Document Page: First | Prev | Next | All | Image | This Release | Search

Filename:84429041
PATHFINDER RECORD NUMBER: 29041
GENDATE:         950623
NNNN
TEXT:            
ENVELOPE CDSN = LGX121 MCN = 91116/14684 TOR = 911160902
PTTSZYUW RUEKJCS0370 1160902-RUEALGX.
ZNY 
HEADER P 260902Z APR 91
FM JOINT STAFF WASHINGTON DC
INFO RUFGAID/USEUCOM AIDES VAIHINGEN GE
RUCQVAB/USCINCSOC INTEL OPS CEN MACDILL AFB FL
RUCJACC/USCENTCOM REAR MACDILL AFB FL //CARA//
RUEATAC/CDRUSAITAC WASHINGTON DC//KT//
RHEPAAB/TAC IDHS LANGLEY AFB VA//IDHS//
RUFTAKA/USA INTEL CENTER HEIDELBERG GE
RUFTAKC/UDITDUSAREUR HEIDELBERG GE
RUDOGHA/USNMR SHAPE BE//SURVEY//
RUEALGX/SAFE
RUEADDS/DITDS
P 122100Z APR 91
FM DIRAFMIC FT DETRICK MD//AFMIC-SA//
[      (b)(1) sec 1.3(a)(4)    ]
[    b.2.    ]
INFO ZEN/CINCUSAREUR HEIDELBERG GE//AEAGB-FI-SOF//
RUEKJCS/DIA WASHDC
RUEKJCS/DIA WASHDC//DAT-4//
RUEORDA/TCC FT DETRICK MD
BT

