Gorilla’s Guides

Cholera Sitrep_17

Overview:

As of 23rd of September 2007, districts of Northern Iraq and districts in the south and center have reported laboratory-confirmed cases of cholera. The outbreak is mostly in the northern governorates but appears to be spreading to the neighbouring governorates:

• Dohuk reported a case in one district.
• Only one district of Sulaymaniyah governorate does not have reported laboratory-confirmed cases of cholera.
• Dokan district which is the main water supply for Sulaymaniyah city has reported 40 confirmed
  cholera cases.
• All five districts of Kirkuk governorate have reported laboratory-confirmed cases of cholera.
• Only one district of Arbil governorate does not have reported laboratory-confirmed cases of cholera.

In the southern and central governorates  One district in each of:

• Baghdad.
• Basra.
• Mosul.

has reported confirmed cases

• Tikrit.

has reported cases in three districts.

• There are cases awaiting confirmation from Babil and Wasit.
• The overwhelming majority of cases were reported from Sulaimaniyah and Kirkuk with the majority of those being in Kirkuk and Sulaimaniyah cities.
• As the weather cools and become more favourable for transmission, the organism is expected to spread to other provinces.
• The surveillance system for diarrhoeal disease has been intensified in all provinces

Table-1: Cases of laboratory confirmed cholera cases reported from Iraq¹

*One case from Mosul and another from Tikrit are pending central public health lab confirmation

¹ There is a discrepancy in the figures between this sitrep (number 17) and the most recently available sitrep (number 15.) Sitrep Number 16 is not available.

Sitrep 15 gives a total 2253 lab confirmed cases of which 2245 are of the inaba serotype and 8 of the ogawa serotype. Sitrep 17 gives a total of 2116. We include below the table from Sitrep 15 for ease of reference.

Arbil Governorate

96 confirmed cases - an increase of 3.  The total number of cases of diarrhoeal disease reported from this province  at 16326 with no death.  3436 stool samples were collected out of which 109 were positive. 96 of those positive results were for cases and 13 from contacts. It is too early to detect any pattern but the general trend in reports show a slight decrease in the daily confirmed cases

At-Ta’mim (Kirkuk) Governorate

There is a discrepancy in the data from this governorate. See above.

Babil Governorate

There is a report of a case in Babil. Confirmatory test results are expected by WHO within 48 hours.

Baghdad

The confirmed cholera case from Baghdad died on 22nd of September bringing the national death toll to 11 cases. Stool sample of one of her contracts who later developed symptoms was also positive as vibrio cholera of the inaba sero type bringing the confirmed cases in Baghdad to 2.

Basra Governorate

1 confirmed case - No change from last available sitrep.  

Dahuk Governorate

On 23rd of September; Dahuk health authority reported the first laboratory confirmed V cholera in a 5 year old  female child from Bardarash district in Dahuk governorate. It is important to note that the first index case for 1999 out break (over 900  cases) started in the same area which the WHO requested to visit during her last mission to
north Iraq, however, the request was denied. The case was detected during the routine testing of cases presenting to health facilities with watery diarrhea. Further investigation of contacts and water supply was negative for V cholera organism.

Diyala Governorate

17 patients from this governorate presented to Baladruz, salahaddin and Baquba hospitals with severe dehydrating diarrhea with renal shut down in one of them. They were diagnosed and treated for Cholera. Specimen collection was done late after patient had antibiotics for the majority of cases.

Ninawa Governorate

Nothing to add to latest report.

Salah ad Din Governorate

Tikrit: Another 2 cases were confirmed positive for vibrio cholera bring the total cholera cases to 4.

Sulaymaniyah Governorate

638 confirmed cases from this governorate with 9 deaths. 70% of those confirmed cholera cases were reported from the governorate capital.  Data on admitted diarrhea cases to the pediatric and teaching hospitals in Sulaimaniyah since September 1st show little change in the incidence among the under 5 age group but a clear declining trend in the over 5 age group.

A cause for concern is that there are 40 confirmed cases from the Dokan Lake district this is the main source for water supply for Sulaimaniyah city. The water department and health authorities are exerting “special effort” to protect the lake from any possible contamination by cases or carriers. It is to be hoped that these efforts are successful.

Wasit Governorate

There is a report of a case in Wasit. Confirmatory test results are expected by WHO within 48 hours.

Indexed under: Arbil (Erbil), Babil (Governorate), Baghdad, Baghdad (Governorate), Basrah, Cholera Situation Reports, Dahuk (Dohuk) (Governorate), Disputed Areas, Diyala, Follow Up, Khalis, Kirkuk, Kirkuk (At-Ta'mim) Governorate, Mosul, Ninawa (Governorate), Salah ad Din (Governorate), Sulaymaniyah, Tikrit, Wasit, Water Borne Disease, World Health Organisation, الكوليرا