Published Date: 2007-09-03 20:00:12
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2007 (31)
Archive Number: 20070903.2901
CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2007 (31)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
In this update:
 &  Cholera - Iraq (northern)
 Cholera - India (Orissa)
 Cholera - Iraq (northern)
Date: Sun 1 Sep 2007
Source: International Herald Tribune [edited]
An outbreak of cholera in the northern province of Sulaimaniyah
appears not to been caused by contaminated water and is unlikely to
spread to Baghdad, the USA military said Sun 2 Sep 2007.
There have been 70 confirmed cases of the disease and more than 4000
reports of people suffering from symptoms like severe diarrhea and
vomiting, said Col. Glynda Lucas, chief of the military's clinical
operations in Iraq. "This appears to be an outbreak, it is not an
epidemic," Lucas said in a statement. "It is typical for these areas
in Iraq to have cholera at this time of year."
Sherko Abdullah, the head of the regional health ministry department
in Sulaimaniyah, said that a 9th person had died from the disease on
Fri 31 Aug 2007. The Iraqi government has taken steps to contain the
disease and prevent it from spreading to other areas, she said.
 Cholera - Iraq (northern)
Date: Mon 3 Sep 2007
Source: Associated Press [edited]
An outbreak of cholera in northern Iraq that has killed 9 people was
caused by inadequate water infrastructure, said a UN official Mon 3
Sep 2007 who has been working with the Iraqi government to
investigate the disease. The findings seemed to contradict those
announced by the USA military on Sun 2 Sep 2007 that the outbreak was
not caused by contaminated water.
"The root cause of the outbreak lies in the inadequacy of the water
supply system and deteriorated infrastructure," said Paolo Lembo, the
Iraq country director for the UN Development Program. Lembo recently
returned to Jordan from Iraq and warned of the spread of the
gastrointestinal disease, which is typically linked to contaminated
water and can cause severe diarrhea and lead to death.
"Apparently the epidemic is expanding beyond its origin and spreading
to other cities within Sulaimaniyah province and exhibiting a wider
geographical coverage," Lembo said in a written statement. The UNDP
and the World Health Organization are developing a strategy to
address contaminated water in the area, the statement added.
On Sun 2 Sep 2007 Col. Glynda Lucas, chief of the military's clinical
operations in Iraq, said the cholera outbreak in the northern
Sulaimaniyah province appeared not to have been caused by
contaminated water and was unlikely to spread to Baghdad.
"It is typical for these areas in Iraq to have cholera at this time
of year," said Lucas, adding that there have been 70 confirmed cases
of the disease and more than 4000 reports of people suffering from
symptoms like severe diarrhea and vomiting.
Meanwhile, Jordanian health officials said Mon 3 Sep 2007 that they
would take appropriate measures to prevent the spread of the disease
into the kingdom from neighboring Iraq. Health ministry official Adel
al-Balbissi told The Associated Press that travelers from northern
Iraq would be given preventive medicine against cholera and would
undergo medical checkups if they exhibited any symptoms of the disease.
[It is not easy to accept as truth the statement of Col. Lucas who
does not appear to understand the basic principles of epidemiology.
The CDC defines an epidemic as "the occurrence of cases of an illness
in a community or region which is in excess of the number of cases
normally expected for that disease in that area at that time"
(<http://www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm>). That "it
is typical for these areas in Iraq to have cholera at this time of
year" is irrelevent.
Likewise, Lucas appears not to be schooled on the transmission of _V.
cholerae_. Cholera is classically a waterborne infection which
becomes prominent in areas where the infrastructure for the supply of
safe water is not present or has been destroyed by war or neglect or
both. Whether the epidemic will spread 300 kilometers (186.4 miles)
south to Baghdad (see map at:
establish itself there is dependent on the status of the water
infrastructure there. - Mod.LL]
 Cholera - India (Orissa)
Date: Sun 2 Sep 2007
Source: Kalinga Times [edited]
With the authorities failing to control the cholera epidemic, the
official death toll in 4 tribal-dominated districts of Orissa
increased to 178 on Sun 2 Sep 2007. The number of deaths was likely
to rise as the waterborne disease was spreading to more and more
villages. Unconfirmed reports put the death toll over 350.
According to reports received from the worst-hit blocks of Kashipur
in Rayagada district and Dasmantpur in Koraput district, almost all
the health centers and dispensaries in the area continued to receive
patients suffering from cholera.
Although the state government was making efforts to send doctors on
special duty to the affected region, lack of road communication to
hundreds of villages was hampering the operation.
The deaths due to diarrhea and cholera started in Kashipur and
Dasmantpur in early July 2007.
[The location of this quite large and growing Indian outbreak of
cholera following a typhoon in Orissa can be found at: