November

Iraq - Cholera
30 Nov 2008
Government of Iraq & World Health Organization (WHO) [edited] [Promed]
The recent report of the Iraq Ministry of Health indicates that 892 laboratory-confirmed cholera cases have been detected and registered in Iraq, up to 27 Nov 2008.
Most of the new confirmed cases were from Diwanyia. 48 percent of the cases are found in children below 5 years of age. There have been 11 deaths (7 males and 4 females). 36 percent of the deaths have been in below-5-year-old children.
Province / No. districts / Date 1st case / Date most recent case / Deaths / Cases / Attack rate per 100,000
-----------------------------------------------
Diala / 1 / 9 Sep 2008 / 9 Sep 2008 / 0 / 1 / 0.1
Wasit / 1 / 30 Sep 2008 / 16 Oct 2008 / 0 / 3 / 0.2
Erbil / 2 / 14 Oct 2008 / 14 Oct 2008 / 0 / 2 / 0.1
Missan / 1 / 22 Sep 2008 / 28 Sep 2008 / 1 / 3 / 0.4
Anbar / 2 / 7 Sep 2008 / 27 Sep 2008 / 0 / 8 / 0.5
Muthana / 1 / 14 Oct 2008 / 9 Nov 2008 / 0 / 21 / 2.6
Najaf / 3 / 7 Sep 2008 / 3 Nov 2008 / 0 / 39 / 4.8
Kerbala / 3 / 5 Sep 2008 / 1 Nov 2008 / 0 / 61 / 6.6
Basra / 6 / 14 Sep 2008 / 11 Nov 2008 / 2 / 64 / 2.6
Baghdad / 10 / 18 Aug 2008 / 16 Nov 2008 / 2 / 106 / 1.6
Diwanyia / 4 / 20 Sep 2008 / 16 Nov 2008 / 3 / 305 / 29.7
Babil / 4 / 28 Aug 2008 / 16 Nov 2008 / 3 / 279 / 17.2
-----------------------------------------------
Total: Deaths = 11 / Cases = 892 / Attack rate: 3.0
Related stories
24 Nov 2008 - Cholera
UN ReliefWeb, Government of Iraq & World Health Organization (WHO) report [edited] [Promed]
The recent report of Iraq's Ministry of Health indicates that 889 laboratory-confirmed cholera cases have been detected and registered in Iraq, up to 21 Nov 2008. Most of the newly confirmed cases were from Diwanyia (13 of 36). 47 percent of the cases are found in children below 5 years of age. There have been 11 deaths (7 males and 4 females). 36 percent of the deaths have been in children below 5 years of age.
Epidemiological findings have indicated that contaminated water is the most probable source of the outbreak.
Total: Deaths = 11 / Cases = 889 / Attack rate: 3.0
17 Nov 2008- Iraq - Cholera
UN ReliefWeb, Government of Iraq & World Health Organization (WHO) report [edited] [Promed]
The recent report of Iraq's Ministry of Health indicates that 853 laboratory-confirmed cholera cases have been detected and registered in Iraq, up to 13 Nov 2008. Most of the new confirmed cases were from Muthana. 47 percent of the cases are found in children below 5 years of age. There have been 11 deaths (7 males and 4 females). 36 percent of the deaths have been in children below 5 years of age.
Epidemiological findings have indicated that contaminated water is the most probable source of the outbreak. 852 cases have been identified as Inaba and 1 case as Ogawa serotypes.
Total: Deaths = 11 / Cases = 853
4 Nov 2008 - Cholera in Irak
UN Office for the Coordination of Humanitarian Affairs
(OCHA), ReliefWeb, Government of Iraq & World Health Organization (WHO) report [edited][Promed]
The recent report of Iraq Ministry of Health indicates that 738 laboratory-confirmed cholera cases have been detected and registered in Iraq, up to 4 Nov 2008. Most of the new confirmed cases were from Babil and Muthana. There have been 8 deaths (6 males and 2 females). 50 percent of the deaths have been in children below 5 years of age.
Epidemiological findings have indicated that contaminated water is the most probable source of the outbreak. 737 cases have been identified as Inaba and 1 case as Ogawa serotypes.
20 Oct 2008 - Cholera
UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, Government of Iraq, World Health Organization (WHO) report [edited] [Promed]
Situation report on diarrhea and cholera in Iraq, 20 Oct 2008
The recent report of Iraq's Ministry of Health indicates that 531 laboratory-confirmed cholera cases have been detected and registered in Iraq, up to 20 Oct 2008.
- 56 percent of the cases are found in children under 5 years of age.
- There have been 8 deaths (6 males and 2 females). 50 percent of the deaths have been children under 5 years of age.
- Epidemiological findings have indicated that contaminated water is the most probable source of the outbreak.
- 530 cases have been identified as Inaba and one case as Ogawa serotypes.
13 Oct 2008 - Cholera
UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, World Health Organization (WHO) report [edited] [Promed]
In line with the implementation of International Health Regulation (IHR 2005), Iraq is actively involved in surveillance and care for the cholera cases. A robust diarrhea surveillance system already exists countrywide. The Public Health and hospital laboratories are actively engaged in surveillance system for acute watery diarrhea and cholera. The recent report of Ministry of Health indicates 462 laboratories confirmed cholera cases have been detected and registered up to 13 Oct 2008. 60 percent of the cases are below 5 years of age. 8 deaths are reported, 4 among children below 5 years of age. Epidemiological findings have clearly indicated contaminated water as the most probable source of the outbreak. 461 cases have been identified as Inaba and one case as Ogawa serotypes.Related stories
6 Oct 2008 - Cholera - Iraq
UN Office for the Coordination of Humanitarian Affairs (OCHA), Integrated Regional Information Networks (IRIN) News [edited] [Promed] < http://www.reliefweb.int/rw/rwb.nsf/db900SID/PANA-7K6FXU?OpenDocument >
The number of confirmed cholera cases has risen to 418 in central and southern Iraq, with 6 dead since an outbreak began on 20 Aug 2008, a government spokesman said on 5 Oct 2008. "We've registered 418 cholera cases in 10 provinces so far: Babil 222 cases, Baghdad 71, Basra 44, Karbala 34, Qadissiyah 30, Anbar 7, Najaf 5, Maysan 3, and Diyala and Kut 1 case each," said Ihsan Jaafar, director-general of the public health directorate and spokesman for the ministry's cholera control unit. Jaafar told IRIN that one new cholera-related death, a child under 5 in Qadissiyah Province, had been added to the already registered 5 fatalities: a 10-year-old girl and a 61-year-old man in Babil Province; a 3-year-old boy in Maysan; and an adult and child in Baghdad. He said that of the newly registered cases 228 were males and 190 females; in 159 cases the patients' ages were 5-70, with all other cases being among the under 5. About 25 km (15.5 mi) to the west of Qadissiyah's capital, Diwaniyah, residents of al-Kafi village (population 4000), where the new death occurred, complained about poor public infrastructure and health services and called for immediate help.
