Deadly nosebleed fever shocks Iraq as cases rise

The sight of health workers, dressed in full protective gear, has become common in Iraq.

Nasiriyah, Iraq:

Spraying a cow with pesticides, health workers target blood-sucking ticks at the heart of Iraq’s worst fever outbreak that is causing people to bleed to death.

The sight of health workers, dressed in full protective gear, has become common in rural Iraq as Crimean-Congo hemorrhagic fever spreads, jumping from animals to humans.

This year, Iraq has recorded 19 deaths among 111 cases of CCHF in humans, according to the World Health Organization.

The virus has no vaccine and its onset can be rapid, causing severe internal and external bleeding, particularly from the nose. It causes death in two-fifths of cases, according to doctors.

“The number of registered cases is unprecedented,” said Haidar Hantouche, a health official in Dhi Qar province.

A poor agricultural region in southern Iraq, the province accounts for nearly half of Iraq’s cases.

In previous years, the cases were counted “on the fingers of one hand”, he added.

Tick-borne, hosts of the virus include both wild and livestock animals such as buffaloes, cattle, goats and sheep, all of which are common in Dhi Qar.

tick bites

In the village of Al-Bujari, a team disinfects animals in a stable next to a house where a woman was infected. Wearing masks, goggles and coveralls, workers spray a cow and her two calves with pesticides.

A worker shows ticks that have fallen from the cow and collected in a container.

“Animals are infected by the bite of infected ticks,” according to the World Health Organization.

“The CCHF virus is transmitted to humans either through tick bites or through contact with blood or tissues of infected animals during and immediately after slaughter,” he adds.

The spike in cases this year has shocked officials, as the number far exceeds cases recorded in the 43 years since the virus was first documented in Iraq in 1979.

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

The numbers are still tiny compared to the Covid-19 pandemic – where Iraq has had more than 25,200 deaths and 2.3 million recorded cases, according to WHO figures – but health workers are worried .

Endemic in Africa, Asia, the Middle East and the Balkans, the mortality rate of CCHF is between 10 and 40%, according to the WHO.

The WHO representative in Iraq, Ahmed Zouiten, said there were several “hypotheses” for the outbreak in the country.

They understood the spread of ticks in the absence of livestock spraying campaigns during Covid in 2020 and 2021.

And “very cautiously, we attribute part of this epidemic to global warming, which has lengthened the period of multiplication of ticks”, he specified.

But “mortality seems to be falling”, he added, as Iraq launched a spraying campaign as new hospital treatments had shown “good results”.

Slaughterhouses under surveillance

Since the virus is “primarily transmitted” to humans by livestock ticks, most cases involve farmers, slaughterhouse workers and veterinarians, according to the WHO.

“Human-to-human transmission can occur through close contact with the blood, secretions, organs or other bodily fluids of infected people,” he adds.

Along with uncontrolled bleeding, the virus causes high fever and vomiting.

Doctors fear there will be an explosion in cases after the Muslim holiday of Eid al-Adha in July, when families traditionally slaughter an animal to feed guests.

“With the increase in animal slaughter, and more contact with meat, there are fears of an increase in cases during Eid,” said Azhar al-Assadi, a doctor specializing in blood diseases at a hospital in Nasiriya.

Most of those infected were “around 33 years old”, he said, although their ages ranged from 12 to 75.

The authorities have implemented disinfection campaigns and are cracking down on slaughterhouses that do not comply with hygiene protocols. Several provinces have also banned the movement of cattle across their borders.

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

The virus has hurt meat consumption, workers and officials say.

“I used to slaughter 15 or 16 animals a day – now it’s more like seven or eight,” said butcher Hamid Mohsen.

Fares Mansour, director of the Najaf Veterinary Hospital, which oversees slaughterhouses, meanwhile noted that the number of cattle arriving for slaughter had fallen to around half of normal levels.

“People are afraid of red meat and think it can transmit infections,” he said.

(This story has not been edited by NDTV staff and is auto-generated from a syndicated feed.)

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