SECTION 001 OF 005

/*********** THIS IS A COMBINED MESSAGE ************/
SUBJ: HEALTH THREATS NORTHERN IRAQ (U)
1. DISEASES OF OPERATIONAL IMPORTANCE.
A. INDIGENOUS DISEASES ARE PRIORITIZED IN DESCENDING ORDER OF
EXPECTED IMPACT ON MILITARY OPERATIONS IF NO PREVENTIVE MEASURES
ARE TAKEN. EXTRAORDINARY EVENTS INCLUDING EPIDEMICS OF CYCLIC
DISEASES, NATURAL DISASTERS, AND NATIONAL EVENTS LEADING TO A
COMPROMISE OF ESTABLISHED PREVENTIVE MEDICINE PROGRAMS MAY ALTER
THE PRIORITIZATION.
B. ACUTE RESPIRATORY INFECTIONS (ARIS) AND DERMATOLOGIC
CONDITIONS MAY BECOME A MAJOR SOURCE OF MORBIDITY AMONG
NONINDIGENOUS PERSONNEL, BUT EFFECTS ON OPERATIONAL READINESS OF
MILITARY UNITS MAY VARY. DUE TO THEIR UBIQUITOUS NATURE, THESE
DISEASES ARE NOT DISCUSSED IN THIS STUDY.
2. DISEASES WITH SHORT INCUBATION PERIODS (USUALLY LESS THAN
%5 DAYS)
A. ACUTE DIARRHEAL DISEASES 6 HOURS TO 10 DAYS)
TRANSMISSION: INGESTION OF CAUSATIVE AGENTS OR THEIR TOXINS IN
CONTAMINATED FOOD OR WATER.
RISK PERIOD/DISTRIBUTION: YEAR-ROUND, WITH OVERALL RISK ELEVATED
FROM JULY THROUGH SEPTEMBER; RISK FROM BACTERIAL ETIOLOGIES IS
ELEVATED FROM JUNE THROUGH OCTOBER, AND RISK FROM VIRAL ETIOLOGIES
IS ELEVATED FROM DECEMBER THROUGH MARCH. RISK GREATER IN RURAL
VILLAGE AREAS. COUNTRYWIDE.
REMARKS: MODERATELY ENDEMIC; MAY BE A MAJOR CAUSE OF MORBIDITY
AMONG NONINDIGENOUS PERSONNEL. FREQUENTLY OCCURRING PATHOGENS
INCLUDE ENTEROTOXIGENIC ESCHERICHIA COLI (ETEC), ROTAVIRUS (MOST
COMMON IN CHILDREN), SHIGELLA SPP. (PRIMARILY SHIGELLA SONNEI OR
S. FLEXNERI), SALMONELLA SPP., AND CAMPYLOBACTER SPP.
SALMONELLOSIS INCREASINGLY IS BEING REPORTED. MULTIPLE DRUG-
RESISTANCE STRAINS OF SALMONELLA AND SHIGELLA PRESUMABLY ARE
PRESENT.
B. ENTERIC PROTOZOAL DISEASES (1 WEEK TO SEVERAL MONTHS)
TRANSMISSION: INGESTION OF CAUSATIVE AGENTS IN FECALLY
CONTAMINATED WATER OR FOOD.
RISK PERIOD/DISTRIBUTION: YEAR-ROUND, WITH INCREASED INCIDENCE IN
AUGUST TO SEPTEMBER. COUNTRYWIDE.
REMARKS: FREQUENTLY ASSOCIATED WITH MORE CHRONIC INFECTIONS,
PROTOZOANS SUCH AS ENTAMOEBA HISTOLYTICA, GIARDIA LAMBLIA, AND
CRYPTOSPORIDIUM SPP. CAN CAUSE ACUTE DIARRHEA. MODERATELY ENDEMIC;
CLINICAL CASES OF GIARDIASIS AND AMEBIASIS ARE COMMON. GIARDIASIS
USUALLY IS SEEN IN CHILDREN AND IS THE MOST COMMONLY DETECTED
INTESTINAL PARASITE. AMEBIASIS IS THE MOST COMMON CAUSE OF
CLINICAL DYSENTERY; CARRIERS ARE COMMON IN APPARENTLY HEALTHY
ADULTS, INCLUDING HIGHER SOCIOECONOMIC GROUPS IN URBAN AREAS.
C. SANDFLY FEVER 3-4 DAYS)
TRANSMISSION/VECTOR ECOLOGY: BITE OF AN INFECTIVE SAND FLY.
PHLEBOTOMUS PAPATASI, THE PRIMARY VECTOR, IS MOST ACTIVE BETWEEN
DUSK AND DAWN, HAS A LIMITED FLIGHT RANGE, IS PERI-DOMESTIC IN ITS
BREEDING HABITS, AND READILY ENTERS HUMAN HABITATIONS TO FEED.
RISK PERIOD/DISTRIBUTION: TRANSMISSION OCCURS PRIMARILY FROM APRIL
TO OCTOBER, COINCIDING WITH VECTOR ACTIVITY, WHICH PEAKS IN AUGUST
AND SEPTEMBER. FOCI MAY OCCUR THROUGHOUT THE COUNTRY, PARALLELING
THE DISTRIBUTION OF SAND FLY VECTORS; RISK MAY BE LIMITED ALONG
THE SOUTHWESTERN BORDER WITH SAUDI ARABIA.
REMARKS: ALTHOUGH LOCAL POPULATIONS GENERALLY BECOME IMMUNE DURING
CHILDHOOD, SANDFLY FEVER POSES A SIGNIFICANT RISK TO NONINDIGENOUS
PERSONNEL. SANDFLY FEVER CAUSED SIGNIFICANT MORBIDITY AMONG ALLIED
FORCES IN THE PERSIAN GULF THEATER DURING WORLD WAR II.
SEROLOGICAL STUDIES INDICATE THAT THE SICILIAN AND NAPLES VIRUSES
ARE PRESENT.
D. TYPHOID AND PARATYPHOID FEVERS (1-3 WEEKS)
TRANSMISSION: INGESTION OF CAUSATIVE AGENT IN FOOD AND WATER
CONTAMINATED BY FECES OR URINE OF INFECTIVE HUMANS.
RISK PERIOD/DISTRIBUTION: YEAR-ROUND, WITH INCREASED INCIDENCE
FROM JUNE TO AUGUST. COUNTRYWIDE.
REMARKS: MODERATELY ENDEMIC. THE CARRIER RATE LIKELY IS HIGH, BUT
DATA ARE NOT AVAILABLE. MULTIPLE DRUG RESISTANCE HAS BEEN
REPORTED. MAY BE A SIGNIFICANT SOURCE OF MORBIDITY AMONG
NONINDIGENOUS PERSONNEL.
E. MALARIA 12-14 DAYS)
TRANSMISSION/VECTOR ECOLOGY: BITE OF AN INFECTIVE MOSQUITO
(ANOPHELES SPP.). THE PRIMARY MOSQUITO VECTORS ARE AN. SACHAROVI
AND AN. SUPERPICTUS COUNTRYWIDE, AND AN. STEPHENSI (ASSOCIATED
WITH URBAN MALARIA) IN THE SOUTH; ALL WILL FEED ON HUMANS INDOORS.
LARVA OF AN. SACHAROVI BREED IN BRACKISH AS WELL AS FRESH WATER.
RISK PERIOD/DISTRIBUTION: TRANSMISSION OCCURS FROM MAY THROUGH
NOVEMBER, WITH A SEASONAL PEAK IN JULY AND AUGUST. RISK AREAS
INCLUDE RURAL AND URBAN AREAS IN THE NORTHERN PROVINCES OF DAHUK,
NINAWA, IRBIL, AS SULAYMANIYAH, AND TAMIN AT ELEVATIONS BELOW
1,500 METERS. (BAGHDAD IS RISK FREE.)
REMARKS: A PERSISTENT LOW LEVEL OF ENDEMICITY EXISTS IN THE NORTH;
MALARIA TRANSMISSION WAS INTERRUPTED IN OTHER PARTS OF THE COUNTRY
DURING THE EARLY 1980S. THE MAJORITY OF CLINICAL CASES USUALLY ARE
SEEN FROM JULY THROUGH SEPTEMBER. NEARLY ALL INDIGENOUS CASES ARE
ATTRIBUTED TO PLASMODIUM VIVAX, AND DRUG-RESISTANT FALCIPARUM
MALARIA IS NOT CONSIDERED A RISK. MOST CASES REPORTED FROM
SOUTHERN AREAS ARE IMPORTED, BUT THE REGION IS CONSIDERED
RECEPTIVE.
F. INFLUENZA 1-10 DAYS)
TRANSMISSION: DIRECT OR INDIRECT CONTACT WITH INFECTIOUS DROPLETS.
RISK PERIOD/DISTRIBUTION: YEAR-ROUND; RISK ELEVATED FROM DECEMBER
THROUGH FEBRUARY. COUNTRYWIDE.
REMARKS: PRESUMABLY HIGHLY ENDEMIC. LARGE OUTBREAKS OF INFLUENZA
HAVE OCCURRED. DURING THE LATE 1980S, ISOLATES OF INFLUENZA
A(H3N2) PREDOMINATED OVER THOSE FOR AH1N1) AND B.
G. ARBOVIRAL FEVERS (OTHER THAN SANDFLY FEVER) (3-12 DAYS)
LACK OF INCIDENCE DATA MAY REFLECT INADEQUACIES IN DIAGNOSTIC
CAPABILITIES.
SINDBIS FEVER AND WEST NILE FEVER HAVE NOT BEEN DOCUMENTED IN
IRAQ, BUT ARE KNOWN TO OCCUR IN NEIGHBORING COUNTRIES; POTENTIAL
MOSQUITO VECTORS ARE PRESENT. RISK WOULD BE GREATEST IN SPRING AND
SUMMER MONTHS.
CRIMEAN-CONGO HEMORRHAGIC FEVER (CCHF) IS ENZOOTIC AND IS WIDELY
DISTRIBUTED IN DISCRETE FOCI, WITH A SMALL NUMBER OF CLINICAL
CASES REPORTED SPORADICALLY. THE VIRUS IS TRANSMITTED BY INFECTIVE
HYALOMMA TICKS OR BY EXPOSURE TO INFECTED ANIMALS (USUALLY SHEEP,
GOATS, OR CATTLE) OR HUMANS. TRANSMISSION RISK IS GREATEST FROM
JUNE THROUGH SEPTEMBER. CCHF FIRST WAS REPORTED IN 1979 FROM
BAGHDAD, DYALA, AND KARBALA; AN UNCONFIRMED SOURCE REPORTED OVER

