In mid-2003, the World Health organization reported on cholera in Iraq:
rom 28 April to 4 June 2003, a total of 73 laboratory-confirmed cholera cases have been reported in Iraq : 68 in Basra governorate, 4 in Missan governorate, 1 in Muthana governorate. No deaths have been reported.
From 17 May to 4 June 2003, the daily surveillance system of diarrhoeal disease cases in the four main hospitals of Basra reported a total of 1549 cases of acute watery diarrhea. Among these cases, 25.6 % occurred in patients aged 5 years and above.
Here’s the WHO’s more recent report:
Since the cholera outbreak was first detected in Kirkuk, Northern Iraq, on 14 August 2007, it has spread to 9 out of 18 provinces across Iraq. It is estimated that more than 30 000 people have fallen ill with acute watery diarrhoea, among which 3 315 were identified as positive for Vibrio cholerae, the bacterium causing the disease. A total of 14 people are known to have died of the disease. The case-fatality rate has remained low throughout the outbreak indicating that those who have become sick have been able to access adequate treatment on time.
The disease is continuing to spread across Iraq and dissemination to as yet unaffected areas remains highly possible. Epidemiological curves are still rising in the provinces from which the majority of laboratory-confirmed cases have originated, Kirkuk (2309) and Sulaymaniah (870). An increasing number of cases of acute watery diarrhoea has also been reported in Diala, a province neighbouring Baghdad. Although V. cholerae has not yet been laboratory confirmed, the clinical symptoms indicate the presence of cholera. The numbers of cases are remaining stable in Basra, Baghdad, Dahuk, Mosul and Tikrit. However, a case has now been confirmed in Wasit, a province that has previously been unaffected by the outbreak.
Link.
Mark Drapeau’s December 4th Op-Ed in the Times, no longer behind the pay-to-read wall:
The threat is bad enough in the overcrowded communities of poor countries, but epidemics thrive in war zones. In dense areas like Baghdad or refugee camps, the Vibrio cholerae bacterium spreads quickly via untreated water or raw sewage. Latrines in these places often adjoin living quarters, making the spread of germs almost inevitable, and mothers commonly scavenge for leftover food to feed children — food that may be mixed with contaminated water or feces.
It’s no coincidence that Iraqi areas with the filthiest water and most raw sewage are breeding grounds for both V. cholerae and insurgents. In a perverse feedback loop, insurgents in these places are more likely to become ill, but conditions for the surrounding populace simultaneously deteriorate, increasing support for the insurgency. Another perverse circumstance is that chlorine is often used to treat cholera-infected water, but because insurgents have started using chlorine trucks in bombing attacks, restrictions on chlorine distribution have led to reduced water treatment and possibly increased the prevalence of cholera.
War and sickness are inextricably intertwined. Large groups of men living at close quarters on scant sleep are perfect carriers. Indeed, microbes have had a larger effect on the outcome of wars than many care to admit, from smallpox outbreaks in the French and Indian War to the pandemic influenza in World War I. As Clausewitz (who died from cholera in 1831) might have said, war is the continuation of disease by other means.
In Iraq, of course, it’s not only insurgents and civilians who are at risk of disease. Given the asymmetric nature of conflict, which group do we expect to be more affected by an epidemic: large, centralized conventional military forces or small, agile insurgent units? The answer is that a 10 percent loss within a 5,000-member brigade is far more devastating than losing two members of a 20-man terrorist cell. And suicide bombers don’t call in sick.