OCHA Situation Report on Diarrhea and Cholera in Iraq 17 Sep 2008


Diarrhea and laboratory confirmed Cholera 07/08- 16/09/08

1. Summary

During the last 24 hours 35 new cholera have been reported, bringing the total confirmed cases to 161, as follows:

- One case each in Basra, Missan, and Diyala

- 2 cases each in Najaf and Baghdad Resafa.

- 14 cases in Karbala 9 of which are confirmed by the Central Public Health Laboratory (CPHL) and 5 provisionally diagnosed as cholera in the Governorate laboratory. Isolates have been sent to CPHL in Baghdad for confirmation.

- 22 cases in Baghdad-Kerkh.

- 118 cases in Babil Governorate, 63 of which are confirmed at the CPHL and 55 diagnosed in the Governorate laboratory and are awaiting confirmation.

Summary of overall situation

- Total deaths due to confirmed or suspect cholera cases have risen to 12 from 10 on 11 September. Six of them in Missan, 3 in Babil, 2 in Baghdad Kerkh and one in Basra Governorate. Five of the 12 fatalities were due to laboratory confirmed cholera.

- 15 suspect cases are still under investigation.


- In Missan only one case was laboratory confirmed as cholera out of a cluster of 138 cases presenting with acute watery diarrhea. Six cases in this cluster resulted in death including that of a 3 year old male child confirmed by laboratory as caused by cholera. Ninety eight out of Missan's 138 cases (71%) were reported from 3 communities in one district (Qula'at Salih). The deaths of 6 out of 138 cases presenting with dehydrating diarrhea shows a high case fatality ratio of 5%. However, the case fatality ratio drops to the acceptable level of 0.7% when calculated against all the diarrhea cases reported in week 34 (890 cases)


- In Babil, the deaths of 3 out of 118 confirmed cholera cases also shows a high fatality ratio of 3%. However, the case fatality ratio drops to the acceptable level of 0.73% when all the diarrhea cases reported in week 35 (958 cases) are taken into consideration. Hashimiya hospital in Babil has the highest patient load presenting with acute watery diarrhea since the beginning of the outbreak. However, the hospital did not report any laboratory confirmed cholera cases during the period 30/08 up to 08/09. Babil Governorate PHL need to validate Hashimiya laboratory results by retesting all stool isolate and original stool samples if positive for the mentioned period.


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