/****** BEGINNING OF SECTION 002 ******/
300 FATALITIES AMONG EGYPTIAN AGRICULTURAL WORKERS IN 1980. THE
VIRUS CIRCULATES IN RURAL AGRICULTURAL AREAS, ESPECIALLY IN THE
NORTH. MANY INFECTIONS ARE APPARENTLY ASYMPTOMATIC, AND
SEROLOGICAL EVIDENCE INDICATES EXPOSURE RATES OF UP TO 30 PERCENT
AMONG PERSONS ASSOCIATED WITH LIVESTOCK.
DENGUE FEVER HAS HISTORICALLY BEEN REPORTED IN THE SOUTHERN
REGIONS, BUT CURRENT DATA IS NOT AVAILABLE; THE POTENTIAL MOSQUITO
VECTOR, AEDES AEGYPTI IS PRESENT.
H. MENINGOCOCCAL MENINGITIS 2-10 DAYS, USUALLY 3 TO 4 DAYS)
TRANSMISSION: DIRECT CONTACT, INCLUDING DROPLETS AND DISCHARGES
FROM NOSES AND THROATS OF INFECTED PERSONS.
RISK PERIOD/DISTRIBUTION: YEAR-ROUND, WITH PEAK INCIDENCE FROM
NOVEMBER THROUGH FEBRUARY' COUNTRYWIDE, WITH INCREASED RISK UNDER
CROWDED LIVING CONDITIONS.
REMARKS: ENDEMIC BUT CYCLIC. USUALLY OCCURS AS SPORADIC CASES, BUT
WITH EPIDEMICS EVERY 8 TO 12 YEARS. MOST CASES OCCUR IN CHILDREN
AND YOUNG ADULTS, WITH AN OVERALL CASE FATALITY RATE BETWEEN 10
AND 25 PERCENT. GROUP A USUALLY PREDOMINATES, BUT AN UNCONFIRMED
OUTBREAK ATTRIBUTED TO GROUP W-135 OCCURRED IN BASRAH IN 1989;
ADDITIONALLY, GROUP W-135 CASE REPORTING INCREASED IN NEIGHBORING
COUNTRIES DURING THE LATE 1980S.
I. SEXUALLY TRANSMITTED DISEASES STDS) (2 DAYS TO 3 WEEKS)
TRANSMISSION: SEXUAL CONTACT.
RISK PERIOD/DISTRIBUTION: YEAR-ROUND; COUNTRYWIDE.
REMARKS: ENDEMIC BUT LEVELS ARE UNCLEAR. RECENT UNCONFIRMED
REPORTS INDICATE THAT GONORRHEA IS A SEVERE PROBLEM.
PENICILLIN-RESISTANT STRAINS OF NEISSERIA GONORRHOEAE (PPNG) AND
OTHER ACUTE STDS HAVE NOT BEEN OFFICIALLY REPORTED, BUT PRESUMABLY
OCCUR.
J. CHOLERA (USUALLY 2-3 DAYS, RANGE OF 6 HOURS TO 5 DAYS)
TRANSMISSION: INGESTION OF CAUSATIVE AGENT, PRIMARILY IN WATER
CONTAMINATED WITH FECES OR VOMITUS OF INFECTIVE HUMANS.
RISK PERIOD/DISTRIBUTION: UNDETERMINED.
REMARKS: ENDEMIC STATUS UNCLEAR, BUT NONINDIGENOUS PERSONNEL ON
WESTERN MILITARY RATIONS ARE AT LOW RISK OF INFECTION. ALTHOUGH
CASES WERE NOT REPORTED OFFICIALLY FROM IRAQ IN THE 1980S THE
MOST RECENT REPORTED OUTBREAK OCCURRED IN 1978), OUTBREAKS HAVE
OCCURRED IN NEIGHBORING COUNTRIES AS RECENTLY AS 1990.
3. DISEASES WITH LONG INCUBATION PERIODS (USUALLY MORE THAN 15
DAYS)
A. ENTERICALLY TRANSMITTED ACUTE VIRAL HEPATITIS (A AND E)
15-65 DAYS) TRANSMISSION: PERSON TO PERSON BY THE FECAL-ORAL
ROUTE.
RISK PERIOD/DISTRIBUTION: YEAR-ROUND, COUNTRYWIDE.
REMARKS: HEPATITIS A IS HIGHLY ENDEMIC AND MAY POSE A MAJOR HEALTH
THREAT TO NONINDIGENOUS PERSONNEL; MOST IRAQIS CONTRACT HEPATITIS
A VIRUS INFECTION DURING CHILDHOOD. HEPATITIS E HAS NOT BEEN
REPORTED, BUT PRESUMABLY OCCURS.
B. LEISHMANIASIS (1 WEEK TO MANY MONTHS)
TRANSMISSION/VECTOR ECOLOGY: BITE OF AN INFECTIVE SANDFLY
PHLEBOTOMUS SPP.). MOST SAND FLIES ARE ACTIVE FROM BETWEEN DUSK
AND DAWN, AND HAVE A VERY LIMITED FLIGHT RANGE. THE PRIMARY
VECTORS FOR CUTANEOUS LEISHMANIASIS CL) INCLUDE P. SERGENTI FOR
L. TROPICA AND P. PAPATASI FOR LEISHMANIA MAJOR. THE SUSPECTED
VECTORS FOR VISCERAL LEISHMANIASIS (VL), CAUSED BY L. DONOVANI