29 Sep 2008 - Cholera
World Health Organization (WHO) Epidemic and Pandemic Alert and Response (EPR) disease outbreak news [edited] [Promed]
On 20 Aug 2008, the Government of Iraq reported the first cholera cases of 2008. As of 28 Sep 2008, a total of 341 laboratory-confirmed cholera cases, including 5 deaths, had been verified (case-fatality rate: 1.5 percent). 9 provinces have already been affected, with Babil accounting for the majority of cases (58 percent), followed by Baghdad (18 percent) and Kerbala (9 percent). Other provinces in which cholera cases have been reported include Anbar, Basra, Diala, Diwanyia, Maysan, and Najaf.
In addition to the confirmed cholera cases, there are a further 31 suspected cases currently under investigation and 7 fatal cases of acute watery diarrhoea with symptoms similar to those of cholera.
Although the outbreak this year [2008] appears to be less intense then that of 2007, further waves are still possible. It is therefore too early to consider this epidemic to be under control. In addition, long-term inadequacies in the area of water and sanitation remain of immediate concern and cholera outbreaks will recur in Iraq until access to safe water and proper sanitation is ensured for all people.
In response to a request from the Ministry of Health, WHO is providing technical support. The WHO regional expert for water and sanitation has arrived in Baghdad and a joint WHO-UNICEF [United Nations Children's Fund] assessment mission to Babil and Maysan will take place as soon as the security situation allows.
WHO does not recommend any restrictions to travel or trade to or from affected areas as a means to control the spread of cholera. However, neighbouring countries are encouraged to reinforce their active surveillance and preparedness systems. Mass chemoprophylaxis is strongly discouraged, as it has no effect on the spread of cholera, can have adverse effects by increasing antimicrobial resistance and provides a false sense of security.
Use of the current internationally available prequalified oral cholera vaccine is not recommended once an outbreak has started due to its 2 dose regimen and the time required to reach protective efficacy as well as the high costs and the heavy logistics associated with its use. The use of the parenteral cholera vaccine has never been recommended by WHO due to its low protective efficacy and the high occurrence of severe adverse reactions.
21 Sep 2008 – Cholera- IRIN report
UN Integrated Regional Information Networks (IRIN) [edited] [Promed]
A cholera outbreak is continuing to spread in central and southern Iraq, with 65 new cases registered over the past week, bringing the total number of confirmed cases to 172, a health ministry spokesman said on 20 Sep 2008. "We have registered so far 172 confirmed cases of cholera in 8 provinces: Babil 104 cases, Baghdad 42 cases, Karbala 17 cases, Basra 3 cases, Najaf 2 cases, Anbar 2 cases, Diyala 1 case and Maysan 1 case," said Ihsan Jaafar, director-general of the public health directorate and spokesman for the ministry's cholera control unit. Dozens of suspected cases are being tested, Jaafar added. Despite 40 cases having been diagnosed in Babil Province last week, Jaafar said that ongoing awareness campaigns have helped limit watery diarrhea cases, often caused by cholera. Since the outbreak began in late August 2008, 5 fatalities have been registered so far: a 10-year-old girl and a 61-year-old man in Babil Province; a 3-year-old boy in Maysan; and an adult and child in Baghdad. Babil and Maysan are about 100 km and 350 km south of Baghdad, respectively. The Iraqi Health Ministry and the World Health Organization have blamed the country's rundown water and sanitation infrastructure for the cholera outbreak.
19 Sep 2008 - WHO report
Government of Iraq & World Health Organization (WHO) [edited] [Promed]
Diarrhea and laboratory confirmed cholera June 2008-19 Sep 2008
The total number of cholera cases up to 19 Sep 2008 has reached 171,
an increase of 9 cases over yesterday's [18 Sep 2008] total.
There are another 7 deaths due to acute watery diarrhea; however, other stool specimens were not collected (3 deaths) or stool on examination turned out to be negative for cholera organisms (4 deaths). The Central Public Health Laboratory will forward cholera positive and negative isolates to WHO for confirmation, serotyping, antimicrobial sensitivity pattern and relation to the 2007 or 2008 outbreaks in Iran.
15 Sep 2008 - Cholera - Iraq: IRIN report
UN Integrated Regional Information Networks (IRIN) [edited] [Promed]
15 Sep 2008 - Cholera - Iraq
Azzaman [Promed]
12 Sep 2008 – Cholera (Karbala)
Associated Press [edited] [Promed]
10 Sep 2008 – Iraq: WHO report
WHO [Promed]
8 Sep 2008 – Cholera in Babil
IOL (Independent Online, South Africa) [edited] [Promed]
Local Iraqi authorities declared a state of emergency on Monday [8 Sep 2008] after cholera killed 8 people in Babil province, south of Baghdad, in 3 days, with another 500 suspected to have contracted the disease. 20 other cases of cholera, which can sometimes kill victims with sudden severe diarrhea, have been confirmed. Scarcity of water during Iraq's scorching summer forces many to drink water from unsafe sources.
8 Sep 2008 – Cholera in Baghdad
UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, UN Integrated Regional Information Networks (IRIN) report [edited] [Promed]
28 Aug 2008- Cholera - (Maysan)
China View, Xinhua News Agency report [edited] [Promed]
28 Aug 2008 – Iraq - Cholera
redOrbit, United Press International (UPI) report [edited] [Promed]
[11.4.002 A]

