INFECTIOUS DISEASES IN KUWAIT

File: 062096_cia_64183_60873_01.txt
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Subject: INFECTIOUS DISEASES IN KUWAIT

Not Finally Evaluated Intelligence







TO FACILITATE ELECTRONIC ACCESS, THIS DOCUMENT HAS BEEN

REFORMATTED TO ELIMINATE INFORMATION THAT DOES NOT PERTAIN

TO GULF WAR ILLNESS ISSUES OR THAT IS CLASSIFIED. A COPY OF

THIS REDACTED DOCUMENT, IN ORIGINAL FORMAT, IS AVAILABLE ON

REQUEST.







WARNING: INFORMATION REPORT, NOT FINALLY EVALUATED INTELLIGENCE.







DIST:          OCTOBER 1990



COUNTRY:  KUWAIT



SUBJ:  INFECTIOUS DISEASES IN KUWAIT







SUMMARY:  THIS REPORT DISCUSSES THE INCIDENCE OF THE FOLLOWING

INFECTIOUS DISEASES IN KUWAIT.



CHOLERA

SALMONELLOSIS

VIRAL HEPATITIS

MALARIA

BACTERIAL MENINGITIS

TUBERCULOSIS

AIDS

POLIO

MEASLES

WHOOPING COUGH

DIPHTHERIA







2. DISEASES OF THE DIGESTIVE TRACT



A. CHOLERA: CHOLERA IS NOT ENDEMIC TO KUWAIT,

ALTHOUGH IT TENDS TO APPEAR SPORADICALLY EACH SUMMER. USUALLY LESS

THAN 10 CASES ARE DIAGNOSED PER YEAR, THE EXCEPTION BEING 1985 (WHEN

ABOUT 40 CASES WERE REPORTED) AND 1986 (110 CASES). THESE WERE IN

FACT "IMPORTED" CASES, INTRODUCED BY FOREIGN WORKERS FROM COUNTRIES

WHERE CHOLERA IS COMMON. FROM AUGUST TO NOVEMBER 1989, HOWEVER, 130

CASES WERE REPORTED IN KUWAIT -- THE HIGHEST FIGURE FOR THE PAST 15

YEARS, AT LEAST







DURING JULY 1990, ABOUT 20

CASES OF CHOLERA WERE DIAGNOSED IN KUWAIT. ALL THESE CASES INVOLVED

CITIZENS OF A NEIGHBORING STATE. THE PATIENTS WERE HOSPITALIZED

UNDER QUARANTINE, AND NO SECONDARY INFECTIONS WERE REPORTED. THE

MINISTRY OF HEALTH (MOH) DECLARED A STATE OF EMERGENCY TO COPE WITH A

POSSIBLE OUTBREAK OF CHOLERA DURING THE HAJ.



B. SALMONELLOSIS: DURING THE PAST YEARS, THERE HAS

BEEN A SIGNIFICANT INCREASE IN THE NUMBER OF REPORTED CASES OF

SALMONELLOSIS. IN 1989, THERE WERE 70 CASES PER 100,000 INHABITANTS,

COMPARED WITH ONE CASE PER 100,000 IN 1970. THIS INCREASE CAN BE

ATTRIBUTED PARTLY TO IMPROVED REPORTING AND REGISTRATION. ANOTHER

FACTOR IS THE CHANGING EATING HABITS IN KUWAIT; I.E., MORE PROCESSED

FOOD, MORE DINING OUT, AND THE EMPLOYMENT OF FOREIGN WORKERS IN FOOD

PREPARATION.



C. VIRAL HEPATITIS: THIS IS COMMON. THE REPORTED

AVERAGE ANNUAL INCIDENCE IN 1980-1984 WAS ABOUT 4,400 CASES. IN 1985

AND 1986, ABOUT 2,500 CASES WERE REPORTED. AMONG 1,800 CASES

REVIEWED IN ONE YEAR, 77 PERCENT WERE CAUSED BY THE "HEPATITIS A"

VIRUS. MOST VICTIMS WERE CHILDREN. TWELVE PERCENT OF THE CASES WERE

CAUSED BY HBV. MOST VICTIMS WERE YOUNG ADULTS. THE RATIO OF WOMEN

TO MEN WAS TWO TO ONE. NINE PERCENT OF THE CASES WERE CAUSED BY

HEPATITIS NANB, AND MOST VICTIMS WERE YOUNG ADULTS OF INDIAN ORIGIN.

SOME 1.3 PERCENT OF ALL CASES SHOWED CONTAMINATION BY DELTA AGENT.

ABOUT THREE PERCENT OF THE WOMEN IN KUWAIT SHOWED A POSITIVE HB-AG.



