SPRAYING a cow with pesticides, health workers target blood-sucking ticks at the heart of the worst detected outbreak of a fever that causes people to bleed to death in Iraq.

The sight of the health workers, dressed in full protective kit, has become common in the Iraqi countryside, as the Crimean-Congo haemorrhagic fever (CCHF) spreads, jumping from animals to humans.

Iraq recorded 19 deaths among 111 CCHF cases in humans this year, according to the World Health Organisation (WHO).

The virus has no vaccine and onset can be swift, causing severe bleeding both internally and externally, especially from the nose.

It causes death in as many as two-fifths of cases, according to medics.

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

A poor farming region in southern Iraq, the province accounts for nearly half of the cases in the country.

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

Transmitted by ticks, hosts of the virus include both wild and farmed animals such as buffalo, 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 overalls, the workers spray a cow and her two calves with pesticides.

A worker displays ticks that have fallen from the cow and been gathered into a container.

“Animals become infected by the bite of infected ticks,” according to WHO.

“The CCHF virus is transmitted to people either by tick bites or through contact with the blood or tissues of infected animals during and immediately after slaughter.”

The surge of cases shocked officials, as numbers far exceed recorded cases in the 43 years since the virus was first documented in Iraq in 1979.

Hantouche said in his province, only 16 cases resulting in seven deaths were recorded last year.

But Dhi Qar recorded 43 cases, including eight deaths, this year.

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

Endemic in Africa, Asia, the Balkans and the Middle East, CCHF’s fatality rate is between 10% and 40%.

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

They include 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 outbreak to global warming, which has lengthened the period of multiplication of ticks”, he said.

But “mortality seems to be declining”, he added, as Iraq has mounted a spraying campaign and new hospital treatments have shown “good results”. – AFP, May 29, 2022.