (3 cases), Salaheddine (2 cases) Sulaimanneya (1 case) and Ninewa (1 case).
Public health response

The Government of Iraq, with the support of WHO and UNICEF, completed the first round of the oral cholera vaccination campaign. The campaign, which ended on the second week of November, led to the vaccination of 229,000 refugees and internally displaced people (93% of the target population) across 62 camps in 13 Governorates. The turnout was very high. No refusals or concerns were raised regarding the vaccine. The second round of vaccinations will begin in the first week of December to complete the recommended dosing regimen and maximize clinical protection in the target population. Oral cholera vaccination should be part of a comprehensive and integrated package that also includes clean water supply, improved sanitation and hygiene to provide the greatest chance of protection against cholera and other diarrheal diseases.
On 2 December, the pilgrimage of Arbaeen is going to take place in Karbala. A total of 10 million pilgrims are expected to attend. The National IHR Focal Point of Bahrain, the Islamic Republic of Iran, Jordan, Kuwait, Oman, Qatar and the United Arab Emirates have put in place preparedness measures for the early detection and management of any imported cholera case from Iraq. The measures include

• activating the public health preparedness and response plan;
• enhancing disease surveillance at all points of entry and at all health care facilities;
• ensuring the availability of sufficient supplies and kits at laboratories;
• enhancing water surveillance for cholera;
• enhancing food inspection measures at points of entry;
• training health care workers in the assessment and management of cholera cases,
• enhancing strict compliance of infection prevention and control measures at all health facilities, particularly those designated to receive cholera suspected cases, and
• conducting activities to promote awareness of travellers to Iraq and the public about the disease.

Between 16 and 17 October, WHO Office for the Eastern Mediterranean held a sub-regional meeting for Iraq and its neighboring countries. Another regional consultative cholera meeting was held in Amman, Jordan from 17 to 19 November and all cholera endemic countries in the region as well as other stakeholders participated the meeting. The two meetings provided a set of recommendations for enhancing disease surveillance, including laboratory confirmation; case management and infection control; water sanitation and hygiene practice; capacities at points of entry; and risk communication.
WHO advice

WHO does not recommend any travel or trade restrictions on any country affected by cholera outbreak.