A Flashback to Cholera Outbreaks in Kurdistan region-Iraq

Abstract

Cholera is a contagious acute diarrheal disease due to ingestion of contaminated water and food with Vibrio cholera, a Gram-negative bacterium that naturally inhabits coastal and estuarine ecosystems. Millions of cholera cases and thousands of deaths are annually reported worldwide. Cholera is endemic in Iraq with every 3-5 years interval. Meanwhile, cholera outbreaks have been reporting in Kurdistan region. However, the epidemiology of the disease has not been investigated. This study comprehensively reviewed the cholera outbreaks in Kurdistan region, depending on the WHO situation reports, online resources and scientific researches. The results showed seven reported cholera outbreaks from 1995 to 2022. The cholera epidemics happened at irregular intervals that makes the prediction of next outbreak difficult. Moreover, the trend of cholera is greatly decreasing from thousands to hundreds of cases throughout the outbreaks and in total about 30 people died. These might be the consequences of effective prevention measures, population health and natural acquired immunity against cholera. It was found that Sulaymaniyah is the most affected governorate in the region. This is probably related to the contamination of the main drinking water resource, little Zab river. Besides, the irrigation of the vegetable fields with untreated sewage could be another cause. Also, both Inaba and Ogawa serotypes of Vibrio cholera, O1, El Tor individually caused the outbreaks. Thus, cholera outbreak will be happening in Kurdistan region, particularly in Sulaymaniyah governorate. This definitely needs more scientific investigations, hoping to tackle the future outbreaks and total eradication of the disease.