Tunisia – Salmonella outbreak hits British tourists in Tunisia
11 Nov 2008
from a pres release [edited][iFSN]
Specialist travel law solicitor Andrew Morton, from Manchester law firm Pannone, has confirmed that holidaymakers returning from the Riu Park El Kebir hotel in Hammamet, Tunisia, have been diagnosed with Salmonella poisoning. Commented Andrew Morton from Pannone, “From all reports coming out of the resort, we expect the number of cases to rise significantly over the next few days. Hammamet is a major winter sun destination and we expect the number of people affected to rise significantly over the next few days.” He added finally, “Anyone returning to the UK from this hotel who has been ill, should see their doctor immediately.
[11.4.001 A]

October

Sudan - Cholera (Northern Bahra el-Ghazal)
14 Oct 2008
UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, Miraya FM report [edited] [Promed]
The Commissioner of Aweil East County Cirelo Diing Aher said at least 25 people died of cholera in Tiitchok Mareeng area. Speaking to Miraya-FM from the state government headquarters in Aweil town on Monday [13 Oct 2008], the Aweil East county commissioner said that citizens of Toich Area have been displaced by floods forcing them to over crowd some highlands in the area where acute watery diarrhea is now in progress. Cases of cholera were first discovered in the Aweil North and West counties in July 2008 before it spread to Aweil town. Over 2-dozen deaths in Aweil East indicate the huge toll the disease is having in Northern Bahra el-Ghazal State.
[10.4.003 A]