INFANTUM, ARE P. ALEXANDRI AND P. PAPATASI.
RISK PERIOD/DISTRIBUTION: TRANSMISSION PRIMARILY OCCURS FROM APRIL
THROUGH NOVEMBER, PEAKING AUGUST TO OCTOBER. CL AND VL OCCUR
COUNTRYWIDE, BUT CASES ARE MORE COMMONLY REPORTED FROM FOCI IN THE
CENTRAL REGIONS.
REMARKS: MOST CL CASES, ESPECIALLY IN URBAN AREAS SUCH AS BAGHDAD
AND MOSUL), ARE CAUSED BY L. TROPICA, WITH PEAK INCIDENCE FROM
OCTOBER THROUGH FEBRUARY. NO ANIMAL RESERVOIR HAS BEEN IDENTIFIED,
AND THE DISEASE LIKELY CIRCULATES ONLY BETWEEN HUMANS AND SAND
FLIES. INFECTIONS CAUSED BY L. MAJOR USUALLY OCCUR IN RURAL AREAS;
THE PRINCIPAL ZOONOTIC RESERVOIRS ARE CRICETID RODENTS,
PARTICULARLY GERBILS (PSAMMOMYS OBESUS AND MERIONES SPP.). THESE
RODENTS ESTABLISH THEIR BURROWS IN AREAS WHERE HALOPHILIC PLANTS
ARE AVAILABLE AS A FOOD SOURCE. VL IS MORE COMMON IN RURAL AREAS
IN FOCAL LOWLAND AREAS HAVING ALLUVIAL SOIL AND PEAK INCIDENCE IS
FROM DECEMBER TO APRIL. THE RESERVOIR FOR VL IS UNKNOWN, BUT
SUSPECTED TO BE JACKALS AND DOGS.
C. SCHISTOSOMIASIS (2 TO 6 WEEKS)
TRANSMISSION/VECTOR ECOLOGY: PENETRATION OF THE SKIN BY WATERBORNE
LARVAL FORMS (CERCARIAE) THAT DEVELOP IN SNAILS IN FRESHWATER
IMPOUNDMENTS. THE PRIMARY INTERMEDIATE HOST FOR SCHISTOSOMA
HAEMATOBIUM (URINARY SCHISTOSOMIASIS) IS BULINUS TRUNCATUS.
RISK PERIOD/DISTRIBUTION: TRANSMISSION OCCURS YEAR-ROUND, WITH
INCREASED RISK FROM JUNE THROUGH SEPTEMBER. FOCALLY DISTRIBUTED IN
AREAS NEAR THE TIGRIS AND EUPHRATES RIVERS, ESPECIALLY IN THE
CENTRAL REGIONS. NO TRANSMISSION OCCURS SOUTH OF BASRAH BECAUSE
THE DELTA WATERS ARE TOO SALINE FOR THE SNAIL INTERMEDIATE HOSTS.
REMARKS: ONLY S. HAEMATOBIUM IS PRESENT IN IRAQ, WHICH HAS LOW
LEVEL PREVALENCE IN ENDEMIC FOCI. REPORTED ANNUAL CASE TOTALS
DECREASED IN THE 1980S AS A RESULT OF CONTROL PROGRAMS.
D. PARENTERALLY TRANSMITTED ACUTE VIRAL HEPATITIS (B, C, AND
D) (15-180 DAYS)
TRANSMISSION: CONTACT WITH CAUSATIVE AGENT THROUGH BLOOD
TRANSFUSIONS, CONTAMINATED NEEDLES, SEXUAL CONTACT, AND
CONTAMINATED PERINEAL WOUNDS.
RISK PERIOD/DISTRIBUTION: YEAR-ROUND, COUNTRYWIDE.
REMARKS: HEPATITIS B VIRUS (HBV) IS PREVALENT IN THE GENERAL
POPULATION (NEARLY 40 PERCENT OF PREGNANT WOMEN IN ONE STUDY HAD
HBV MARKERS), AND THE HBV CARRIER RATE IS ESTIMATED AT 4 PERCENT.
HEPATITIS D HAS BEEN FOUND IN APPROXIMATELY 5 PERCENT OF HBV
CARRIERS. HEPATITIS C HAS NOT BEEN REPORTED, BUT PRESUMABLY
OCCURS.
4. OTHER DISEASES ENDEMIC IN THE INDIGENOUS POPULATION
A. ZOONOTIC DISEASES: BRUCELLOSIS (ENZOOTIC, PARTICULARLY IN
GOATS AND CAMELS; HUMAN CASES, USUALLY DUE TO CONSUMPTION OF RAW
GOAT OR CAMEL MILK, CAUSED BY B. MELITENSIS ARE COMMON, WITH
RECENT OUTBREAKS); Q FEVER ENZOOTIC; RARELY REPORTED IN HUMANS,
BUT HUMAN SEROLOGY IN RURAL AREAS INDICATES EXPOSURE); ANTHRAX
(ENZOOTIC, WITH OUTBREAKS IN LIVESTOCK REPORTED; OCCUPATIONAL
EXPOSURE USUALLY INVOLVES SHEEP); ECHINOCOCCOSIS (ENZOOTIC, WITH
STRAY DOGS IN RURAL AGRICULTURAL AND URBAN AREAS COMMONLY
INFECTED; HYDATID DISEASE ENDEMIC, ACCOUNTING FOR 1 PERCENT OF ALL
SURGICAL PROCEDURES); RABIES (ENZOOTIC, PARTICULARLY IN THE

