Cholera in Iraq

2,116 confirmed cases of Cholera have been identified in Iraq resulting in 11 deaths. Since it appears that Iraq may be heading for a Cholera epidemic let's get up to speed on Cholera.



Cholera is an acute, gastrointestinal illness caused by infection with the bacterium Vibrio cholerae. The aerobic bacterium is a short, curved, motile, gram negative rod with a single polar flagellum. A person becomes infected with the cholera bacterium by drinking or eating contaminated water or food. The source of the contamination is usually the feces of an infected person. Thus a safe drinking water supply and proper sewage treatment is absolutely necessary.

The illness can be mild and without symptoms. However, 1 in 20 infected persons can have severe illness characterized by massive loss of water via the intestinal tract resulting in saline depletion, shock and acidosis.

Cholera disease is due to an exotoxin secreted by the cholera bacteria. The exotoxin traverses the cell membrane and activates the adenylate cyclase enzyme which leads to increased levels of cyclic AMP. This results in the loss of sodium, potassium, chloride, and water.

Cholera is a key indicator of social development because it occurs mainly where minimum standards of hygiene exist.

There is a vaccine for cholera called Dukoral but it isn't licensed for use in the USA nor does the CDC recommend it for travelers. Cholera is treated by replacement of fluids and salts lost through diarrhea. Antibiotics may shorten the course of the disease but rehydration therapy is the treatment of choice.

Much more about cholera here.

Check out the condition of Bagdad tap water here.