Unprecedented number of deadly fever cases recorded in Iraq

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Iraq's health workers are targetting blood-sucking ticks at the heart of the country's worst detected outbreak of a fever that causes people to bleed to death.

The scene of health workers dressed in full protective kits is one that has become common in the Iraqi countryside, as the Crimean-Congo hemorrhagic fever (CCHF) spreads, spreading from animals to humans.

According to the World Health Organization (WHO), this year Iraq has recorded 19 deaths among 111 CCHF cases in humans.

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, medics say.

"The number of cases recorded is unprecedented," highlighted Haidar Hantouche, a health official in Dhi Qar province.

In previous years, cases could be counted "on the fingers of one hand," he noted.

A farming region in southern Iraq, Dhi Qar province accounts for nearly half of Iraq's cases.

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 the province.

Surge of cases shocked officials

The WHO indicated that "Animals become infected by the bite of infected ticks."

"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 added.

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 Dhi Qar, only 16 cases resulting in seven deaths had been recorded in 2021, Hantouche said. But this year the province has recorded 43 cases, including eight deaths.

Considered an Endemic in Africa, Asia, the Middle East and the Balkans, CCHF's fatality rate is between 10 and 40%, the WHO noted.

Mortality seems to be declining

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.

"Very cautiously, we attribute part of this outbreak to global warming, which has lengthened the period of multiplication of ticks," he pointed out.

But "mortality seems to be declining", Zouiten noted, as Iraq had mounted a spraying campaign while new hospital treatments had shown "good results".

Fears that cases may boom following Eid Al-Adha

Since the virus is "primarily transmitted" to people via ticks on livestock, most cases are among farmers, slaughterhouse workers and veterinarians, the WHO said.

"Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs or other bodily fluids of infected persons," the Organization explained.

Alongside uncontrolled bleeding, the virus causes intense fever and vomiting.

Medics fear that cases may boom following the Eid Al-Adha in July - a Muslim holiday 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.

Meat consumption hit

Authorities have put in place disinfection campaigns and are cracking down on abattoirs that do not follow hygiene protocols.

Near Najaf, a city in the south, slaughterhouses are monitored by the authorities.

According to workers and officials, the virus has adversely hit meat consumption.

"I used to slaughter 15 or 16 animals a day -- now it is more like seven or eight," mentioned butcher Hamid Mohsen.

Fares Mansour, director of Najaf Veterinary Hospital, which oversees the abattoirs, 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.