/****** BEGINNING OF SECTION 003 ******/
NORTHERN RURAL AREAS, WHERE JACKALS CONSTITUTE THE PRIMARY
RESERVOIR, WITH SOME SPILLOVER INTO STRAY DOGS; FEWER THAN 10
HUMAN CASES ANNUALLY).
B. VECTORBORNE DISEASES: PLAGUE (FLEA-BORNE; CASES HAVE NOT
BEEN REPORTED, BUT ENZOOTIC FOCI HISTORICALLY HAVE EXISTED IN THE
HIGHLANDS NEAR THE BORDER WITH SYRIA AND ALONG THE TIGRIS-
EUPHRATES RIVER EXTENDING TO KUWAIT); FLEA-BORNE TYPHUS (SPORADIC
CASES OCCUR, PARTICULARLY IN SOUTHERN AREAS); TICK-BORNE RELAPSING
FEVER (CASES HAVE NOT BEEN REPORTED, BUT RESTRICTED ENZOOTIC FOCI
EXIST IN A BELT THROUGH CENTRAL IRAQ, EXTENDING FROM SYRIA TO
IRAN); LOUSE-BORNE TYPHUS (LAST REPORTED IN 1977-78 FROM ENDEMIC
FOCI IN CENTRAL REGIONS); LOUSE-BORNE RELAPSING FEVER (ENDEMIC IN
NORTHERN IRAQ).
C. SEXUALLY TRANSMITTED DISEASES: AIDS (ALTHOUGH SOME ARE
THOUGHT TO HAVE OCCURRED, NO OFFICIALLY REPORTED CASES THROUGH THE
END OF 1990; IN-COUNTRY TESTING FOR HIV INFECTION REPORTEDLY IS
PERFORMED, BUT NO DATA ARE AVAILABLE).
D. OTHER INFECTIOUS DISEASES: TRACHOMA (WIDESPREAD, ESPECIALLY
IN RURAL AREAS AND AMONG NOMADIC TRIBESMEN; CONTROL MEASURES
REDUCED INCIDENCE DURING THE 1980S, BUT IT IS STILL THE MOST
COMMON CAUSE OF PREVENTABLE BLINDNESS IN IRAQ); INTESTINAL
HELMINTHIC INFECTIONS (INCLUDING HYMENOLEPIASIS, ASCARIASIS,
ENTEROBIASIS, TRICHURIASIS COMMON IN RURAL AREAS AND AMONG LOWER
SOCIOECONOMIC GROUPS); TUBERCULOSIS (ENDEMIC, ANNUAL INCIDENCE
REPORTEDLY DECLINED DURING THE LATE 1980S, BUT PREVALENCE REMAINS
MODERATE, ESPECIALLY IN RURAL AREAS).

