Gorilla’s Guides

Cholera Update 2: September 11th 2007

Summary Latest data available is:

• 10 Fatalities throughout KRG.
• More than 7,000 case of acute watery diarrhoea.
• Estimated 2.8 Million people living in the affected areas.

Twelve districts of Northern Iraq have reported laboratory-confirmed cases of cholera putting over 2.8 million people exposed to public health risk from this current outbreak. Five out of eleven districts of Sulaymaniyah province, all five districts of Kirkuk province and two out of seven districts of Erbil province are now affected by this cholera outbreak in Northern Iraq.

Sulaymaniyah

The cumulative number of cases of acute watery diarrhoea reported from five out of eleven districts stands at 48401 including 9 deaths with an overall case fatality rate of 0.18%. In Sulaymaniyah province, Vibrio cholerae has been laboratory confirmed in 315 stool specimens out of 1,629 specimens (19%) collected so far.

Kirkuk:

The health authority of Kirkuk province reported a total of 3,728 cases of acute diarrhoeal disease including 1 death (CFR: 0.026%). The first index case of cholera, confirmed by laboratory test, was reported from Kirkuk province on 14 August 2007. So far, from the Kirkuk province, a total of 291 stool specimens out of 5,610 samples collected so far have tested positive for Vibrio cholerae. Out of these, 116 stool specimens out of 3,207 samples (4%) collected tested positive in the month of August and 175 stool specimens out of 2,403 stool specimens (7%) tested positive in the first week of September so far.

Erbril:

On 6th of September, the first laboratory-confirmed case of cholera was reported for the first time from one of the  districts (Erbil centre) of Erbil province. Later on, laboratory confirmed case was also reported from Koisnjaq district. So far 21 stool specimens from these two districts of Erbil province have tested positive for Vibrio cholerae serogroup 01 Inaba signifying that cholera has now spread to three provinces of Northern Iraq (Sulaymaniyah, Kirkuk and Erbil). Consolidated figure on cumulative number of cases of acute watery diarrhea since the first index case of Vibrio cholerae was laboratory confirmed are still not available.

Actions Taken/Bodies Involved:

The International Committee of the Red Cross, Medecins Sans Frontieres (Doctors Without Borders), and United Nations agencies including UNICEF and the U.N. Development Programme have joined WHO efforts to respond to the cholera epidemic.

All public water systems in the affected areas have been chlorinated, and samples are being regularly collected and tested to ensure potable water standards are being met.

(Note: Many in the affected areas rely on well water according to our sources.)

URGENT NEEDS

While surveillance system for acute watery diarrhea/cholera is showing signs of improvement in general, there is an urgent need to improve it further in order to obtain better quality data for continuous risk assessment and assess  the effectiveness of the control measures real time. In order to strengthen the surveillance system for acute watery diarrhea/cholera in the affected districts of Northern Iraq, two international qualified epidemiologists needs to be deployed temporarily (One in Sulaymaniyah province and the other in Kirkuk province) to assist the local health authority in improving surveillance, conducting case investigation, imparting training to the rapid response team members for outbreak verification etc.

In terms of medical and laboratory supplies, the current need is to expedite the shipment of 10 Inter Agency
Diarrhoeal Disease Kits to Erbil and 5000 rapid diagnostic kits (SMART kits) to Northern Iraq

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