Since late August 2007, an outbreak of cholera has spread to 25 districts of Northern Iraq and 4 districts in Southern Iraq and across the centre of the country. It is estimated that more than 30 000 people have fallen ill with acute watery diarrhoea, among which 2 116 were identified as positive for Vibrio cholerae. The case fatality rate is 0.52% and has remained low throughout the outbreak, although it continues to spread across Iraq and dissemination to as yet unaffected areas remains highly possible.
The outbreak was first detected in Kirkuk province, where 68% of laboratory-confirmed cholera cases have so far been reported, and then spread to Sulaymaniah and Erbil provinces. Additional isolated cases of Cholera have also been identified in other parts of the country, including Tikrit (6 cases confirmed), Mosul (2 cases confirmed), Basra (1 case confirmed), Baghdad (2 cases confirmed) and Dahuk (1 case confirmed).
The Government of Iraq has mobilized a multi-sectoral response to the outbreak. Specific control measures have been reinforced and preventive measures to reduce the risk of transmission to unaffected areas have been put in place. However, a severe shortage of chlorination products has been noted and replenishment is urgently needed to enable water supplies to be treated to render it safe for human consumption. Provision of safe water is the highest priority in controlling an outbreak of cholera.
WHO continues to support the National and local health authorities in the ongoing response operations. Ten interagency diarrhoeal disease kits, each sufficient to treat 400 moderate and 100 severe cases, arrived in Erbil International airport on 16 September. Rapid diagnostic tests are being pre-positioned in remote health care facilities. In addition, 10% of all positive stool samples are being sent to NAMRU 3 reference laboratory(US Navy Advanced Research Unit) in Cairo for further confirmation and phenotypic characterization.
In controlling the spread of cholera, WHO does not recommend any special restrictions to travel or trade to or from affected areas.