Iran battles to contain cholera outbreak

Officials fear the disease, spread through contaminated water or food, was brought in through neighbouring Pakistan or Afghanistan

Tehrani's drinking fruit juice by a street vendor in Iran's capital. The Iranian government has advised all citizens not to buy juices on the streets.

TEHRAN // Health officials have imposed emergency measures in Iran to contain an outbreak of cholera, with bans in some cities on the sale of raw salad greens and street food vendors as well as penalties for businesses that do not heed the warnings. Officials fear the disease, spread through contaminated water or food, has been brought in from neighbouring Pakistan and Afghanistan. Ninety-six people, including 18 Pakistani and Afghan nationals, have contracted the disease in the past month. Four people, including an elderly man in Tehran, have died, Hasan Emami Razavi, the deputy health minister, said on Tuesday. Fars News Agency, yesterday, reported a nine-year-old Afghan girl also died, possibly of cholera. The report has not been confirmed by the health ministry. From Saturday, the health ministry will start carrying out inspections of restaurants, cafes and other high risk food businesses in the capital to check hygiene standards as well as to offer advice, Dr Emami said. The new measures also include a ban, to be enforced by police, on food and snacks prepared by street vendors in high-risk places, such as near parks and along trekkers' paths in the mountain in the north of Tehran. "Cholera has spread from neighbouring countries which makes dealing with the illness difficult. It is not possible to contain an illness like cholera independently," said Amir Hossein Qazizadeh, a member of parliament's health committee. "Enforcing quarantine is very difficult. Travellers can't be held at border points for a week," he said. Iran has long borders with Afghanistan and Pakistan. An estimated 2.5 million Afghans, including some 1.5m illegal immigrants, live in Iran. Many illegal immigrants travel back and forth between the two countries. Cholera is an infectious bacterial disease that spreads through contaminated food and water. In some cases it can be fatal. With concern mounting over a pandemic, state television and radio have broadcast warnings about the disease. The statements explain symptoms of cholera and ways to avoid contracting it. People are also advised to drink bottled water when they are travelling and to keep away from well or spring waters or to boil water before drinking it. Because there is some concern that vegetable and herb gardens may have been irrigated with contaminated water, the broadcasts also warn about eating salad greens, raw vegetables and fresh herbs that have not been properly washed and disinfected with chlorine. In Qom and Karaj, the two cities worst hit by the disease, health officials have banned the sale and supply of salad and other greens as well as prepared dishes containing these raw ingredients. Businesses ignoring the warnings face being shut down. Qom, 183km south of Tehran, is Iran's second largest holy city. Millions of Iranians and Shiites from other countries, including Afghanistan and Pakistan, flock to the city every year to pay their respects to the shrine of Lady Fatemeh Masoumeh, the daughter of the seventh Shiite Imam. The first cases of cholera were reported in Qom a month ago. Karaj, 35km west of the capital, is Iran's fifth largest city with a population of 1.3m. After Tehran, it has the largest number of Afghan immigrants and refugees. In Tehran, some restaurants and caterers voluntarily stopped serving raw vegetables when public concern was at its peak. "We voluntarily stopped serving salads since last week because the threat of cholera has become serious and will resume serving them only after the danger is over," said Akbar Rezai, the manager of a sandwich and pizza cafe in west Tehran. Yesterday, the health ministry said there was no threat to Tehran from the cholera outbreak. In 1998, an outbreak of cholera in Iraq that spread to Iran infected 10,000 and killed 100 people. Last September, Iran's Haj and Pilgrimage Organisation suspended sending pilgrims to Iraq after 57 people who had visited the country or been in contact with others returning from there were diagnosed with cholera. @email:[e-mail]