Friday, November 06, 2015

UNICEF Warns On Spread Of Cholera In Middle East


Excerpt From UNICEF Infographic on Cholera





Although it has sparked an immediate denial from Kuwait’s MOH  that they have an `outbreak of Cholera’  (they do admit to 5 imported cases from Iraq), the big story out of the Middle East this morning comes from press conference held by UNICEF’s Iraq director Peter Hawkins on Thursday, where he warns of the spread of Cholera out of Iraq into Kuwait, Bahrain, and Syria.


Cholera spreads from Iraq to Syria, Kuwait, Bahrain: UNICEF

ERBIL, Iraq | By Isabel Coles

Reuters/Ahmed Saad

A cholera outbreak in Iraq has spread to neighboring Syria, Kuwait and Bahrain, and risks turning into a region-wide epidemic as millions of pilgrims prepare to visit the country, UNICEF's Iraq director said.

The disease, which can lead to death by dehydration and kidney failure within hours if left untreated, was detected west of Baghdad in September and has since infected at least 2,200 people in Iraq and has killed six.

"It (the outbreak) already has a regional dynamic and the risk of that can only be increased by people from all over the region coming into Iraq," UNICEF country director, Peter Hawkins, said on Thursday. "Kuwait, Bahrain and Syria have already had confirmed cases."

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While rarely a problem in developed countries with modern water treatment and good sanitation, Cholera remains a serious threat in over 50 nations. This from the World Health Organization Fact Sheet.

Key facts
  • Cholera is an acute diarrhoeal disease that can kill within hours if left untreated.
  • Researchers have estimated that there are 1.4 to 4.3 million cases, and 28 000 to 142 000 deaths worldwide1 due to cholera every year.
  • Up to 80% of cases can be successfully treated with oral rehydration salts.
  • Provision of safe water and sanitation is critical to control cholera and other waterborne diseases.
  • Oral cholera vaccines are an additional way to control cholera, but should not replace conventional control measures.

With the turmoil in the Middle East, the relocation of hundreds of thousands of refugees, and the general increase in travel in the region, the chances of spreading Cholera to Iraq’s neighbors increases with every passing day.  From  the WHO’s:


Global epidemics and impact of cholera

Global epidemics

Man-made and natural disasters can intensify the risk of epidemics considerably, as can conditions in crowded refugee camps. Explosive outbreaks with high case-fatality rates are often the result. For example, in the aftermath of the Rwanda crisis in 1994, outbreaks of cholera caused at least 48 000 cases and 23 800 deaths within one month in the refugee camps in Goma, the Congo. Although rarely so deadly, outbreaks continue to be of major public health concern, causing considerable socioeconomic disruption as well as loss of life. In 2001 alone, WHO and its partners in the Global Outbreak Alert and Response Network participated in the verification of 41 cholera outbreaks in 28 countries.


In 1961, the 7th cholera pandemic wave began in Indonesia and spread rapidly to other countries in Asia, Europe, Africa and finally in 1991 to Latin America, which had been free of cholera for more than one century. The disease spread rapidly in Latin America, causing nearly 400 000 reported cases and over 4000 deaths in 16 countries of the Americas that year.

In 1992, a new serogroup – a genetic derivative of the EI Tor biotype – emerged in Bangladesh and caused an extensive epidemic. Designated V. cholerae 0139 Bengal, the new serogroup has now been detected in 11 countries and likewise warrants close surveillance.

While no evidence is available to gauge the significance of these developments, the possibility of a new pandemic cannot be excluded. EI Tor, for example, was originally isolated as an avirulent strain in 1905 and subsequently acquired sufficient virulence to cause the current pandemic.

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