Iraq: Cholera Epidemic - Emergency Plan of Action (EPoA), DREF n° MDRIQ015


A. Situation analysis

Description of the disaster

A cholera outbreak in Iraq has infected hundreds of people, and records of more suspected cases have been sent for lab testing in the central laboratory in Baghdad, most of which are from the northern Kurdistan region. As announced by the Ministry of Health (MOH) officials in Baghdad, there has been a recent spike in hospitalization following diarrhea cases in Sulaymaniyah, Erbil, Duhok, and southern governorates of Iraq. The KRI Mnistry of Health, published a statement on Thursday 23 June 2022, and issued a directive in regard to dealing with the diarrheal outbreak in the region. The increase in Cholera cases in Sulaymaniyah and other governorates is a reason for concern for the MoH, as it is coming on the backdrop of the COVID-19 pandemic and other epidemic-prone outbreaks. However, the Ministry of Health both in Baghdad and in the Kurdistan region is ready to prepare for and respond to this outbreak and lessen the impact on the affected population. The MoH has also requested that the in-country humanitarian actors support government efforts to deal with this outbreak.

On 19 June 2022, Iraq’s health authorities announced a cholera outbreak after at least 13 cases were confirmed across the country and thousands of hospital admissions for acute diarrhea were reported. Ten of the confirmed cases were in the northern city of Sulaymaniyah. Two more cases are confirmed in the southern province of Al Muthanna and the other in Kirkuk, north of Baghdad. There has also been a spike in hospital admissions because of diarrhea in the nearby cities of Erbil and Duhok but to a smaller degree.

Health officials in Iraq’s Kurdish region are warning of a cholera outbreak after several people were reported to have died in Sulaymaniyah and Erbil provinces. Experts say that vegetables irrigated by sewage water, an increasingly common practice due to the shortage of water in the Tigris and Euphrates rivers, are behind the outbreak. Concerns are growing that a significant outbreak of the disease could put additional pressure on a national health system that is already over-stretched. The Director of the Sulaymaniyah Health Department called a press conference on Sunday 19 June 2022, where the department mentioned that about 4,000 cases of diarrhea were recorded in Sulaymaniyah's hospitals in the previous week. The director further asked the ministry to declare a state of emergency in the city. According to the ministry of health in Erbil, the first fatality was recorded on Tuesday 28, in the northern province of Kirkuk. On Thursday 30, the ministry confirmed a second fatality due to Cholera in the Baghdad governorate.

Based on the available data, a sharp shooting up of diarrhea cases was observed from week nineteen onward to week twenty-three, with about 17,887 diarrhea cases reported from Sulaymaniyah and surrounding districts. According to the World Health Organization (WHO), cholera remains a threat to public health and an indicator of inequity and lack of awareness in the communities. As compared to previous years, the number of diarrhea cases is higher and not in the normal range. The first case was found in Shar hospital, in a 35 years old woman from the Ashti Internally Displaced Peoples’ (IDP) camp.1 During the health cluster meeting held in Sulaymaniyah on 21 June, the directorate of health (DOH) highlighted the challenges to the health department and requested support for providing medicine and medical supplies, including intravenous (IV) fluid (ringer lactate), infusion sets, and Infection Prevention and Control (IPC) materials. The DOH also requested logistic support, such as hiring vehicles to facilitate the activities of rapid response teams, water quality monitoring, and disease surveillance teams, and humanitarian actors, International and National Non-Governmental Organizations (NGOs). Agencies interested to support such activities can communicate with Centers for Disease Control and Prevention (CDC) section in the preventive health directorate in DOH, Sulaymaniyah.