The cholera outbreak in Iraq has continued to decline over the past 3 weeks with a few cases being reported from the affected districts or governorates. A total of 4858 laboratory-confirmed cases tested at provincial laboratories have been reported from the country, with 2 related deaths as of 17 November 2015.

Iraq map/CIA
Iraq map/CIA

Currently, 16 out of the 19 governorates in Iraq have reported laboratory-confirmed cases. The central public health laboratory has identified that the causative strain of this outbreak is Vibrio cholerae 01 Inaba. The strain has been found to be sensitive to commonly-used antibiotics, including tetracycline, ciprofloxacin and erythromycin. A total of 16 vibrio cholera isolates have been sent to the Pasteur Institute in France for genotyping and other advanced testing.

Since the first laboratory-confirmed case of cholera in Iraq was notified officially to WHO on 15 September 2015 in Alshamiya district in Diwaniya governorate, the Ministry of Health has collected 119 983 stool samples for suspected cholera. The positive stool samples were re-tested at the central public health laboratory in Baghdad for quality purposes and only 2745 stools samples were found to be positive for Vibrio cholerae 01 Inaba.

Nearly 10 districts within Baghdad, Babylon, Diwaniya and Muthana governorates have reported over 89% of all laboratory-confirmed cholera cases, and most of these districts receive their water supply solely from the Euphrates river.

The trends in cholera cases in the 4 most affected governorates and 5 most affected districts have been declining significantly in recent weeks. Likewise, district and governorate’s specific attack rates have clearly shown a downward trend in the last few weeks.

Considering the available surveillance data, there is no evidence that cholera is spreading to new communities or districts. According to the Ministry of Health none of the internally displaced persons and refugee camps across Iraq reported any laboratory-confirmed cholera case.