Cholera outbreak in Baghdad in 2007: an epidemiological study

Abstract

In 2007 there was an epidemic of cholera in Iraq with 4667 cases. The first case in Baghdad was diagnosed on 19 September 2007 and the last case on 13 December 2007. In all, 136 cases were reported (2.9% of the country total) in 6 of the 13 districts of Baghdad. The median age of the cases was 11 years (range = 0.3-71 years). There were 3 deaths giving a case fatality rate of 2.2%. Bacteriological testing confirmed that the outbreak was caused by Vibrio cholerae 01, biotype El Tor, serotype Inaba. The strain was resistant to trimethoprimsulfamethoxazole, but sensitive to tetracycline and chloramphenicol. Efforts are needed in Baghdad to establish safe drinking-water and proper sanitation as limited availabilty of tap-water and sewage contamination probably contributed to the spread of the disease.

The Isolation of <i>Vibrio cholera</i> and Other Enteric Bacteria with Molecular Characterization of <i>Vibrio cholera</i> during the Outbreak of Baghdad/Iraq in 2015

“…This finding is similar to that reported in Baghdad 2007 cholera outbreak and in Babylon in 2012 and 2014 [28] [37] [55]. This new variant of V. cholera was first reported in Bangladesh 2002 [48].…”

“…Similar results were also reported for the above mentioned sectors of Baghdad [28] [33]. Cholera transmission is a result of fecal contamination of drinking-water which is closely linked to inadequate environmental management [58].…”

“…These percentages are widely acceptable for the cholera infection outbreak in 2015, which was confirmed that 2651 cases comprising of 1477 (55.7%) males and 1174 (44.3%) females, all age groups were included [32], and, similar to previous researches, it has been shown that age groups were ranged from 12 -65 years old [76], and 54.4% are male and 45.6% are female out of 160 cases of cholera infections [33]. On the other hand, these results are inconsistent with other results that reported cholera infections in age groups < 1 year (16.3%), 1 -5 years (62.5%) and >5 years (21.3%) [28]. Interestingly, the studies in 1999, 2009 and 2014 reported that cholera usually affect the age group between 1 -5 years and occasionally in the neonatal period 2 -30 days [37] [58] [77].…”

“…This cholera genotype did not exist prior to this period. These results give indication that Iraq cholera disease represents epidemics spreading from some neighboring countries visitors to holy shrine sites in Iraq [28]. This may be due to inadequate supplies and a shortage of health personnel, among other factors which provide adequate conditions for V. cholera O1, biotype El Tor, serotype Inaba to survive better in the warm environment and crowded areas which give better transmission from human to human by food and water since the El Tor strains have efficiency transmission from host to host when compared with classical cholera strains [56] [57].…”

“…As a result of that, some sectors in Baghdad suffer from the shortage of municipal drinking water. Therefore, the people living in those sectors dig their own wells without using the adequate methods of water treatment, or they transfer their drinking water via unclean tankers [28]. On other hand, infrastructure destruction as a result of the multiple crises which Iraq has suffered from and events such as floods, famine and wars, displacement of populations to inadequate and overcrowded camps for internally displaced persons or refugees [82], all have participated to spread cholera in Iraq and it has become an epidemic that threatens other neighboring countries since bacterial pathogens can be transmitted via birds, air, foods, and rivers.…”