5. [   (b)(1) sec 1.3(a)(4)   ]

6. ENVIRONMENTAL THREATS IN NORTHERN IRAQ
A. (U) THE TOPOGRAPHY OF THE NORTH AND NORTHEAST IS DOMINATED BY
RUGGED HILLS AND SERRATED MOUNTAIN SUMMITS RISING TO 3,600 METERS.
GROUND MOVEMENT IN THIS REGION WOULD BE RESTRICTED BY THE LIMITED
NUMBER OF FINISHED ROADWAYS AND LANDSLIDES DUE TO SPORADIC SEISMIC
ACTIVITIES. EARTHQUAKES IN THE NORTHEAST MOUNTAINS ARE NOT COMMON,
HOWEVER, IT SHOULD BE NOTED THAT A DEVASTATING EARTHQUAKE OCCURRED
IN THE NEARBY NORTHWESTERN PROVINCE OF IRAN ON 20 JUNE 1990.
B. (U) IN THE WEST, VAST DESERTS PREDOMINATE AND WADIS, SOME UP TO
400 KILOMETERS LONG, ARE NUMEROUS. DURING THE WINTER RAINS,
TORRENTIAL WATER FLOWS IN THE WADIS SHOULD BE AN IMPORTANT
CONSIDERATION FOR PERSONNEL TRAVERSING OR BIVOUACKING IN THIS
REGION.
C. (U) CENTRALLY, BETWEEN THE TIGRIS AND EUPHRATES, MAJOR LAND
FEATURES VARY AND INCLUDE DESERT, DEEPLY CUT RIVER VALLEYS, AND
CLIFFS (IRAQ IS AN ARABIC WORD FOR CLIFF). THE RUGGEDNESS OF
TERRAIN WOULD IMPEDE MOST CROSS COUNTRY VEHICULAR MOVEMENT.
D. (U) THE BETTER TRANSPORTATION ROUTES IN NORTHERN IRAQ, AS IN
THE REMAINDER OF THE COUNTRY, ARE CONCENTRATED IN THE AREAS
SURROUNDING THE TIGRIS AND EUPHRATES RIVERS. WATER NAVIGATION
ALONG THE NORTHERN PORTION OF THE TWO RIVERS WOULD BE COMPLICATED
BY RAPID WATER CURRENT, ESPECIALLY DURING THE RAINY SEASON.
7. (U) CLIMATE
A. (U) MIGRATORY LOW PRESSURE SYSTEMS AFFECT IRAQ AND ARE MORE
FREQUENT IN NOVEMBER AND APRIL THAN THE OTHER WINTER MONTHS. ONE
FEATURE OF THE MIGRATORY SYSTEMS IN THE DESERT REGIONS IS THE
PRODUCTION OF SAND AND DUST STORMS BY THE ACCOMPANYING WINDS
SWEEPING OVER DRY, LOOSELY PACKED SURFACES.
B. (U) SUMMERS IN THE NORTHEAST ARE GENERALLY WARM, CLEAR, AND DRY
WITH HIGHS IN BETWEEN 16 DEGREES AND 27 DEGREES CELSIUS. DAYTIME

