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Cablegate: Iraq Not in a Time of Cholera

VZCZCXRO9417
RR RUEHBC RUEHDA RUEHDE RUEHIHL RUEHKUK
DE RUEHGB #2928 2541113
ZNR UUUUU ZZH
R 101113Z SEP 08
FM AMEMBASSY BAGHDAD
TO RUEHC/SECSTATE WASHDC 9346
INFO RUCNRAQ/IRAQ COLLECTIVE

UNCLAS BAGHDAD 002928

SIPDIS
SENSITIVE

E.O. 12958: N/A
TAGS: ECON SOCI KSCA IZ
SUBJECT: IRAQ NOT IN A TIME OF CHOLERA

Reference: 07 BAGHDAD 2899

This report is Sensitive But Unclassified (SBU), for official use
only, and not for dissemination outside USG channels or over the
internet.

1. (SBU) Summary: Iraq Ministry of Health (MoH) officials said
September 9 that there have been a total of 26 cases of cholera
reported in 2008; according to health officials, this is far below
the number of cases reported by this time last year and falls well
short of the threshold of an outbreak. Due to Iraq's poorly
designed and maintained water treatment and sewage systems, cholera
cases are not unusual, especially during the summer months. Iran is
presently experiencing a similar surge in cholera cases. In
coordination with the World Health Organization (WHO), the Embassy
Health Attache has made several offers of assistance to the MoH, all
of which have been declined. Informally, however, the Baghdad
Central Public Health Lab has accepted supplies provided by the U.S.
Naval Medical Research Unit and the US Centers for Disease Control
in Cairo, Egypt shipped via the WHO pouch. End summary.

--------------------------------------------- ---
IRAQ 2008 CHOLERA CASES FAR BELOW OUTBREAK LEVEL
--------------------------------------------- ---

2. (SBU) Iraq Ministry of Health (MoH) officials said on September 9
that a total of twenty-six cases of cholera located in six districts
across Iraq have been reported thus far in 2008. These include
three from Abu Ghraib, Baghdad, one from Amarah, Maysan (the only
confirmed fatality), twenty from Hashimiya and Jufr Al-Sakr, Babil,
and one from Al Amiryah, Baghdad. Embassy Health Attache and
Centers for Disease Control (CDC) Officer note that this volume of
cases, including the 20 cases in one district alone, falls far short
of the threshold of an outbreak. These numbers are also far smaller
than the number of cases reported in 2007 (reftel), with ten deaths
and over 1,600 cases reported by this time last year, most of which
occurred in the Kurdish region.

3. (SBU) Due to Iraq's poorly designed and maintained water
treatment and sewage systems, cholera bacteria from untreated human
waste can easily get into waterways or into groundwater used for
drinking water supplies. This leads to pockets of cholera cases.
Warm temperatures make it easier for the bacteria to survive in the
water system. Cholera is a regional problem, and media reports that
Iran is now also reporting numerous cases.
4. (SBU) While BBC reports of six cholera related deaths in Babil
have not yet been confirmed by the MoH or the Babil PRT, the Babil
Provincial Council has declared a state of emergency. Babil PRT
comments in a September 9 update that while tents have been set up
outside the Hillah and Hashimiyah hospitals in Babil, they have not
yet begun treating patients in those tents. These tents have been
set up in the past at this time of year as a preemptive measure in
case of a cholera outbreak. The Provincial Council has also
purchased 2,000 water containers with a large supply of chlorine
tablets for water treatment to distribute through a local NGO in the
two affected districts. Dr. Osama, Chairman of the Provincial
Council's Health Committee, made it clear to the PRT that he does
not consider the current situation a cholera epidemic, noting that
cholera is endemic in southern Iraq, especially this time of year.
--------------------------------------------
ASSISTANCE OFFICIALLY DECLINED, BUT SUPPLIES
ACCEPTED ANYWAY
--------------------------------------------

5. (SBU) In coordination with the World Health Organization, Embassy
Health Attache has made several formal offers of assistance to the
MoH, all of which have been declined. Informally, however, the
Baghdad Central Public Health Lab accepted assistance from the U.S.
Naval Medical Research Unit (NAMRU-3)and the US Centers for Disease
Control in Cairo, Egypt, including 200 Cary-Blair sampling tubes,
one bottle of Thiosulfate Citrate Bile Salts Sucrose agar powder, 50
API 20E test strips, 100 Oxidade tests, and Antisera for typing O1
Inaba, O1 Ogawa, and O139. These items were shipped to Baghdad last
week via the WHO pouch and are used in the testing of samples to
determine whether or not cholera bacteria are present.
CROCKER

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