Iraq Tackles Swine Flu Fears

   

As more US troops are diagnosed, Iraq says it can cope.

By Faleh Hassan and Zaineb Naji in Baghdad (ICR No. 303, 02-Sep-09)

Iraq is taking steps to prevent a swine flu epidemic after an outbreak among US military personnel, but some officials and health experts say they remain concerned about the country’s ability to contain and treat the virus.

The US military told IWPR it had diagnosed 141 troops with the H1N1 virus, with the last case confirmed on August 28. Iraqi health officials reported three weeks earlier that 67 US troops had been diagnosed.

While the number of cases has climbed among US forces, the virus has not spread widely among Iraq’s population. Twenty-three Iraqis had been diagnosed with the disease, health ministry spokesman Sabah Abdullah reported, and no new cases have been recorded in recent weeks.

The World Health Organisation reported on August 29 that Iraq has had a total of 166 confirmed cases, including the US troops and one Iraqi death. By comparison, the United States has reported 44,000 cases and 556 deaths.

The Iraqi government has allocated 100 million US dollars to purchase Tamiflu medication - enough to treat about a quarter of the population - and has budgeted 60 million dollars for anti-viral vaccinations, Abdullah said.

Some hospitals in Baghdad have set up isolation rooms to treat patients, and individuals arriving in Iraq are being screened for flu-like symptoms at airports and land border crossings, he reported.

“The measures taken by the health ministry have enabled us to completely control the disease,” Abdullah said.

Yet despite the health ministry’s assurances, officials and health experts said they were concerned about the virus spreading in Iraq.

WHO, which has declared swine flu an influenza pandemic, has warned of a widespread global outbreak this autumn. The organisation reported this week that swine flu is now the most common strain of influenza and that a potentially more fatal strain appears to have emerged.

"Iraq is an open country that is connected to the rest of the world, so I don’t rule out that Iraq will be affected by this dangerous epidemic," said Basim al-Sharif, who serves on the parliament’s health and environment committee.

The virus has primarily affected North America, and Iraqi officials have expressed concern that the disease may spread from US troops, who frequently travel to and from Iraq, to the larger population.

Lieutenant John Brimley of the US military wrote in an email interview with IWPR that patients are being treated in isolation for seven days but that most cases have “very mild” symptoms.

Thirty-seven patients are currently in isolation, Brimley reported, while the rest have fully recovered and returned to duty.

Brimley said the US military and Iraq are monitoring each other’s swine flu statistics daily. Jenan Obeidi, a member of parliament on Iraq’s health and environment committee, said the US and the ministry of health were closely collaborating to prevent the virus from spreading.

In addition to US bases, areas that attract thousands of foreign visitors are also considered higher risk. Three pilgrims in the Shia holy city of Karbala were treated for swine flu in early August.

The patients were treated in a hospital and recovered. Their hotel, which was hosting dozens of pilgrims, was quarantined for days.

Despite the tight measures, some experts are concerned that Iraq’s health care system -- which has been crippled by the recent war and a decade of United Nations-imposed sanctions before it - may not be properly equipped to diagnose and treat patients.

"Isolation rooms are available and there are good treatments to curb the virus ... but the initial diagnosis is the most important step in controlling it,” said Zahra Salim, a doctor with Al-Yarmook hospital in Baghdad. “We lack this capability because so many medical workers have left the country due to security problems.”

Obeidi said Iraq is not seriously vulnerable to swine flu because the country has recorded relatively few cases. Nearly 2,200 people have died from the virus worldwide since April.

But she expressed concern that Iraq may not be able to treat vulnerable patients. A 22-year-old woman who had suffered pneumonia and respiratory problems died of swine flu in Najaf last month.

Iraqi hospitals “are prepared to control the disease in its early stages, so people need to cooperate by [getting examined] when they first feel symptoms”, Obeidi said.

But she warned if patients seek treatment when they are in the final stages of the illness, the hospitals cannot help them. “These cases require special treatment centres, intensive care units and advanced equipment that aren’t available in Iraqi hospitals."

The World Health Organisation, WHO, told IWPR that Iraq had not requested its assistance in dealing with the virus.

Abdullah said the health ministry had not called on the WHO for help “because we are in control of the situation. I can say that with our preventative health measures, we aren’t worried about the disease”.

Faleh Hassan and Zaineb Naji are IWPR-trained journalists. Iraq editor Tiare Rath contributed to this report from Sulaimaniyah.