Afghanistan - Cholera
7 Oct 2008
UN Office for the Coordination of Humanitarian Affairs (OCHA), Integrated Regional Information Networks (IRIN) News [edited] [Promed]
An outbreak of El Tor cholera in northern, eastern, and southeastern Afghanistan has killed at least 17 people, mostly women and children, in the past few weeks, the Ministry of Public Health (MoPH) said on 6 Oct 2008. Over 1100 people with diarrhoea and vomiting caused by the outbreak have received treatment at medical facilities in 13 of the country's 34 provinces. The worst affected provinces are Laghman, Nooristan, and Nangarhar (in the east); Samangan and Faryab (north); and Nimruz (west), the MoPH said. "It's not a classic cholera which quickly turns into an epidemic," Abdullah Fahim, a spokesman for the MoPH, told IRIN. El Tor (a strain of the bacterium Vibrio cholerae ) is less fatal, Fahim said. Less than 24 percent of Afghanistan's estimated 26.6 million people have access to improved drinking water and only 12 percent have access to improved sanitation, according to the UN Children's Fund (UNICEF). A severe drought affecting large swaths of the country has made life very difficult for many communities, forcing people to use unsafe water for drinking, washing, and cooking.
[10.4.002 A]

Pakistan - Cholera - (North-West Frontier)
3 Oct 2008
eFluxMedia [edited] [Promed]
According to this story, health authorities treated hundreds of patients affected by a cholera outbreak in Pakistan's conflict-ridden Swat mountain district, a media report said Friday [3 Oct 2008]. At least 600 suspected cases were reported in the past 3 days in Swat, where security forces have been battling Islamist militants for nearly a year, the Urdu-language Aaj news channel said. On Thursday [2 Oct 2008], 2 children admitted to a state-run hospital in Saidu Sharif died from cholera. The town appeared to be the worst-affected area as more than 100 patients were registered Friday [3 Oct 2008]. It is reported that scores of people in the adjacent areas of Mingora and Saidu Sharif also complained of symptoms of the potentially fatal disease, which is mainly transmitted through contaminated water. The supply of potable water piped from reservoirs was suspended to most parts of Swat 2 weeks ago after insurgents blew up a key grid station in Mingora, forcing a large number of people to use water from streams and underground sources.
Related stories
5 Oct 2008 - The International News [edited] [Promed]
[10.4.001 A]

September

Pakistan - Cholera - (Federally Administered Tribal Areas)
22 Sep 2008
The News [edited] [Promed]
According to this story, contaminated water and unfavorable environment have caused cholera and other contagious diseases in a number of people, mostly children, in the makeshift camp established at Vocational Institute, Pulosa near here for the displaced persons of Bajaur. Sources said several people have been admitted to nearby hospitals that were suffering from cholera and other contagious diseases. They said there was no arrangement for the provision of clean drinking water to the victims. According to an official record, over 4000 displaced persons had been put up in the camp, while there were only 76 rooms and 170 tents. A victim, who wished not to be named, said they were being provided substandard and unhygienic edibles for Iftar [the evening meal breaking the fast each day during Ramadan]; that, he claimed, was the main reason for the spread of diseases. They urged the government to ensure the provision of enough items along with clean drinking water.
Related stories
5 Sep 2008 - Cholera
Reuters India [edited] [Promed]
Cholera has broken out among some of up to 300 000 people in northwestern Pakistan who have fled fighting between government forces and militants, the International Committee of the Red Cross (ICRC) said on Friday [5 Sep 2008]. The ICRC had no figures for the number of cases of cholera, which had been confirmed in local laboratories by Pakistani doctors.
[09.4.005 A]

Afghanistan - Mass food poisoning leaves 360 sick
21 Sep 2008
The Australian [edited][iFSN]
According to this story, about 100 men fell ill in the eastern province of Nuristan late yesterday after eating iftar, the evening meal that breaks a day of fasting during the holy month of Ramadan, the deputy provincial governor said. They had all eaten food prepared in the kitchen of the governor which feeds some provincial authorities and police who guard the compound. Many had fainted and about 360 people were treated were given medical treatment. The source of the poisoning appeared to have been the bread but it was being investigated. NATO's International Security Assistance Force, in Afghanistan to help the government defeat a Taliban-led insurgency, said about 160 people were treated at a clinic and 200 more at a local police station."Although the cause of the illness is not fully understood it is believed to be a straightforward case of food poisoning and the matter is being investigated by the Afghan National Police,'' it said in a statement. It is reported that a man who gave his name as Ajab Khan and said he was a Taliban commander in the region claimed responsibility for the poisoning and said 300 people had been affected.
[09.4.004 A]

