Gorilla’s Guides

Cholera Sitrep_20 (Corrected)

Overview:

As of 27th of September 2007, 26 districts of Northern Iraq and 7 districts in the south and center have reported 2758 laboratory-confirmed cases of cholera.

• 13 out of the 14 districts of Sulaymaniyah governorate.
• All five districts of Kirkuk governorate
• All seven districts of Arbil governorate
• One district in Dahuk
• 3 districts in (Salah Ad Din) Tikrit
• One district in Ninawa (Mosul),
• One district in Baghdad
• One district in Basrah
• One district in Wasit

are now affected by this cholera outbreak. This represents an increase of 295 laboratory confirmed cases since the last situation report. 14 deaths have now been reported an increase of 3 since the last situation report.

• 95% of cases reported nationally were reported from Sulaimaniyah and Kirkuk the vast majority of these from Kirkuk and Sulaimaniyah cities - the governorate capitals. The out break seems to be slowly spreading to the neighboring provinces of Arbil which has 106 confirmed cases and Diyala which has 22 cases diagnosed on clinical grounds.
• There appears to be a developing upward trend in Sulaymaniyah governorate.
• One of the important features in this out break is that most of the cases seen have mild to moderate signs
  and symptoms. The traditional signs and symptoms of severe dehydrating diarrhea were seen only very
  occasionally, out of the 2758 lab confirmed cases; only 14 death were reported, most the deceased have
  another serious underlying cause.
• Normally reliable sources are reporting a death from Cholera in Al Anbar (Hit) because of reporting lags this is unlikely to show in WHO for some time.
• Apart from the affected governorates there is no sign that the disease has spread to any other part of Irak. However, as the weather cools and become more favorable for transmission, the organism is expected to spread.

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

Detailed reports by governorate/district are below the fold:

Al Anbar

• Aswat Al Iraq are reporting that the health authorities in Hit have confirmed that a 5 year old child died of Cholera in the public hospital in Hit on Saturday night.

Arbil Governorate

• Arbil seems to have a fairly sensitive diarrhea disease surveillance system that was able to pick up cholera cases very early a swift response seems to have succeeded in halting and limiting the spread and magnitude of the out break.
• The below figure show the number of confirmed V cholera by date of onset for the period 05-28 September
  2007. It is too early to detect any pattern but the general trend shows slight downwards trend in the number of the daily confirmed cases.

  

• The 7 districts in Arbil governorate have reported 111 laboratory-confirmed cases.
• The total number of cases of diarrhoeal disease reported 1st of September to 27th of September stands at 17518 with no deaths.
• 4125 stool samples were collected of which 123 were positive - 111 for cases and 12 from contacts.

At-Ta’mim (Kirkuk) Governorate

• The data for the period 27/08 up to 23/09 show a step wise increase in the number of reported diarrhea cases. This reflects better reporting and community awareness.

  

• The number of confirmed cholera cases as expected is showing a similar trend. However, WHO do not have the complete data for weeks 38 & and 39 to reach any plausible conclusion.
• 68% of the total confirmed cholera cases reported from Iraq, are from Kirkuk province. 90% of Kirkuk province cases are from the city of Kirkuk.
• Despite the effort exerted by the DoH authorities; the daily reported diarrhea cases, confirmed cholera cases and severity of the disease seems to be on the increase.
• It is worth noting that despite assurances that the public water supply is safe and repeated efforts by local health authorities that the source of this outbreak is still untraced for the cases in Kirkuk city.

Babil Governorate

• No reported change.

Baghdad

• No secondary cholera confirmed cases were reported from Baghdad following the reported case 10 days ago

Basra Governorate

• No secondary cholera confirmed cases were reported from Basra following the reported case 10 days ago

Dahuk Governorate

• This governorate has so far reported one laboratory confirmed case in a 5 year old female child from Bardarash district. 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

• Between 15-26 September in a new focus 22 patients presented to Baladruz, Salahaddin, Hibhib, Al-Udhem and Baquba hospitals and PHCs (Public Health Clinics) with severe dehydrating diarrhea with renal shut down in one of them. Specimen collection was done late after patient had antibiotics for the majority of cases. The results of 21 cases tested negative to V cholera while 1 is still pending.

Ninawa Governorate

• Mosul : 2 confirmed cases - Nothing to add to previous sitrep.

Salah ad Din Governorate

• Tikrit: Three districts are affected in Tikrit. During the period 11-27 September 1438 diarrhea cases were reported; 1031 stool specimens collected, 8 of them were positive for 01 vibrio cholera, 4 were for cases and 4 for healthy carriers.

Sulaymaniyah Governorate

• The total number of laboratory confirmed cases up to the 28th of September reached 761 an increase of 83 since WHO’s last sitrep.
• The figure below shows that confirmed cases peaked in week 36 and then leveled during weeks 37 & 38 however a definite upward trend is seen during the first 5 days of week 39.

  

• 70% of confirmed cholera cases in this governorate were reported from the capital of Sulaymaniyah. The chart below shows admitted diarrhea cases to the pediatric and teaching hospitals during the period 1-27 September 2007. It is clear that there is slight upward trend the number of admitted below 5 children in the last 2 days, as for above 5 cases there is a clear upward trend in the number of admitted cases in the last 3 days. (For purposes of comparison see Figure 2 in sitrep 18 Sulaymaniyah Section of the posting.)

Wasit Governorate

• There is one confirmed case reported from this governorate.

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Indexed under: Al Anbar (Governorate), Arbil (Erbil), Babil (Governorate), Baghdad, Baghdad Hospitals, Basrah, Cholera Situation Reports, Dahuk (Dohuk) (Governorate), Disputed Areas, Follow Up, Hit, Kirkuk, Kirkuk (At-Ta'mim) Governorate, Mosul, Ninawa (Governorate), Sulaymaniyah, Tikrit, Wasit, Water Borne Disease, Water Crisis (Iraq), World Health Organisation, الكوليرا