/****** BEGINNING OF SECTION 004 ******/
HIGHS APPROACHING 43 AND HIGHER ARE NOT UNCOMMON IN THE REMAINDER
OF THE COUNTRY.
C. (U) NINETY PERCENT OF THE ANNUAL RAINFALL OCCURS BETWEEN
NOVEMBER AND APRIL. ANNUAL PRECIPITATION IN THE NORTHEAST IS
BETWEEN 30 AND 45 CM AND MAY TAKE THE FORM OF TORRENTIAL RAINS.
STANDING WATER IN AREAS OF HEAVY RAINFALL CONTRIBUTES TO EXCESSIVE
HUMIDITY.
8. (U) WATER
A. FRESH WATER IS PERENNIALLY AVAILABLE FROM THE TIGRIS AND
EUPHRATES RIVERS WHICH RUN IN A SOUTHEASTERLY DIRECTION FROM
NORTHERN IRAQ TO THE PERSIAN GULF. THE NORTHERN PORTIONS OF THE
RIVERS ARE GENERALLY LESS BRACKISH THAN THE SOUTHERN PORTIONS.
FLOODING ALONG THE TIGRIS AND EUPHRATES IS COMMON DURING THE
WINTER RAINY SEASONS.
B. NORTHEASTERN STREAMS OFFER MEAGER TO SMALL QUANTITIES OF
FRESH WATER BETWEEN LATE NOVEMBER AND JUNE, AND MEAGER TO NONE THE
REST OF THE YEAR. BRACKISHNESS OF THE WATER INCREASES AS THE WATER
LEVEL DECREASES.
C. IN THE WEST, FRESH WATER IS TRANSIENTLY AVAILABLE ONLY
AFTER INFREQUENT RAINS.
D. ALL FRESH WATER SOURCES IN IRAQ ARE SUBJECT TO BIOLOGICAL
CONTAMINATION FROM MAN AND ANIMAL WASTE AND CHEMICAL CONTAMINATION
FROM PESTICIDES AND FERTILIZERS. ALL SURFACE WATER SHOULD,
THEREFORE, BE TREATED PRIOR TO CONSUMPTION.
VENOMOUS ANIMALS
E. U) THE VENOM OF MANY SNAKES AND INVERTEBRATES (BUGS AND
SPIDERS) IS CYTOTOXIC, WHICH MEANS THE VENOM HAS A SPECIFIC
POISONOUS EFFECT ON SPECIAL CELLS IN THE BODY. THE MOST COMMON
CELLS AFFECTED ARE BLOOD CELLS AND NERVE CELLS. HEMOTOXIN VENOM
ATTACKS BLOOD CELLS MAY CAUSE UNSTOPPABLE BLEEDING. NEUROTOXIC
VENOM ATTACKS NERVE CELLS. NEUROTOXIN MAY AFFECT BOTH NERVES AND
MUSCLES, CAUSING CONVULSIONS, SEVERE PAIN (POSSIBLY NO PAIN AT
ALL), AND/OR MUSCLE SPASMS OR PARALYSIS (INVOLVEMENT OF LUNG
MUSCLES CAN STOP BREATHING).
SNAKES.
F. (U) SOME NORMALLY NOCTURNAL SNAKES IN WESTERN DESERT, MAY BE
MORE ACTIVE DURING WINTER AND EARLY-SPRING DAYLIGHT HOURS.
G. (U) PUFF ADDER (BITIS ARIETANS) - RESPONSIBLE FOR THE MAJORITY
OF SERIOUS BITES AND DEATHS TO MAN AND DOMESTIC ANIMALS. COMMON
THROUGHOUT THE REGION; PREVALENT IN THE SHORT GRASSLANDS WITH FEW
SCATTERED TREES. ITS BODY COLOR USUALLY IS ADAPTED TO ITS
ENVIRONMENT, BUT CAN BE IDENTIFIED BY DARK CHEVRONS POINTING
TOWARDS ITS TAIL. A HEAVY AND THICK BODIED SNAKE WITH AN AVERAGE
LENGTH OF .8 TO 1.3 METERS' VENOM IS HEMOTOXIN.
H. (U) SAW-SCALED VIPER (ECHIS COLORATUS/CARINATUS) - ONE OF THE
MOST DANGEROUS SNAKES IN THE WORLD. WIDELY DISTRIBUTED IN THE
WESTERN DESERT AND ROCKY HIGHLANDS OF THE EAST AND NORTHERN PART
OF THE COUNTRY. OCCUPIES RODENT BURROWS AND SCRUB FORESTS. MAY
CLIMB INTO BUSHES TO ESCAPE FLOODING FROM RAINS. ONE SPECIES IS
REPORTED IN VARIOUS DARK SHADES OF GRAY, BLUE, OR SILVER, DAPPLED
WITH LIGHTER SPOTS AND HAS A WHITE UNDERSIDE; HEAD IS BELL SHAPED.
A RELATED SPECIES IS REDDISH BROWN WITH WHITE BARS ON ITS BACK, A
YELLOWISH COLORED BELLY, AND AN EGG SHAPED AND SPECKLED HEAD WITH
A TRIDENT POINTING TO THE REAR. AVERAGE LENGTH, .4 TO .6 METERS.
CHARACTERIZED BY A DISTINCTIVE SIDEWINDING MOVEMENT AND RAPID
DIGGING INTO THE SAND. WHEN CONFRONTED ASSUMES A FIGURE 8 AND