Egypt – Foodborne illness (Sharm El-Sheik)
15 Sep 2008
RIA Novosti News Agency [edited] [Promed]
More than 80 Russian tourists vacationing at the Sheraton Sharm Resort in Egypt are believed to be suffering from food poisoning, a Moscow radio station said on Monday [15 Sep 2008], citing one of the victims. The Ekho Moskvy radio station said it is not clear what caused the poisoning, but the tourists believe they fell ill after consuming contaminated food. "
[09.4.002 A]

Sudan - Cholera (South)
4 Sep 2008
UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, Miraya FM report [edited] [Promed]
The Ministry of Health in the Government of Southern Sudan said that over 9000 cases of acute watery diarrhea have been reported in Southern Sudan in 2008. The Ministry's director general for preventive medicine told Miraya FM that from January to August 2008 several outbreaks of diarrhea have been registered in Juba [Central Equatoria], Magwi [Eastern Equatoria], Torit [Eastern Equatoria], and Aweil [North Bahr al Ghazal].
[09.4.001 A]

August

Iran - Cholera - (Tehran, Qom)
27 Aug 2008
The National (UAE) [edited] [Promed]
According to this story, health officials have imposed emergency measures in Iran to contain an outbreak of cholera, with bans in some cities on the sale of raw salad greens and street food vendors as well as penalties for businesses that do not heed the warnings. Officials fear the disease, spread through contaminated water or food, has been brought in from neighboring Pakistan and Afghanistan. The deputy health minister, said on Tuesday [26 Aug 2008], 96 people, including 18 Pakistani and Afghan nationals, have contracted the disease in the past month, and 4 people, including an elderly man in Tehran, have died. A News Agency, yesterday [26 Aug 2008], reported a 9-year-old Afghan girl also died, possibly of cholera. The report has not been confirmed by the health ministry.
[08.4.004 A]

Afghanistan - Rare Liver Disease Kills 10 Afghans - Wheat Blamed
22 Aug 2008
Health.bloglico.us [edited] [Promed]
According to this story, as many as 10 people have died in western Afghanistan from a rare liver disease believed to be caused by contaminated wheat, officials said Saturday. At least 161 people were also hospitalized with Gulran disease although estimates were as high as 200 affected in Herat province, on the Iranian border, said the resident representative of the U.N. World Health Organization. It is reported that a toxic weed called charmak, which grows in the area, contains alkalines [alkaloids] that affect the liver causing Gulran disease, which is named after the affected district in Herat. The representative of the U.N. World Health Organization said the disease is not new but rare, and has killed as many as 10 people in recent weeks. The director of the Heart public health department, said 112 Gulran cases have been recorded in the province's clinics, and six people died.
[08.4.003 A]

Pakistan - Gastroenteritis (Punjab)
16 Aug 2008
The Post [edited] [Promed]
According to this story, a gastroenteritis outbreak killed three minors in Kohlan Hatthar Village, including two brothers aged 4 and 2 who died of the disease here [in Kasur] on Saturday [16 Aug 2008]. Another 3-year-old child also died with the same disease in another area of Kasur. Dozens of others suffering from gastroenteritis were admitted at Chuniyan hospital. Doctors said that majority of the patients were children, adding that more than 60 patients suffering from the disease were being brought to DHQ Hospital alone.
[08.4.002 A]

Sudan - Cholera - (Northern Bahr al-Ghazal)
4 Aug 2008
Reuters Africa [edited] [Promed]
According to this story, cholera has seen a resurgence in southern Sudan, where 20 have died over the weekend [2-3 Aug 208] following heavy rains that drove hundreds of thousands from their homes, a local official said on Monday [4 Aug 2008]. It is reported that cholera has infected almost 6000 people in the region and killed at least 44 in 2008 in other parts of the semi-autonomous region.
[08.4.001 A]

