Unprecedented levels of haemorrhagic fever in Iraq. The doctors are explaining.

 

An unprecedented rise in crimean-Congo haemorrhagic fever infections that dominated the Covid-19 epidemic, as the sight of a medical team sterilizing a cow and its young with insecticides inside a small barn in a remote village in southern Iraq became a diary on the country's farms.

The numbers speak for themselves. Since January, the country has recorded 111 human cases, including 19 deaths, according to the World Health Organization.

In previous years, "cases recorded were not more than one finger per year," said Haidar Hantosh, director of the Disease Control Division within the Health Department in the southern province of Dhi Qar.

This poor and rural province alone recorded half of all cases of haemorrhagic fever in Iraq. Livestock farming is common in this area from buffaloes, cows, goats and sheep, which are the intermediate animals in the transfer of Crimean-Congo fever to humans.

In the village of Albu Jari in Dhi Qar, a team from the Health Service is sterilizing a house where a woman has become ill. Team members wearing white robes, masks and protective glasses. Under a tin roof, they sprayed a cow and its young with a swastika to kill the virus-carrying insects.

The team then proceeds to sterilize buckets and iron ponds placed in the barn, then dirt and gravel in the surrounding garden. After the team has completed the sterilization task, one of its members carries a plastic container with very small brown insects removed from the animals.

According to the World Health Organization, the transmission of Crimean-Congo fever to humans occurs "either through tick bites or by contact with the blood or tissues of infected animals during or immediately after slaughter".

"Unprecedented"

The virus was first detected in 1979 in Iraq, causing 10 to 40% of infections. According to who, "the virus is transmitted from one human to another as a result of direct contact with the infected person's blood, secretions, organs or other bodily fluids."

In 2021, Dhi Qar province recorded 16 cases, including 7 deaths, while this year the province recorded 43 cases, including 8 deaths. Most of the injured were livestock breeders and butchers, according to authorities.

WHO representative Ahmed Zweiten attributes this rise in infection numbers to several "hypotheses."

It indicates that there were no sterilization campaigns by the authorities for animals during 2020 and 2021, due to the coronavirus-related closure. As a result, "insect numbers have grown".

The expert explains that "insect breeding" began this year early, "about two or three weeks ago" than usual. The rise is "very cautiously due in part to climate warming, which has caused an extension of insect reproduction".

Dhi Qar Azhar al-Assadi, a clinical hematologist at Dhi Qar Azhar al-Assadi Health Department, said the injuries were increased because "people are not aware of the ways in which this disease is transmitted and that it is not taken seriously, especially about the guidance provided by doctors."

He noted that the "spread of displaced animals" is also a "serious issue", recommending in particular that butchers "slaughter animals" in their own places and "clean them up".

The doctor says the majority of patients are in "youth, aged about 33,"although injuries were recorded in a 12-year-old boy and a 75-year-old man.

In the most advanced cases of the disease, you experience bleeding from the mouth, nose, subcutaneous, digestive tract and urinary system, your doctor explains.

He points to fears of "high numbers of infections during the Eid al-Adha period due to the high rate of slaughter" of animals and proximity to meat.

"Fear of red meat"

The virus is not limited to Iraq, it has also been infected for years in the Balkans as in Sudan, Namibia, Iran and Turkey, and has seen a marked increase in Afghanistan in 2018 with 483 infections, in 2019 with 583 infections, and in 2020, there were 184 infections, including 15 deaths, according to the World Health Organization.

Iraq, together with the United Nations, has recently intensified sterilization and awareness campaigns among the population. Hospitals have introduced new antiviral treatment that "started with good results," Zweiten said, adding that "the mortality rate seems to have decreased."

Near the southern Iraqi city of Najaf, health authorities are monitoring hygiene procedures adopted by slaughterhouses, while red meat consumption in the province has declined by 50%.

"We slaughtered between 15 and 16 animals a day, but now we slaughter between 7 and 8," said Qassab Hamid Mohsen.

Faris Mansour, director of the Najaf Veterinary Hospital, acknowledges that there has been a decrease in consumption. "Health and veterinary measures are continuing very intensively," he said, calling on residents to buy meat only from "stores that conform to health specifications."

"People are starting to fear red meat and think red meat will infect," he says, adding that "we have noticed that the number of meats we receive every day has decreased by 50%.

 

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