Children and the poor were especially at risk

BASRA, Iraq, May 8 (IslamOnline.net & News Agencies) - The UN's World Health Organization (WHO) said Wednesday, May 7, it expected a cholera epidemic in southern Iraq, where 17 cases have already been registered in two hospitals, and warned that other infectious waterborne diseases could break out.

A team from the World Health Organization, which now has a permanent presence in Basra, visited Al Tahrir Hospital in Basra together with local health experts in order to assess the health situation there.

Doctors in the hospital reported a significant increase in the number of cases of diarrhea diseases, gastroenteritis and dehydration.

Seven cases of clinically confirmed cholera were reported, mainly among very young children (between 13 months and 4 years old).

The children were rehydrated and subsequently returned home. The doctors said there are currently more than 30 admissions per day for diarrhea disease. They expressed concern that it is not possible to perform medical tests at the hospital because the central laboratory is not functioning and some vital reagents are missing or have been stolen.

The same situation was confirmed at the Basra Children's Hospital. Doctors said that out of 200 outpatients a day, 90% are for diarrhea; others are diagnosed with hepatitis, Acute Respiratory Infections, malnutrition, shigella and typhoid.

"We expect a cholera epidemic in southern Iraq and we fear hundreds of cases," WHO spokeswoman Fadila Shaib told a press conference in Basra, Agence France-Presse (AFP) said.

Tests on the 17 cases were being carried out in Kuwait and the results were due on Thursday, May 8, Shaib said, expressing concern but not surprise at the appearance of the disease.

WHO disease specialist Denis Coulombier estimated that there were 10 times the number of cholera cases than the 17 "discovered by chance".

Coulombier said three other hospitals in Basra were believed to have diagnosed the disease among several patients.

Drinking contaminated water, sometimes directly from the Shatt al-Arab waterway, and the non-collection of garbage in this city of 1.5 million people were behind the outbreak, according to the WHO.

Coulombier said that apart from cholera, an acute infectious disease of the small intestine, cases of bloody diarrhea were also being reported.

In 2002, "around 250 cases of cholera were confirmed in Basra. Under Saddam's regime, the hygiene system worked very well but all control programs have now disappeared," he said.

Cholera can be fatal if goes untreated. WHO said it had enough medicines to treat cholera cases but warned that current health conditions would help transmit the disease.

People in the region who do not have access to potable water were urged to boil water before drinking it.

Health Security

Drinking contaminated water and the non-collection of garbage were behind the outbreak

"The real problem is health security," Coulombier said. "Tomorrow, it will be hepatitis, malaria and other diseases whose incubation period is longer" than the two or three days for cholera.

Iraqi doctor Abed Hassan al-Shattal, however, was not alarmist: "We are not worried, we are used to it, you know. Many cases are usually recorded in summer days, mainly in the south of Iraq.

"Old people and babies are vulnerable to the disease," he told AFP, recommending people to wash their hands well in addition to boiling water.

In Baghdad, WHO official Ghulam Popal also said cholera cases occurred every year in Iraq and could normally be prevented from getting out of control.

"Now all these measures are very weak because of the concentration of resources on war wounded," he said.

With the fall of Saddam Hussein's regime following the invasion of U.S.-led forces, many Iraqi hospitals have been badly looted, and are also overburdened by the number of casualties.

Meanwhile, the nation is suffering from impure water supplies, uncollected garbage and a lack of electricity.

"The health situation will deteriorate because of the lack of water and sanitation and the breakdown in public health programs," Popal warned, stressing that infections spread more easily during the hot summer months.

"We know we will face more outbreaks, particularly waterborne diseases like cholera, typhoid fever and hepatitis," Popal said," Children and the poor were especially at risk."

cholera is water-borne. It thrives in warm climates where there is poor sanitation. People can catch it by drinking or bathing in cholera-tainted water or eating infected food. It is only rarely transmitted by direct person-to-person contact.

The bacterium lodges in the mucous membranes of the small intestine. After a short incubation period of between two and five days, it propagates, secreting toxin that causes the gut to produce water and electrolytes, expelled as diarrhea. Up to 20 liters (four gallons) of fluids can be expelled in 24 hours. The shock can be fatal without early dehydration.

Cholera ranked alongside the plague and smallpox as one of the most fearsome diseases. In the 19th century, it spread panic in Europe after it spread there from Asia. Despite its reputation, it was stamped out thanks to better sanitation and the advent of antibiotics.