'IRAQ AND THE PERSIAN GULF' [‎272r] (546/862)

PUBLIC HEALTH AND DISEASE
419
increased the risk of infection, but there is a much more efficient pre
ventive service and control procedure than formerly. The supply of
advance information regarding cholera from other countries is one
• safeguard. Prophylactic inoculation and quarantine are the two chief
measures of defence. It is difficult to prevent the entry of disease
from PersM across the Shatt al Arab, but the headquarters of the
quarantine service of the port of Basra have been moved to Fao,
where vessels may be medically inspected whether proceeding to
Persian ports or to Basra. On the authorized desert route between
Najaf and Medina all pilgrims have to be inoculated against both
cholera and typhoid and vaccinated against small-pox, and they must
possess a sanitary pass granted only after medical examination. With
in the country the importance of diagnosing the first cases of cholera
is stressed. Police control of infected populations is difficult, but
cordons are established to prevent the smuggling of sick persons to
uninfected localities.
The healthy carrier of infection is an added complication. As in
typhoid fever, healthy persons as well as convalescents may harbour
and excrete the infecting germ for considerable periods. In the
quarantine station of Syria, cholera vibrios have been found in the
stools of healthy travellers by the desert route from Iraq, who had not
been within 50 miles of an infected area.
In 1939 the number of inoculations against cholera carried out in
Iraq was 216,956.
Plague
No case of plague has been reported from Iraq since 1936. Until
that year outbreaks of plague had occurred in the city of Baghdad
every year since at least 1917- The energetic measures taken to combat
the disease reduced the number of cases to less than 100 in 11 of those
years. The worst outbreaks in Baghdad city were in 1919 (883 cases,
679 deaths), 1922, 1923, and 1926. From 1916 to 1924 plague in
fection also persisted in the city and port of Basra, where the most
severe epidemics occurred in 1918 and i9 I 9> when 489 an d 4 I 3 cases
and 233 and 265 deaths respectively were reported. With the ex
ception of one fatal case in i 93 °> Basra appears to have been free from
plague since 1925. There was one outbreak at Amara in 1918 when
1,000 cases and 415 deaths were reported, but otherwise plague has
not been a matter of serious concern except in Basra and Baghdad.
Plague cases have been reported in every month of the year but, as
in most countries, there has been a well-marked seasonal prevalence: