WHO confirms cholera outbreak

The World Health Organisation (WHO) on Wednesday confirmed the first outbreak of cholera in Iraq, in the southern city of Basra. Of 38 samples taken to Kuwait for testing from three Basra hospitals, four had tested positive, a WHO spokeswoman, Fedela Chaib, said. But for every four that tested positive, there were probably 400 that had not been diagnosed, she added, as doctors had for weeks been reporting an increasing number of diarrhoeal diseases. The four cases are in addition to 18 others that tested positive in Iraqi hospital laboratories over a week ago. The severe diarrhoea which is symptomatic of cholera, along with vomiting, can lead to the loss of 12 litres of body fluids every day, leading to severe dehydration. "Cholera shouldn’t be deadly, because treatment exists," said Chaib. "If it is contained, there should be less than 1 percent fatalities, but if it is not, we could have 50 percent." "The question is to find the source of contamination," she added. "We need to investigate what people’s drinking habits are outside the city as well as inside." One of the consequences of the war has been the destruction of the city’s health surveillance system, which in normal circumstances would investigate and monitor cases of disease, but is now unable to do so. The Department of Preventive Medicine (DPM), which ran a successful cholera-control programme, has been completely looted. WHO was currently distributing reporting forms to hospitals and clinics, Chaib said, so that health staff could report in detail on any suspected cases. Several hospitals had already started using the forms, which were being collected by the DPM. Re-equipping the city’s central laboratory, which serves the four southern governorates, is also deemed essential to kick-starting the health system. "We need US $200,000 to rebuild it, not just for cholera, but for all communicable diseases like typhoid and measles, as well as vector-borne diseases like malaria and leishmaniasis," said Chaib. Hepatitis A, which has an incubation period of a month, and is also linked to water, was expected to follow the cholera outbreak in Basra, she said. Basra’s population takes its water from various sources - from taps in people’s homes, rivers and canals, pierced pipes and bottled sources. Desalinated water is available, but only about one-third of the population can afford it. Tankers rented by the United Nations Children’s Fund are also delivering water to the city each day, but it is suspected that other, uncontrolled, tankers may also be selling water. Outside the city, the picture is much less clear. People continue to illegally tap water pipes to gain access and to drink direct from the Shatt al-Arab river, but no data is available on the presence of cholera.