Climate change and Congo Fever collide in Iraq

A herd of cattle is rounded up as members of a veterinary team spray disinfectant, in Iraq's northern city of Kirkuk. All photos: AFP

Authorities said one person died on Friday of Crimean-Congo haemorrhagic fever as cases of the virus spread to the country's north.

Veterinary workers spray cattle and enclosures with disinfectant at a farm in Kirkuk.

Iraq has registered eight deaths from 40 cases of the illness since the start of the year.

Also known as Congo fever, the disease is tick-borne and causes severe haemorrhaging.

People are generally infected through contact with the blood of infected animals, often after slaughtering livestock.

It can also be transmitted between humans through close contact with the blood, secretions, organs or other bodily fluids of infected persons.

The disease has a high death rate of between 10 and 40 per cent of all cases.

Kirkuk authorities have prohibited the transport of cattle to or from the province.

The poor, largely rural southern province is known for rearing cattle, sheep and goats, all of which are potential carriers of the disease.

A deadly outbreak of Congo Fever is gripping Iraq, with reports of increasing cases and fatalities in various parts of the country.

Teaming up with international organisations, health authorities have enacted urgent measures to contain the spread of the disease and provide medical assistance to affected people.

Congo Fever, also known as Crimean-Congo Haemorrhagic Fever, is a viral disease transmitted to humans through ticks or direct contact with the blood or bodily fluids of infected animals. The virus causes symptoms including high fever, headache, muscle pain and bleeding.

As of Tuesday, Iraq had reported 634 suspected cases, among which 208 were confirmed, with 32 deaths, Ahmed Zouiten, the World Health Organisation's representative in Iraq, told The National.

The most affected groups are animal breeders, butchers and homemakers, Dr Zouiten said. He added that 73 per cent of confirmed cases occur among people within the 15-45 year age bracket. A little under 40 per cent are women.

“The outbreak poses a significant risk on communities across the country and can also have a regional impact especially in neighbouring countries due to porous land borders and the movement of livestock,” he warned.

Responding to the outbreak

The most affected groups are animal breeders, butchers, and housewives. Photo: ICRC

The WHO says it has been actively involved in responding to the CCHF outbreak in Iraq by training rapid response teams and enhancing outbreak investigation.

It also supports the state-run Central Public Health Laboratory with diagnostic kits for the detection and confirmation of CCHF and other haemorrhagic fevers.

The escalating threat of climate change has been linked to an increased risk of Congo Fever outbreaks as shifting temperatures and altered ecological patterns create more favourable conditions for the transmission of the disease.

“The outbreak is believed to be a result of climate change, which has led to drought and water scarcity, causing rural displacement and an increase in tick density and profuse animal infestation,” Dr Zouiten said.

Iraq is ranked fifth on a list of countries most vulnerable to climate change, according to the UN. It is experiencing its worst drought in decades, with temperatures exceeding 50°C last summer.

He added that “poor prevention and control measures against ticks in agricultural fields, as well as a lack of standard slaughterhouses and control over the movement of livestock, have also contributed to the outbreak”.

Dr Zouiten warned that the escalating outbreak “highlights the need for continued and co-ordinated efforts to address the root causes of the outbreak and implement long-term solutions to prevent future epidemics”.

Emergency measures

Public awareness campaigns have been launched to educate the population about disease transmission, symptoms and preventive measures. Posters and social media aim to teach people how to reduce the risk of infection.

Efforts are also under way at the Agriculture Ministry to eliminate ticks on animals by spraying cattle with disinfectant and security forces are imposing tough measures on livestock movement across the country.

In addition, surveillance systems have been strengthened to enable early detection and swift response to new cases. Isolation wards have been set up in hospitals to ensure the proper management and containment of infected people.

According to the WHO, the disease has been endemic in Iraq since 1979.

Since then, the country has reported a few cases every year, with a big outbreak in 1996 that affected mainly Baghdad, Babylon and Wassit governorates.

In the last months of 2021, Iraq reported 19 confirmed cases and nine deaths from the disease. During 2022, it reported 380 confirmed cases with 74 deaths.

Worst-hit community

Although the virus has been endemic in Iraq since the 1970s, it has been intensifying since 2021. Photo: ICRC

The worst-hit province is Thi Qar, about 400 kilometres south of Baghdad, where 59 confirmed cases and seven deaths had been registered as of Tuesday.

Although these numbers are still lower that those registered last year – 162 confirmed cases and 41 deaths – a senior provincial health official expressed deep concern over the rapid spread of the disease.

“The situation is critical,” Haider Hantoush, general director of the Department of the Communicable Department in the province, told The National.

“The problem could potentially worsen in the coming days with the increasing temperatures as cases increase during hot months.”

The risk will be higher during Eid Al Adha and the month of Muharram, when Muslims slaughter livestock to mark religious rituals, he added.

Eid Al Adha is one of the most important festivals in Islam. The “festival of the sacrifice” coincides with the annual Hajj pilgrimage to Makkah, and the four-day holiday will start late this month.

In Muharram, the first month in the Islamic calendar, Shiites commemorate the death of a revered imam through different ceremonies, including donating free food.

We are all worried about him and scared

Aymen Basheer,
son of patient

Dr Hantoush said the actual number of confirmed cases and deaths could be higher.

“We only see those who come to the hospital as about 88 per cent of infected people are either showing no symptoms or not reaching us, so it’s hard to know the exact number,” he added.

“We need a lot. The awareness campaigns in countryside need teams, publications and cars, the employees can’t go by his own car to remote villages and spend from his own money.”

Earlier this week, a butcher in Thi Qar countryside started to experience symptoms.

“Severe fever and fatigue started to appear followed by vomiting and diarrhoea with his eyes turning red and red spots in skin,” Aymen Basheer told The National from Al Nasiriyah Teaching hospital, where his 51-year old father was being treated.

“We are trying to lift his spirits and God willing he’ll recover, but it needs time.

“We are all worried about him and scared.”