Health Ministry on Alert Over Cholera

Despite zero cases of cholera, the Food and Waterborne Diseases Office at the Health Ministry is on alert to counter cholera ahead of the hot summer season, and its personnel are on standby, the head of the office said in a statement on Thursday.

“We are fully prepared to prevent and control potential outbreaks of cholera in the country during summer,” said Babak Eshrati.

All universities of medical sciences have been notified and ordered to step up inspections of food supply chains and restaurants, as part of the ministry’s drive to prevent a cholera epidemic during this time every year.

The World Health Organization warns Iran every year about the risks of cholera outbreak due to its geographical proximity to two main sources of the epidemic, Pakistan to the east and Iraq in the west.

A cholera epidemic in Sistan-Baluchestan is expected every year in April-May when the disease usually breaks out in neighboring Pakistan, and once every few years in Khuzestan and Kurdistan, following regular outbreaks in northern Iraq.

However, no cases of cholera has been registered in the country so far this year, said Dr Mohammad Mehdi Guya, director general and head of the ministry’s Center for Communicable Disease Control, on Thursday.

“There were zero cases of cholera in Iran last year too,” he said, thanks to regular screenings and precautionary measures taken by the ministry.

In 2015, six cases were reported among foreigners living in Iran (mostly Afghans) and one Iranian. In the same year, an epidemic in Iraq was transmitted to Khuzestan but did not spread further in Iran as it was controlled by the provincial health centers. The rare cases of the bacterial disease in other provinces that year were caused by pilgrims who had travelled to Iraq.

Cholera is a bacterial infection of the intestine, and causes severe diarrhea and dehydration, leading to death if untreated. It is transmitted from contaminated food and water due to poor sanitation. Unclean drinking water is a major reason for cholera.

Noting that currently over 90% of Iranians have access to clean drinking water, Eshrati urged people to use tap water and avoid consuming water from lakes, rivers, or tap water in parks, which are for gardening.

Several lawmakers including Heydarali Abedi, member of the Majlis Health Commission have expressed concern over the main cause of cholera in Iran which is contamination of vegetables irrigated by untreated wastewater. Improving public sanitation has been repeatedly stressed as a way of preventing the disease.

Guya noted that during the first half of every fiscal year (starts in March) all hospitals are on standby to deal with known cholera cases.

As a result of public education programs on standards of hygiene of consumable products over the past three decades, the rate of water-borne diseases including diarrhea, typhoid and cholera has decreased. Typhoid has declined now from an annual 30,000 to 300 cases and cholera infections have dropped from 20,000 to 1,000 cases per year.

Cholera first came to Iran in 1965. The most devastating epidemic occurred in 1970 and 20,000 people were infected. Between 1978 and 1998, nearly 10,000 infections were registered but the number fell to 1,000 after 2005 thanks to chlorination of drinking water. In 2011, only 1% of the patients died of cholera.

The disease is caused by types of Vibrio cholera bacterium which are spread mostly by water and food that has been contaminated with human feces containing the bacteria. Chlorination is one of the methods of purifying water since the microorganism is sensitive to chlorine.