June

Pakistan - Cholera - (Punjab)
25 Jun 2008
The News [edited] [Promed]
The Rawalpindi General Hospital (RGH) received another five suspected patients of cholera Tuesday [24 Jun 2008] taking the total number of cases of the infectious disease so far registered at RGH to 40. The RGH has received confirmatory reports of 23 suspects of the disease from the National Institute of Health, Islamabad, within past 24 hours. Of the 23 cases, 10 have been tested positive while 13 were negative. After confirmation of 10 more cases of cholera, the total number of confirmed cases of cholera registered at the RGH reached 14. All cases of cholera including suspected and confirmed ones so far reached RGH are below the age of 13 years. At present 8 patients including suspected and confirmed ones of cholera are undergoing treatment at the RGH.
[06.4.004 A]

Sudan - Cholera (south)
11 Jun 2008
Reuters [edited] [Promed]
Cholera has infected almost 6000 south Sudanese and killed at least 44 in 2008, with more than half dying within the past 4 weeks, officials from the South Sudanese Health Ministry said on Wednesday [11 Jun 2008]. "From previous experience it always starts (in the south) and goes north," the South Sudan's director for preventable medicinesaid. The epidemic has now reached Bor town, in the center of South Sudan, he said.
[06.4.003 A]

Afghanistan - Dysentery (Kandahar)
4 Jun 2008
Xinhua News Agency [in Chinese] [edited] [Promed]
The Afghan Ministry of Health said on 4 Jun 2008 that an outbreak of dysentery, which began on 25 May 2008 in 3 villages of Spin Boldak region in southern Afghanistan's Kandahar Province, infected 155 people and killed 8. The Afghan Ministry of Health said in a statement that there have been no newly reported dysentery cases since 3 Jun 2008. The statement cited local personnel who said that 8 people had died due to dysentery infection, of which three were children under five years of age. The Ministry of Health pointed out that more medical teams had arrived in the region from the provincial capital Kandahar City to carry out surveys and provide assistance.
[06.4.002 A]


Afghanistan- Cholera in Kandahar
4 Jun 2008
Apna Pakistan Network [edited] [Promed]
Vibrio cholerae has broken out in the troubled southern Kandahar province, affecting 129 people in the Spin Boldak border town alone, the health director said. He told a press conference at the Governors House in Kandahar City 129 cholera cases had been reported in the district, bordering the Balochistan province of Pakistan.The disease has broken out in five villages inhabited by 800 families, which use stream water for drinking.He pointed out the people of Spin Boldak were hit by the ailment for a third year in a row, largely owing to a lack of clean drinking water.
[06.4.001 A]

May

Sudan - Diarrhea, cholera - (south)
23 May 2008
AllAfrica, UN Integrated Regional Information Networks (IRIN) report [edited] [Promed]
According to this story, the tankers that roar down the streets of the Southern Sudanese capital of Juba carry precious water, but health experts suspect much of what they deliver is contaminated. It is reported that Juba has neither a functioning water nor sewage system and the situation has been compounded by generally poor hygiene. Recently there have been reports of diarrheal disease outbreaks, including suspected cholera cases. In May 2008, a diarrheal disease outbreak was reported in the Juba military barracks, a unit that houses about 6000 people, including a joint integrated force made up of both northern and southern troops. There have also been suspected cases in Eastern Equatoria. The WHO office for Southern Sudan said samples had been sent to Nairobi for analysis after rapid tests found cholera in 3 out of 53 suspected cases. It is also reported in this story that cases of cholera have been rising, stemming from sharp increases in the population as people return from being displaced and find few essential services such as safe drinking water or proper sanitation. In April 2008, an outbreak was reported in Yei. According to an NGO (non-governmental organisation), diarrheal diseases have become an endemic problem in Yei town in 2008, with cases rising with the onset of rains.
[05.4.003 A]

Pakistan - Cholera - (Sindh)
20 May 2008
The Nation (Pakistan) [edited] [Promed]
According to this story, scientists at the University of Health Sciences (UHS) have discovered the outbreak of cholera in Mirpur Khas, a district of Sindh province. It is reported that the UHS Microbiology Department's head has claimed that according to the research carried out, the district Mirpur Khas was affected by cholera instead of gastroenteritis. He has also claimed that he has studied stool samples of 18 patients from Mirpur Khas district of Sindh who were supposed to be suffering from gastroenteritis and that 8 out of 18 samples of feces are found to be infected with Vibrio cholerae.
[05.4.002 A]