3. MALARIA: THE INCIDENCE OF MALARIA HAS BEEN INCREASING FOR

THE PAST 15 YEARS. FROM 1975 THROUGH 1979, ABOUT 140 CASES WERE

REGISTERED ANNUALLY. THIS FIGURE ROSE TO 340 PER ANNUM FROM 1980 TO

1983, WITH 590 CASES IN 1984. THE NUMBER WAS ABOUT 510 IN 1985, AND

460 IN 1986.







4. BACTERIAL MENINGITIS: THIS DISEASE APPEARS SPORADICALLY

IN KUWAIT. DURING 1984-1986, AN AVERAGE OF SIX CASES WERE REPORTED

ANNUALLY. FOLLOWING AN EPIDEMIC OUTBREAK OF MENINGITIS IN SAUDI

ARABIA DURING THE 1987 HAJ, THE KUWAITI MOH ORGANIZED AN INOCULATION

CAMPAIGN FOR 1.25 MILLION CITIZENS AND RESIDENTS. TOWARD THE END OF

THE SUMMER OF 1989, ABOUT 30 CASES HAD BEEN DIAGNOSED, INCLUDING

SEVERAL CAUSED BY THE STRAIN W-1 35 WHICH HAD NEVER BEFORE BEEN SEEN

IN KUWAIT. THREE OF THE PATIENTS DIED. AS FAR AS IS KNOWN, THERE

WAS NO INOCULATION PROGRAM AGAINST THIS STRAIN. SEVERAL MORE CASES

WERE DIAGNOSED IN THE SUMMER OF 1990.







5. TUBERCULOSIS: CASES OF TUBERCULOSIS OCCUR, BUT IN RECENT

YEARS THE RATE HAS DROPPED FROM ABOUT 990 NEW CASES ANNUALLY BETWEEN

1980-1984, TO ABOUT 480 IN 1988.



6. AIDS: THERE IS NO GOOD DATA ON THE INCIDENCE OF AIDS IN

KUWAIT. THE MOH HAS SHOWN AWARENESS OF THE THREAT, AND STEPS HAVE

BEEN TAKEN TO CONTAIN IT. IN 1985, THE MINISTRY DREW UP A PLAN FOR

DEALING WITH AIDS, WHICH WAS TO INCLUDE EXAMINATIONS AND DETECTION OF

ANTIBODIES IN HIGH RISK POPULATION GROUPS, E.G., RECIPIENTS OF BLOOD

TRANSFUSIONS ABROAD AND PEOPLE ARRIVING FROM AFFECTED COUNTRIES.

FOREIGNERS APPLYING FOR RESIDENCE PERMITS IN KUWAIT FOR PERIODS

EXCEEDING SIX MONTHS WERE ALSO REQUIRED TO UNDERGO AIDS TESTS.

FURTHER TESTS WERE MADE ON A SAMPLE CHOSEN AT RANDOM AMONG OFFICIALS

OF THE MINISTRIES OF INTERIOR AND DEFENSE. ALL SOLDIERS IN

COMPULSORY SERVICE, STUDENTS AT MILITARY ACADEMIES AND THOSE SENT TO

PARTICIPATE IN STUDY COURSES ABROAD HAD TO UNDERGO AIDS TESTS.

REPORTEDLY, NO CASES WERE DISCOVERED IN THE ARMED FORCES.







A. POLIO: THE DISEASE APPEARS SPORADICALLY. NOT A

SINGLE CASE OF POLIO WAS REPORTED DURING THE YEARS 1986-1988. THE

NATIONAL INFANTS IMMUNIZATION PLAN INCLUDED INOCULATION AGAINST POLIO

(OPV). IN 1986, 90 PERCENT OF THOSE TARGETED FOR INOCULATION

RECEIVED IT.



B. MEASLES: THE DISEASE DOES OCCUR, MOSTLY DURING THE

WINTER AND SPRING MONTHS. IN 1985, AN INCREASE OF ABOUT 2,000 CASES

WAS REGISTERED, COMPARED WITH 600 IN 1984,240 IN 1986, AND 70 CASES

IN 1988. THE INFANT INOCULATION PROGRAM INCLUDES MEASLES, WITH THE

INOCULATION GIVEN AT THE AGE OF 15 MONTHS. REPORTED COVERAGE WAS

FIVE PERCENT.



C. WHOOPING COUGH: IN 1988, ABOUT 190 CASES OF

WHOOPING COUGH WERE REPORTED, COMPARED WITH 20-40 ANNUAL CASES IN

1985 AND 1986. THE NATIONAL INOCULATION PROGRAM INCLUDED INOCULATION

AGAINST WHOOPING COUGH, ADMINISTERED THREE TIMES AS PART OF THE

TRIPLE DTP INOCULATION. THE RATE OF COVERAGE REPORTED IN 1988 WAS 90

PERCENT.



D. DIPHTHERIA: THE DISEASE IS MOST INFREQUENT IN

KUWAIT. THE ANNUAL INCIDENT RATE IS ZERO, OR AT MOST A FEW ISOLATED

CASES.







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