Is a cholera outbreak a natural disaster? Overview on a cholera outbreak in Iran in 2005

Abstract number: 1733_739

Jonaidi jafari N., Radfar M., Ghofrani H., Izadi M.

Objectives: There has been a sharp increase in the number of cholera cases reported to WHO during 2005. A total of 131,943 cases, including 2,272 deaths, have been notified from 52 countries. Overall, this represents a 30% increase compared with the number of cases reported in 2004. During the summer of 2005, an outbreak of choler a struck Iran, infecting 1,118 individuals and killing 11 patients. The epidemic started from the Southern regions and rapidly disseminated across the country.

Methods: In this descriptive, epidemiological research, the related data about all individuals Diagnosed with cholera during the epidemic of summer 2005 has been gathered from the Disease Management Center (DMC). The number of patients in each province, their demographic data, and the death toll were included.

A stool sample from all patients with the clinical diagnosis of cholera was sent to the provincial medical laboratory for confirmation, serotyping, and antibiogram. All confirmed samples were then sent to the central reference laboratory in Tehran for further confirmation. If both these tests were positive for V. cholera, the patient was considered a confirmed case.

Results: It is difficult to pinpoint the first case of the recent outbreak. In 25 June 2005, a 26 month-old Iranian child was admitted in the Southern city of Bushehr with a possible diagnosis of cholera. Ten days later, two Pakistanis were reported to have the same symptoms in the Southeastern city of Chabahar, near the Iran-Pakistan border. Serological studies showed that the former was caused by O1 biotype El Tor serotype Ogawa, while in the two latter cases, the Inab a serotype was isolated.

Most cases were reported in Tehran (216 cases), Hamadan (187 cases) and Qom (152 cases) provinces – all located in central Iran. Almost all Iranian provinces were struck by the epidemic. The total number of confirmed cases at the end of the epidemic was 1,118, of which 11 had died.

Conclusion: There is clear trend that cholera is re-emerging in parallel with the ever-increasing proportion of vulnerable populations who live in unsanitary situations. Globally cholera remains a threat for social development. Almost all of the developing countries in the out world are facing either a cholera outbreak or the threat of an epidemic.