SCRAPES THE SCALES OF ADJACENT COILS TOGETHER TO PRODUCE A LOUD
GRATING, HISSING NOISE. VENOM IS BOTH NEUROTOXIC AND HEMOTOXIN.
I. (U) FIELDS HORNED VIPER PSEUDOCERASTES FIEDLDII) - FOUND IN
WESTERN PART OF THE COUNTRY, IN AREAS OF SANDY ROCK. SNAKE IS
DARK/GRAYISH IN COLOR WITH A SERIES OF DARK BARS ALONG ITS BACK,
ONE-HALF INCH HORNS ABOVE THE EYES, AND A DISTINCTIVE TRIANGULAR
HEAD. AVERAGE ADULT LENGTH, 0.6 TO .7 METERS. VENOM IS PRIMARILY
NEUROTOXIC.
J. U) FALSE HORNED (PSEUDOCERASTES PERSICUS PERSICUS) - FOUND IN
THE SANDY AND ROCKY REGIONS IN THE WESTERN PART OF THE COUNTRY.
AVERAGE LENGTH, .9 METERS. VENOM IS PRIMARILY NEUROTOXIC.
K. (U) BLUNT-NOSED/LEVANTINE VIPER (VIPERA LEBETINA EUPHRATICA) -
THE MAJOR CAUSE OF SNAKEBITE THROUGH THE REGION, BUT THE FATALITY
RATE IS LOWER THAN IN BITES BY SAW-SCALED VIPERS. FOUND THROUGHOUT
THE COUNTRY; OBSERVED INHABITING BARREN, ROCKY AREAS IN THE NORTH
UP TO ALTITUDES OF 2,100 METERS AND AT LOWER ALTITUDES IN THE WEST
AND SOUTH. AVERAGE LENGTH .8 TO 1.2 METERS. VENOM IS PRIMARILY
HEMOTOXIN.
9. (U) INVERTEBRATES
A. (U) CENTIPEDES (SCOLOPENDRA SPP.) - HIDES IN LITTER, UNDER
LOOSE BARK, STONES, LEAVES, AND DEBRIS IN THE DAYTIME. BITES ARE
PAINFUL AND MAY CAUSE VOMITING, HEADACHE, AND SWELLING. FATALITIES
ARE RARE AND USUALLY OCCUR AMONG CHILDREN.
B. (U) SCORPIONS (ANDROCTONUS CRASSICAUDA AND LEIURUS
QUINQUESTRIATUS) - LIVES IN DRYER AREAS AND HUNT INSECTS AT NIGHT.
THE ANDROCTONUS CRASSICAUDA IS A LARGE SCORPION, HEAVY-BODIED,
WITH SLENDER PINCERS AND THICK, ROBUST TAIL, APPROXIMATELY 120-
140MM IN LENGTH, AND DARK BROWN TO BLACK IN COLOR. THE LEIURUS
QUINQUESTRIATUS IS A SMALLER, THINNER SCORPION, BROWN TO LIGHT
YELLOW COLORATION, VERY SLENDER PINCERS WITH LONG FINGERS, THIN
TAIL WITH SHARPLY CURVED STINGER, 80-90 MM IN LENGTH. MOST
SCORPION STINGS ARE NOT DANGEROUS, HOWEVER, POTENTIAL DANGER
EXISTS WHERE DUGOUTS, BUNKERS, OR OTHER SUBTERRANEAN OR TERRANEAN
SHELTERS HAVE BEEN ABANDONED, SINCE SCORPIONS WILL TAKE UP
RESIDENCE IN THEM IN LARGE NUMBERS.
C. (U) BLACK WIDOW SPIDERS LATRODECTUS SPP.) IS WIDELY
DISTRIBUTED THROUGHOUT WARM RURAL REGIONS, ESPECIALLY OPEN FIELDS.
IT IS OFTEN FOUND UNDER STONES, NEAR OUT-HOUSES, HOUSES, TRASH,
AND DUMPS. THE VENOM IS NEUROTOXIC.
10. MEDICAL MATERIEL
A. MEDICAL SUPPLY SHORTAGES HAVE BEEN REPORTED IN
BOTH MILITARY AND CIVILIAN HOSPITALS IN NORTHERN IRAQI CITIES
SINCE THE UN IMPOSED EMBARGO ON IRAQ. DESPITE DELIVERY OF TONS OF
MEDICAL SUPPLIES FROM VARIOUS COUNTRIES AND INTERNATIONAL
HUMANITARIAN ORGANIZATIONS, SHORTAGES ARE BELIEVED TO PERSIST; IN
PART BECAUSE MOST ARE DIVERTED TO THE MILITARY AND PARTLY TO
PUNISH THE NORTHER KURDISH INHABITANTS. NEED IS GREATEST FOR
ANTIBIOTICS, ANTI-ASTHMATICS, ANTI-CONVULSANTS, VACCINES, INSULIN,
ANTI-DIABETICS, AND POTASSIUM CHLORIDE.
B. PRE-EMBARGO IRAQ IMPORTED OVER 80% OF REQUIRED
PHARMACEUTICALS FROM PRIMARILY WESTERN EUROPEAN COUNTRIES AND THE
US. DURING THE EMBARGO, IRAQ RELIED ON PHARMACEUTICAL SUPPORT

/****** BEGINNING OF SECTION 
BT

#0374


INFODATE:        0

 



 

 

Document Page: First | Prev | Next | All | Image | This Release | Search