Cholera Sitrep_1

September 7, 2007
By Editors
Pattern Of Transmission In Sulaymaniyah Province
As of 1st of September, the outbreak, since reported on 23 August, has spread to four out of eleven districts in the province (Please see the map below) exposing over 1,502,009 people at great public health risk. No surveillance system for diarrhoeal diseases existed in the province before the outbreak started on 23 August. Only recently with support from WHO Office of Iraq, the provincial health authority has started collecting surveillance data on cases reported to the health centres and hospitals. Therefore, due to inadequacy of reporting and other limitations of the surveillance system, the cumulative number of cases of cholera reported so far from the province may be grossly underreported and may not represent the true burden of the disease.
Pattern Of Transmission In Kirkuk Province
In Kirkuk province, Vibrio cholerae serogroup O1 Inaba was detected from a stool specimen on 19 August 2007 for the first time ever from a stool specimen collected as part of systematic routine surveillance for detecting enteric pathogens of diarrhoeal diseases. Later on, V. cholerae was isolated from a further 101 stool samples collected from suspected cases …
Currently, however, a daily incidence of 20 to 25 cases per day is still being reported from the outpatients of hospitals and health centres of Kirkuk province. In the absence of information regarding endemicity of cholera in the province, it is too early to elucidate from the available data whether the current situation in Kirkuk represents strong seasonal transmission of cholera or the beginning of a looming outbreak. A close epidemiological monitoring of the situation needs to be maintained to see the progression of the current trend.
Urgent Needs
The following urgent needs, which are preliminary, have been identified by the WRO-Iraq to contain the current outbreak:
  1. The ten interagency diarrhoeal disease kits which have been ordered by WRO-Iraq through WHO/HQ needs to be expeditiously sent to the field. In case these kits can not be airlifted, these could be transported by road from Turkey;
  2. Rapid Diagnostic Kits (Dipstick) for Cholera- Approximately 5000 kits
  3. Enteric disease bacteriology kits- 10 to support field laboratory investiagtion
  4. Operational cost (USD 200,000) for the surveillance team in the affected districts;
  5. Communication equipment (RB Gan, Mobile telephone, Thuraya, Laptop, etc) to support better information flow between the field and the WHO Iraq Office in Amman;
  6. Chlorine powder: 10 tons
  7. Water purification tablets, Soaps and Gerry cans for 100,000 families;
  8. Cost for printing of 300,000 health education leaflets (Approximately USD 50,000)
  9. Water testing kits for water quality control lab in the field
  10. Cost for production and display of TV spots on health and hygiene promotion (Approximately USD 50,000)

WHO: Sitrep_1.pdf

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