Pakistan - Contaminated food kills two
20 May 2008
The Frontier Post [iFSN]
According to this story, at least 2 people including an 11-year-old child died after eating contaminated food (pikora) while 37 others fell ill at Danin Chitral. It is reported that some spectators that came for a cricket tournament held at Danin Shothar took traditional food (pikora) and fell unconscious while two were expired before getting to the hospital. Those who fell unconscious have been shifted to District Headquarters Hospital (DHQ) Chitral.
[05.4.001 A]

April

Sudan - Cholera (Central Equatoria)
25 Apr 2008
Reuters Foundation AlertNet, Medair - Switzerland report [edited]
According to this story, on 10 Apr 2008, a 2-person Medair Health Services Emergency Response Team (ERT) began working actively in Yei and surrounding villages, after receiving a request for assistance from another NGO (non-governmental organization). Cholera had become an endemic problem within Yei town, and now rising primarily because of the onset of rains. A total of 118 cases of cholera or acute watery diarrhea (AWD) were seen in the Yei Civil Hospital from 12 Mar 2008 to 5 Apr 2008.
[04.4.004 A]

Bahrain - Three restaurants closed over food safety violations
24 Apr 2008
Gulf Daily News - Mandeep Singh [edited]
At least three restaurants have, according to this story, been shut down in the last one week after Health Ministry food control section inspectors found they were violating health and hygiene norms.
[04.4.003 A]

Iraq - Diarrhea - Acute watery diarrhea (AWD) and laboratory-confirmed cholera, 24-30 Apr 2008
15 Apr 2008
World Health Organization [edited]

- For the 1st time since the beginning of 2008 Basra failed to submit a weekly communicable disease report. During weeks 12 and 13 the security situation and the damage inflicted upon the cholera laboratory prevented the hard working and dedicated Basra staff from producing and sending their weekly report. Reports were also not received from Diwaniya, Anbar and Diala.
- Further efforts are needed from CDC Baghdad to create channels of communication with Anbar and ensure that AWD is properly monitored in all districts. Only Falluja hospital is submitting data on AWD but no data about water quality monitoring.
- Ninewa, the 2nd most populated province in the country and one of DOHs that is reporting regularly and in timely fashion, succeeded in submitting week 13 reports on time and have been included in this update.
- Kerbala, a very important sentinel province for AWD surveillance, is now reporting regularly and in timely fashion. Because thousands of visitors from all over Iraq and neighboring countries visit Kerbala on daily basis to visit the holy shrines in this locale, Kerbala surveillance staff must make sure that AWD surveillance remains timely, complete and accurate.
- This week, out of the 769 reporting sites, 681 sites (89 percent) reported data on AWD and water quality. All sites in Basra, Diwaniya, Diala and Anbar failed to report this week.
- In total, 8313 acute watery diarrhea cases were reported, but none of the 3763 stool samples cultured (45 percent) were positive for the cholera organism.
Specific Site reports:
- Kerbala: 334 cases of acute watery diarrhea were reported. None of the 334 samples cultured were positive for cholera.
- Kirkuk: 399 cases of acute watery diarrhea were reported. None of the 263 stool samples cultured were positive for cholera. For the 14th week in a row no cholera cases have been reported in Kirkuk.
- Missan: 390 cases of AWD were reported. None of the 376 stool samples cultured were positive for cholera.
- Thiqar, Muthana, Tikrit and Babylon: 1188 cases of acute watery diarrhea were reported. None of the 724 stool samples cultured were positive for cholera. There is an improvement in the reporting of AWD from Tikrit in the last 4 weeks. Tikrit surveillance officers should maintain this progress during the coming weeks.
Total new confirmed cholera cases: 0
[04.4.002 A]

Israel - Alarming increase in reported cases of shigellosis
13 Apr 2008
The Yeshiva World [edited]
Health officials report an alarming increase in the number of toddlers infected with the shigella bacteria, leading to dangerous symptoms, including diarrhea, often bloody, fever and stomach cramps. It is most commonly found among toddlers not totally toilet trained and nursing homes. Food can become contaminated by soiled fingers, caused by the lack of proper hand-washing, or from vegetables irrigated in fields with sewage water, or ingesting contaminated water. Most of the cases reported in Israel of late were found in the Greater Tel-Aviv/Sharon region.
[04.4.001 A]

March

Dubai - Restaurant gives 25 per cent discount for bugs
26 Mar 2008
New Zealand Herald [edited]
The Gulf News was cited as reporting yesterday that a group celebrating a birthday at a Dubai diner received a 25 per cent discount on their bill after they found four insects crawling around their meals.
[03.4.001 A]

