The cholera outbreak in Iraq has continued to decline over the past 3 weeks with a few cases being reported from the affected districts or governorates. A total of 4858 laboratory-confirmed cases tested at provincial laboratories have been reported from the country, with 2 related deaths as of 17 November 2015.
Currently, 16 out of the 19 governorates in Iraq have reported laboratory-confirmed cases. The central public health laboratory has identified that the causative strain of this outbreak is Vibrio cholerae 01 Inaba. The strain has been found to be sensitive to commonly-used antibiotics, including tetracycline, ciprofloxacin and erythromycin. A total of 16 vibrio cholera isolates have been sent to the Pasteur Institute in France for genotyping and other advanced testing.
Since the first laboratory-confirmed case of cholera in Iraq was notified officially to WHO on 15 September 2015 in Alshamiya district in Diwaniya governorate, the Ministry of Health has collected 119 983 stool samples for suspected cholera. The positive stool samples were re-tested at the central public health laboratory in Baghdad for quality purposes and only 2745 stools samples were found to be positive for Vibrio cholerae 01 Inaba.
Nearly 10 districts within Baghdad, Babylon, Diwaniya and Muthana governorates have reported over 89% of all laboratory-confirmed cholera cases, and most of these districts receive their water supply solely from the Euphrates river. Figure 1 shows the declining trends in the number of laboratory-confirmed cholera cases reported daily in Iraq between 30 August and 17 November 2015.
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