A cholera outbreak in Iraq that has already infected more than 2,200 people and delayed the start of the school year could spread further after recent torrential rains, the UN warned on Friday.
Iraq is considered a cholera "endemic" country, where the disease is latent and can cause outbreaks due to an absence of sanitation and medical care, as well as other factors. This year's outbreak, which is present in 15 of Iraq's 18 governorates, is one of the worst in recent years.
The UN's children's agency, UNICEF, said it was particularly concerned that the eruption would keep more children out of school. More than two million Iraqi children attend no school at all, and often live in conditions that may leave them susceptible to the spread of the disease. A further 1.2 million are in danger of dropping out, and 700,000 are already behind a full year, according to UNICEF.
At least six people have died from the disease, which causes severe dehydration, kidney failure and in some cases can kill a patient within hours of the onset for symptoms.
In light of the disease's rapid spread, the government in Baghdad already delayed the start of the school year in many parts of the country by one month. According to UN figures, roughly 20 percent of all Iraq's current cholera cases are among children.
The disease was first found near Baghdad in mid-September, and threatens to spread further due to rains that flooded many areas around the capital in late October. According to UNICEF, the downpours caused sewage systems to reach capacity and overflow, spreading possibly contaminated water, in one instance into camps housing 65,000 displaced Iraqis.
Those IDPs are among some 3.2 million people displaced by Iraq's ongoing conflict, including roughly 580,000 in Anbar province alone.
Schools in many regions are being forced to run two or three shifts per day in order to handle the influx of new students.
"Sometimes class sizes are up to 60 children," said Karim Elkorany, a spokesperson for UNICEF. "That's not even the worst of it, we are concerned about the nearly two million children who are out of school."
Making matters more dire, said Elkorany, are the one million children in regions of the country outside government control, mostly in areas seized over the past several years by the Islamic State insurgency. Little is know, he said, about the health of children in those areas.
"It's the aggregate situation that makes the consequences for women and children exponentially worse," he said.
According to World Health Organization data, Babylon and Qadisiyyah contained the bulk of infections as of October 8, which at the time totaled 1,263 laboratory confirmed cases. In less than a month, that number has nearly doubled.
UNICEF also said that cases had been reported in neighboring Kuwait and Bahrain, but could not confirm incidences in Syria. The border between Iraq and Syria is largely controlled by the Islamic State.
In recent years, Baghdad has increased spending on security, and an outbreak of disease that during peacetime might be a center of attention is currently only the latest of the state's concerns. UNICEF says it is trying to fill in the service gap, distributing bottled water to 37,000 and providing local health officials with 820,000 oral rehydration sachets. However their operations in Iraq, like most UN programs, is vastly underfunded. On Friday, UNICEF said that it "urgently required $12.7 million."
Next month, millions of Shia Muslims will travel to Iraq to mark Arbaeen, an influx that could further stress the government's ability to prevent Cholera's spread.
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