February

Iraq - Diarrhea
24 Feb 2008
UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, WHO report [edited]
Week of 18-24 Feb 2008
Out of the 893 reporting sites, 829 sites (93 per cent) reported data on AWD [acute watery diarrhea] and water quality. All 19 Directorates of Health (DoHs) submitted reports, however Anbar DoH report was limited to Falluja hospital; data received from Anbar, and Diyala DoHs was not sufficient in regards to monitoring completeness of reporting. Excellent progress in reporting from Sulaymaniyah: in total, 6426 AWD cases were reported, but none of the 3167 samples cultured were positive for cholera.
Related stories
3 Feb 2008 - Iraq - Diarrhea, cholera
UN Office for the Coordination of Humanitarian Affairs (OCHA), ReliefWeb, World Health Organization (WHO) report [edited]
This week (28 Jan-3 Feb 2008), all 19 Directorates of Health (DoHs) submitted reports, Anbar DoH report was limited to Falluja hospital; Wassit provinces did not report data on number of stool samples submitted for cholera testing. Data received from Sulaymaniyah and Diyala DoHs, lacks monitoring of completeness of reporting component. In total, 5443 acute watery diarrhea cases were reported, but none of the 2797 samples cultured were positive for cholera.
- Baghdad: reporting is gradually improving from both sides of the province.
- Basra: Basra remains one of the most regular reporting DoHs. This week, 761 cases of acute watery diarrhea were reported. None of the 586 stool samples tested were culture-positive for cholera.
- Kirkuk: 241 cases of acute watery diarrhea were reported. None of the 67 samples cultured were positive for cholera. For the 7th week in a row, no cholera case has been reported from Kirkuk.
- Sulaymaniyah: this week (28 Jan-3 Feb 2008), 291 acute watery diarrhea cases were reported. None of the 29 samples cultured were positive for cholera.
- Mosul: 441 diarrhea cases reported, none of the 270 stool samples cultured were positive for cholera.
- Najaf: 369 diarrhea cases reported, none of the 346 stool samples cultured were positive for cholera.
- Diyala: 17 diarrhea cases reported, none of the 14 stool samples cultured were positive for cholera
- Missan: 206 cases of acute watery diarrhea were reported. None of the 128 samples cultured were positive for cholera.
- Thiqar, Muthana, Tikrit, and Babylon: 843 cases of acute watery diarrhea were reported. None of the 674 samples cultured were positive for cholera.
- Total new confirmed cholera cases: 0
[02.4.003 A]

Yemen - Cholera (Hajjah)
18 Feb 2008
Yemen Times [edited]
According to this story, cholera is threatening the lives of citizens in Hajjah governorate's Bani Qais district. Bani Qais locals say they are being threatened by cholera, with the epidemic having killed 40 area residents since late 2007. The head of the Epidemic Surveillance Department agreed to comment on the situation, explaining that the disease first appeared in the district in October 2007, beginning in Mistaba, northern Hajjah and a district on the Yemeni-Saudi border, before moving on to Bani Qais and Khairan districts.He noted that 3 children from the same family, ages 5, 8, and 10, died of cholera on 15 Dec 2007 and added that the Bani Qais Health Department has recorded 16 deaths since the disease's appearance in the district. A Bani Qais health worker requesting anonymity said 40 deaths have been observed due to cholera, with the main reason being water contamination, adding that Health Department records are inaccurate because several deaths have occurred at home.
[02.4.002 A]

Egypt - Bottling up food safety
11 Feb 2008
BT Business Today [edited]
As 2007 came to a close, Egyptian citizens were, according to this story, informed that bottled water was contaminated with bacteria. In reaction to this, the Consumer Protection Agency began an investigation, finding that six bottled-water companies were selling products unfit for human consumption. The investigations revealed that locally sold bottled-water is not mineral water at all. Rather, it is extracted from wells. The investigations also revealed that of the 15 bottled-water brands producing small (1.5-liter) bottles, two were contaminated. The investigations also highlighted that some labels did not match the contents of the bottle. Of the companies offering large (1.9-liter) bottles, only two were found to be clean. The head of the CPA, stated that after reviewing the investigation’s findings, the Minister of Trade and Industry had ordered the formation of an emergency committee to investigate the companies’ production facilities and to take random samples for testing, with sanctions to be imposed on companies found to be in non-compliance of regulations.The committee said that the contamination may have been caused by unclean water pipes or introduced during the treatment and filtration phase, especially since no chemical treatment is used during the production process. As the water is taken from wells that must be at least 160 meters in depth, contamination could also be a result of the companies not adhering to suitable well depth.
[02.4.001 A]