NASIRIYAH, Iraq — Spraying a cow with pesticides, health workers target blood-sucking
ticks at the heart of
Iraq’s worst detected outbreak of a fever that causes
people to bleed to death.
اضافة اعلان
The sight of the
health workers, dressed in full protective kit, is one that has become common
in the Iraqi countryside, as the Crimean-Congo hemorrhagic fever (CCHF)
spreads, jumping from animals to humans.
This year Iraq
has recorded 19 deaths among 111 CCHF cases in humans, according to the
World Health Organization.
The virus has no
vaccine and onset can be swift, causing severe bleeding both internally and
externally and especially from the nose. It causes death in as many as
two-fifths of cases, according to medics.
“The number of
cases recorded is unprecedented,” said Haidar Hantouche, a health official in
Dhi Qar province.
A poor farming
region in southern Iraq, the province accounts for nearly half of Iraq’s cases.
In previous
years, cases could be counted “on the fingers of one hand”, he added.
Transmitted by
ticks, hosts of the virus include both wild and farmed animals such as buffalo,
cattle, goats and sheep, all of which are common in Dhi Qar.
Tick bites
In the village of Al-Bujari, a team disinfects animals in a stable next
to a house where a woman was infected. Wearing masks, goggles and overalls, the
workers spray a cow and her two calves with pesticides.
A worker
displays ticks that have fallen from the cow and been gathered into a
container.
“Animals become
infected by the bite of infected ticks,” according to the World Health
Organization.
“The CCHF virus
is transmitted to people either by tick bites or through contact with infected
animal blood or tissues during and immediately after slaughter,” it adds.
The surge of
cases this year has shocked officials, since numbers far exceed recorded cases
in the 43 years since the virus was first documented in Iraq in 1979.
In his province,
only 16 cases resulting in seven deaths had been recorded in 2021, Hantouche
said. But this year Dhi Qar has recorded 43 cases, including eight deaths.
The numbers are
still tiny compared with the
COVID-19 pandemic — where Iraq has registered over
25,200 deaths and 2.3 million recorded cases, according to WHO figures — but
health workers are worried.
Endemic in
Africa, Asia, the Middle East, and the Balkans, CCHF’s fatality rate is between
10 and 40 percent, the WHO says.
The WHO’s
representative in Iraq, Ahmed Zouiten, said there were several “hypotheses” for
the country’s outbreak.
They included
the spread of ticks in the absence of livestock spraying campaigns during COVID
in 2020 and 2021.
And “very
cautiously, we attribute part of this outbreak to global warming, which has
lengthened the period of multiplication of ticks,” he said.
But “mortality
seems to be declining”, he added, as Iraq had mounted a spraying campaign while
new hospital treatments had shown “good results”.
Slaughterhouses
under scrutiny
Since the virus is “primarily transmitted” to people via ticks on
livestock, most cases are among farmers, slaughterhouse workers and
veterinarians, the WHO says.
“Human-to-human
transmission can occur resulting from close contact with the blood, secretions,
organs or other bodily fluids of infected persons,” it adds.
Alongside
uncontrolled bleeding, the virus causes intense fever and vomiting.
Medics fear
there may be an explosion of cases following the Muslim festival of
Eid Al-Adha in July, when families traditionally slaughter an animal to feed guests.
“With the
increase in the slaughter of animals, and more contact with meat, there are
fears of an increase in cases during Eid,” said Azhar al-Assadi, a doctor
specializing in hematological diseases in a hospital in Nasiriya.
Most of those
infected were “around 33 years old”, he said, although their age ranges from 12
to 75.
Authorities have
put in place disinfection campaigns and are cracking down on abattoirs that do
not follow hygiene protocols. Several provinces have also banned livestock
movement across their borders.
Near Najaf, a
city in the south, slaughterhouses are monitored by the authorities.
The virus has
adversely hit meat consumption, according to workers and officials there.
“I used to
slaughter 15 or 16 animals a day — now it is more like seven or eight,” said
butcher Hamid Mohsen.
Fares Mansour,
director of Najaf Veterinary Hospital, which oversees the abattoirs, meanwhile
noted that the number of cattle arriving for slaughter had fallen to around
half normal levels.
“People are
afraid of red meat and think it can transmit infection,” he said.
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