Gorilla’s Guides

Cholera Sitrep_9

Summary:

The outbreak continues to spread in the Northern governorates. 23 local administrative districts are now affected and have reported laboratory-confirmed cases of cholera. So far there are no confirmed cases outside of the these three governorates.

Affected Area Still Spreading:

The areas affected are:

• All the sixteen districts of Sulaymaniyah governorate.
• All five districts of Kirkuk governorate.
• Two out of seven districts of Erbil governorate.

Fatalities:

• The number of reported deaths remains at 10.

Source:

• The source of the outbreak is still not known.

Although, accurate data on number of cholera cases reported from the three affected governorates are not yet available, the disease surveillance system of these three governorates, since the outbreak started, showed that between 23 August and 10 September, a total of 6,142 cases of diarrhoeal disease with 9 deaths (CFR: 0.14%) were reported from Sulaymaniayh governorate while between 29 July to 14 September a total of 6,879 cases of diarrhoeal disease with 1 death (CFR: 0.01%) were reported from Kirkuk governorate. On the other hand, 11,641 cases of diarrhoeal disease with no death (CFR: 0%) were reported from Arbil governorate from 01 to 10 September 2007. Of these reported cases, 1,150 laboratory confirmed cases of cholera have been reported so far.

Arbil Governorate

The outbreak spread to Arbil governorate on September 6th 2007. Apart from Arbil centre and Koisnjaq district, no other district in the province has, so far, reported any laboratory-confirmed case of Vibrio cholerae. The total number of cases of diarrhoeal disease reported from this province from 1st of September to 10th of September stands at 11,641 with no death. In the absence of data on daily progression of cases in Arbil province, it was not possible to determine any epidemiological trend on the evolution of the outbreak.

At-Ta’mim (Kirkuk) Governorate

The number of diarrhoeal diseases reported in 2007 between epidemiological weeks no 30 and 36 shows an
overall increase of 14% compared with the number of diarrhoeal disease cases reported from Kirkuk during
the same period in 2006. While the increase in cases reported in the under 5 year age group is less (8%),
there is an overall increase of 21% between the cases reported in the above 5 year age group between the
comparable periods of 2006 and 2007.

More than 90% of all cases are in the city of Kirkuk itself.  This could be because of:

1. Improved reporting.
2. Increased public awareness resulting in more cases seeking consultation in health centres.
3. An actual increase of case load as the outbreak keeps unfolding and more and more people are being exposed to the source of infection.
4. Some combination of the above.

Sulaymaniyah Governorate

The outbreak spread to Sulaymaniyah province on 23 August 2007. As of 10th of September, the outbreak has spread to all the districts in the province. The daily progression of cases shows that barring some inadequacies and
incompleteness in reporting during the earlier part of this outbreak  the number of cases are now gradually increasing and possibly after 1st of September, the reported cases are appearing to come in a wave which seems to be more consistent with any outbreak.

Rest of Irak:

• No reported change.

Ongoing Control Measures For Containment Of Outbreak:

• See Previous postings

Surveillance for cholera:

• See Previous postings

Risk communication:

• See Previous postings

Improving environmental management:

• See Previous postings

Indexed under: Arbil (Erbil), Kirkuk (At-Ta'mim) Governorate, Sulaymaniyah, Water Borne Disease, Water Crisis (Iraq), الكوليرا