A Flashback to Cholera Outbreaks in Kurdistan region-Iraq

Abstract

Cholera is a contagious acute diarrheal disease due to ingestion of contaminated water and food with Vibrio cholera, a Gram-negative bacterium that naturally inhabits coastal and estuarine ecosystems. Millions of cholera cases and thousands of deaths are annually reported worldwide. Cholera is endemic in Iraq with every 3-5 years interval. Meanwhile, cholera outbreaks have been reporting in Kurdistan region. However, the epidemiology of the disease has not been investigated. This study comprehensively reviewed the cholera outbreaks in Kurdistan region, depending on the WHO situation reports, online resources and scientific researches. The results showed seven reported cholera outbreaks from 1995 to 2022. The cholera epidemics happened at irregular intervals that makes the prediction of next outbreak difficult. Moreover, the trend of cholera is greatly decreasing from thousands to hundreds of cases throughout the outbreaks and in total about 30 people died. These might be the consequences of effective prevention measures, population health and natural acquired immunity against cholera. It was found that Sulaymaniyah is the most affected governorate in the region. This is probably related to the contamination of the main drinking water resource, little Zab river. Besides, the irrigation of the vegetable fields with untreated sewage could be another cause. Also, both Inaba and Ogawa serotypes of Vibrio cholera, O1, El Tor individually caused the outbreaks. Thus, cholera outbreak will be happening in Kurdistan region, particularly in Sulaymaniyah governorate. This definitely needs more scientific investigations, hoping to tackle the future outbreaks and total eradication of the disease.

A Molecular and Epidemiological Study of Cholera Outbreak in Sulaymaniyah Province, Iraq, in 2022

“…The etiological agent was identified as V. cholerae O1 serotype Ogawa ( WHO 1995 ). A comprehensive review of the cholera outbreaks in the Kurdistan region covering seven cholera outbreaks between 1995 and 2022 indicated that both Inaba and Ogawa serotypes of V. cholerae , O1, El Tor individually caused these outbreaks ( Sidiq 2022 ). In the outbreaks in 1995, 1998, 1999, and 2012 in Iraq and the Kurdistan Region the serotype Ogawa was dominant, while only the outbreaks of 2007 and 2015 were caused by the Inaba serotype ( WHO 1995 ; Yassin 2002 ; Al-Abbassi et al 2005 ; Kami 2007 ; WHO 2007b ; Agha et al 2008 ; Health Cluster 2015 ; Zgheir et al 2019 ).…”